“Dengue fever: Understanding the basics from a human perspective(2024)”

Dengue fever is a viral infection transmitted to humans through the bite of mosquitoes infected with the dengue virus.   At first the symptoms of dengue can be similar to the flu, but the condition can escalate severely into what is known as dengue hemorrhagic fever, which can be fatal The most important risk factor for severe dengue is being infected with a different virus a second time.   Interestingly, the vaccine is available, but it is only recommended for those who have already had dengue once.

 What is dengue fever?

  • Dengue fever is caused by any one of four related viruses (known as DENV 1-4), which are transmitted by the Aedes mosquito.   This mosquito grows in tropical and subtropical regions, i.e. Dengue is prevalent in Central and South America, Africa, Southeast Asia, Pacific Islands etc. Although dengue does not spread directly from one person to another, transmission from a pregnant woman to her unborn child  It can be done.
  • An initial encounter with the dengue virus often results in mild symptoms or none at all.   However, if a person is infected again with a different virus, the risk of severe illness increases.

Who is at higher risk of dengue fever?

  • Dengue is a global health issue affecting nearly half of the world’s population who live in or travel to regions where the virus is common.   Some groups are more vulnerable to serious outcomes, such as young children and the elderly.

 How ​​widespread is dengue fever?

  • It is estimated that about 400 million people are infected with dengue each year, although most of these (about 80%) are asymptomatic, meaning infected individuals do not show any noticeable symptoms

How widespread is dengue fever?

  • It is estimated that about 400 million people are infected with dengue each year, although most of these (about 80%) are asymptomatic, meaning infected individuals do not show any noticeable symptoms

 Can you develop immunity to dengue fever?

  • Yes, after infection, your body can develop immunity to a specific strain of dengue virus.   However, because there are four distinct lineages, immunity to one does not protect against the others.   The immune system has a unique way of protecting against viruses;   It uses specially designed antibodies to target specific pathogens.   When the body first encounters a virus, it makes these antibodies to “lock in” the virus and help eliminate it.   Once the body has produced these antibodies, it can recognize and fight off the same virus if it reappears, preventing re-infection of that particular strain
  • However, dengue makes the situation more complicated.   Antibodies that protect one strain do not provide complete protection against another.   In some cases, these antibodies can also help infect cells of different strains more easily, a phenomenon known as antibody-dependent enhancement (ADE) When this occurs, the virus can non-destructively attack immune system cells, increasing the likelihood of severe disease.   This is why a second infection with a different dengue strain can be more dangerous than the first.
  • Understanding dengue and its complications, especially in regions where the virus is prevalent, is important for managing the disease.   Taking preventive measures such as avoiding mosquito bites and considering vaccination after initial infection can help reduce the risks associated with dengue fever.

Symptoms and Causes of Dengue Fever:

What Are the Symptoms of Dengue Fever?

  • For most people, a dengue infection doesn’t cause any noticeable symptoms. However, when symptoms do appear, they can be quite severe. Typically, the most common sign is a sudden high fever, reaching up to 104°F (40°C). Alongside the fever, a person might experience:

– A rash that appears on the body.

– Intense pain behind the eyes.

– Nausea or bouts of vomiting.

– Severe muscle, bone, and joint pain.

  • These symptoms usually start to manifest four to ten days after being bitten by an infected mosquito and can last from three to seven days. However, approximately 1 in 20 people with dengue will see their condition worsen as the initial symptoms begin to subside, developing into a more severe form of the disease.

Severe Dengue (Dengue Hemorrhagic Fever):

  • Severe dengue, also known as dengue hemorrhagic fever, is a dangerous escalation of the initial dengue infection. The warning signs of severe dengue typically appear 24 to 48 hours after the fever has gone away. This form of dengue is considered a medical emergency because it can be life-threatening.
  • If you have dengue or are in an area where the virus is common, you should seek immediate medical attention if you notice any of the following symptoms:

– Severe abdominal or stomach pain.

– Persistent vomiting.

– Vomiting blood or finding blood in your stool.

– Bleeding from the nose or gums.

– Extreme fatigue, restlessness, or irritability.

What Causes Dengue Fever?

