While the country is preparing to combat pandemic H1N1 influenza A virus, another outbreak of a virus called dengue is gradually escalating at an alarming level. City hospitals are seeing huge number of patients everyday. Health experts warned that if proper measures are delayed, the condition could be more fatal than that we are experiencing now.
On an average, around 15 dengue patients stay admitted in this hospital everyday with five to six fresh admissions daily since the end of July. Especially the children are the falling prey to the virus. Experts recommend that early recognition and prompt supportive treatment can substantially lower the risk of developing severe disease.
Dengue fever is caused by any type of four closely related dengue viruses and transmitted by the mosquito named Aedes aegypti. Human transmission takes place when the Aedes mosquito bites a healthy person and feeds on an infected person’s blood.
The principal symptoms of dengue are high fever and at least two of — severe headache, severe eye pain (behind eyes), joint pain, muscle and/or bone pain, rash, mild bleeding manifestation (e.g., nose or gum bleed, easy bruising), low white cell count in blood etc.
People should consult a physician and undergo diagnostic tests if they experience these symptoms. Experts recommend people to go to a hospital immediately if any of the warning signs appear like — severe abdominal pain or persistent vomiting, red spots or patches on the skin, bleeding from nose or gums, vomiting blood, black, tarry stools (feces, excrement), drowsiness or irritability, pale, cold, or clammy skin, difficulty breathing etc.
Most cases are of classical dengue and the symptoms and signs are mild and cured with symptomatic treatment. Dengue Haemorrhagic Fever (DHF) which is a dangerous form of the disease is responsible for death. It is expected to strike as previously identified dengue fever patients had become susceptible to this disease. If a clinical diagnosis is made early, doctors can effectively treat DHF using fluid replacement therapy. Adequately management of DHF generally requires hospitalisation.
There is no specific medication for treatment of a dengue infection. Physicians suggest taking rest, drink plenty of fluids to prevent dehydration, avoid mosquito bites while on fever. People suspected to have dengue should avoid certain analgesics drugs (pain relievers) — Acetaminophen, Ibuprofen, Naproxen, Aspirin or Aspirin containing drugs, experts warned.
Dr Shankor Narayan Das, an Associate professor of Medicine at Mitford Hospital, Dhaka said that there is lack of sufficient public awareness and inadequate measures. He said, “There is no need to be panicked, but people should be aware of. A person bitten with one dengue strain becomes immune to it, but if the same patient is bitten by another strain, the chances of contracting a fatal infection increases.”
“Our target should be aimed at providing life-long protection and we need to raise awareness among households,” he added.
There are not yet any vaccines to prevent the infection with dengue virus. The most effective protective measures are those that avoid mosquito bites. To prevent the spread of dengue fever, first we must prevent the breeding of its vector, the mosquito. It prefers to breed in clean, stagnant water easily found in our homes. Items that collect rainwater or to store water (for example, plastic containers, 55-gallon drums, buckets, or used automobile tires) should be covered or properly discarded. Vases with fresh flowers should be emptied and cleaned (to remove eggs) at least once a week. This will eliminate the mosquito eggs and larvae and reduce the number of mosquitoes.
Proper application of mosquito repellents on exposed skin and clothing decreases the risk of being bitten by mosquitoes. Using door screens also reduces the risk of mosquitoes coming indoors. Moreover, mosquito nets can play a crucial role preventing us from the bites, especially the children.
All dengue patients must be kept under mosquito net until the second bout of fever is over and they are no longer contagious. The Aedes aegypti mosquito is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas. So we have to use mosquito net in those periods.
Dr Md Rajib Hossain
Source: The Daily Star, October 03, 2009