  • Dengue fever is caused by one of four types of the dengue virus, all of which are spread through mosquito bites. When an infected mosquito bites you, the virus enters your bloodstream and starts replicating. The illness is a result of both the virus itself and your body’s immune response to the infection.
  • The dengue virus can attack and destroy components of your blood that help in clotting and maintaining the structure of your blood vessels. At the same time, your immune system releases certain chemicals that can cause blood vessels to leak. This combination can lead to internal bleeding and other severe symptoms that characterize severe dengue.

How Does Dengue Fever Spread?

  • Dengue fever is primarily spread by the Aedes mosquitoes, which are also known to carry other viruses like Zika and chikungunya. The cycle of infection begins when a mosquito bites a person already infected with dengue, picking up the virus, and then biting another person, thereby transmitting the virus to them.

Is Dengue Fever Contagious?

  • Dengue fever does not spread directly from person to person like the flu or common cold. The virus requires a mosquito to move between hosts. However, there is one exception: a pregnant woman infected with dengue can pass the virus to her baby during pregnancy or childbirth. This is the only direct way dengue can be transmitted from one person to another.
  • Understanding the symptoms, causes, and spread of dengue fever is essential for managing and preventing this disease, especially in regions where it is common. Immediate medical attention can be life-saving in cases of severe dengue, and taking steps to avoid mosquito bites can help reduce the risk of infection.

Diagnosis and Tests:

How is Dengue Fever Diagnosed?

  • Dengue fever is usually diagnosed through a blood test. Your healthcare provider will take a blood sample, usually from a vein in your arm, and send it to a laboratory to check for the presence of the dengue virus. This test can also help identify which of the four dengue virus strains you have. Additionally, the blood test can rule out other viruses that cause similar symptoms, ensuring an accurate diagnosis.

Management and Treatment:

dengue

How is Dengue Fever Treated?

  • Currently, there is no specific medication to treat dengue fever. Instead, focus on prevention of complications and treatment management of symptoms. Your healthcare provider will give you guidance on how to alleviate your symptoms and advise you on when you might need to visit the emergency room.

How do I manage dengue fever symptoms?

  • The primary approach to treating dengue fever is through symptom management, following your healthcare provider’s recommendations. These may include:

– Staying Hydrated: Drink plenty of water and other fluids to prevent dehydration, especially since fever and vomiting can lead to fluid loss.

– Resting: Get as much rest as possible to help your body fight off the virus.

– Pain Management: Use acetaminophen (like Tylenol®) to relieve pain and reduce fever. It’s important to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®) or aspirin, as these can increase the risk of internal bleeding, a dangerous complication of dengue fever.

Prevention:

How Can I Reduce My Risk of Dengue Fever?

  • There are two main strategies to protect yourself from dengue fever: avoiding mosquito bites and vaccination.

Mosquito Protection:

  • To reduce your risk of contracting dengue fever, it is crucial to protect yourself from mosquito bites. Here are some effective methods:

– Use Insect Repellents: Apply EPA-registered insect repellents containing 20% to 30% DEET or other ingredients proven to repel Aedes mosquitoes.

– Cover up: Wear long-sleeved shirts and long pants, especially during the morning and evening when mosquitoes are most active.

– Eliminate Standing Water: Remove sources of standing water around your home, such as in flower pots, bird baths, buckets, and old tires. Mosquitoes breed in stagnant water, so eliminating these habitats can reduce mosquito populations.

– Keep Mosquitoes Out: Use screens on windows and doors to keep mosquitoes outside. Repair any holes in screens and keep doors closed.

– Use Mosquito Nets: In areas where dengue is common, sleep under mosquito nets for additional protection.

– Avoid High-Risk Areas if Pregnant: If you are pregnant, it’s best to avoid traveling to regions where dengue fever is widespread. If travel is necessary, take extra precautions to avoid mosquito bites.

– Stay Informed: Before traveling, check for any dengue outbreaks in your destination through resources like the CDC.

Dengue Vaccine:

  • The dengue vaccine, known as Dengvaxia™, is available but is only recommended for individuals who have already had a dengue infection. It can help reduce the risk of severe dengue if you are infected again with a different strain of the virus. The vaccine is not advised for people who have never been infected with dengue, as prior infection with the virus is needed to make the vaccine effective. In fact, vaccinating someone who has never had dengue before could increase their risk of severe disease upon their first natural infection. Your healthcare provider will perform a blood test to confirm past infection before administering the vaccine.
  • It is important to note that the vaccine is not universally available, and eligibility may depend on your location. For example, travelers from the U.S. currently are not eligible. Always consult your healthcare provider to see if you qualify for vaccination.

Outlook / Prognosis:

What Can I Expect if I Have Dengue Fever?

  • Most cases of dengue fever either do not produce symptoms or result in mild symptoms that can be managed at home. However, in some instances, the infection can become severe and require immediate medical attention.

How Long Does Dengue Fever Last?

  • The initial symptoms of dengue fever typically last between three and seven days. While most people begin to recover after this period, some may develop severe dengue, which requires prompt treatment in a hospital or medical facility.

Can You Survive Dengue Fever?

  • Yes, most people recover from dengue fever without long-term complications. Even in cases of severe dengue, if you receive immediate and appropriate medical care, your chances of recovery are very high, with a survival rate exceeding 99%.

Complications of Dengue Fever in Pregnancy:

  • Dengue fever can pose additional risks during pregnancy. It may lead to complications such as miscarriage, low birth weight, or premature birth. Therefore, it is crucial for pregnant women to take extra precautions to avoid dengue infection to protect both their health and that of their unborn child.

Can You Get Dengue Fever Multiple Times?

  • Yes, it is possible to have a fever more than once. There are at least four different strains of the dengue virus, and infection with one strain provides immunity only to that specific strain. If you are infected by a different strain later, you can get dengue fever again. Moreover, a second infection with a different strain can increase the risk of developing severe dengue due to a phenomenon known as antibody-dependent enhancement.
  • Understanding the diagnosis, treatment, and prevention of dengue fever is crucial for effectively managing this disease and minimizing its impact on your health.

Living With Dengue Fever:

How Do I Take Care of Myself if I’ve Had Dengue?

  • If you’ve already had dengue fever once, it’s crucial to take extra precautions to avoid getting it again, especially if you live in or travel to areas where dengue is common. This is because a second infection with a different strain of the dengue virus can increase the risk of developing severe symptoms. To protect yourself, consider getting vaccinated against dengue if you’re eligible, and consistently take measures to avoid mosquito bites. This includes using insect repellent, wearing protective clothing, and ensuring that your living space is free from standing water where mosquitoes can breed.

When Should I See My Healthcare Provider?

  • If you live in or have recently traveled to a region where dengue is prevalent and you begin to experience symptoms such as high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, or mild bleeding, you should contact your healthcare provider promptly. They can guide you on how to manage your symptoms effectively and advise you on whether further treatment or testing is needed.

When Should I Go to the ER?

  • Severe dengue can progress rapidly and become life-threatening. If you notice any warning signs of severe dengue, such as persistent vomiting, severe abdominal pain, bleeding from the nose or gums, blood in your vomit or stool, or extreme fatigue, you should go to the emergency room immediately, even if your initial symptoms seemed to have improved. Quick medical intervention is crucial to prevent serious complications.

What Questions Should I Ask My Doctor?

  • When consulting with your healthcare provider about dengue fever, consider asking the following questions:

– Is the dengue vaccine available for me, and am I eligible to receive it?

– What medications can I safely take to manage my symptoms?

– What specific symptoms or signs should prompt me to seek emergency medical care?

Additional Common Questions:

Dengue fever

Is Dengue Deadlier Than Malaria?

A. No, malaria is generally deadlier than dengue on a global scale. While both diseases can be severe and lead to fatalities, the mortality rate for malaria is higher than for dengue.

Each year, an estimated 400 million people worldwide contract dengue, with about 40,000 resulting in death, which is roughly 0.01% of those infected. In contrast, malaria affects about 271 million people annually, with approximately 627,000 fatalities, equating to a mortality rate of around 0.3%.

It’s important to note that the impact of these diseases can vary significantly depending on geographic location and population vulnerability. For instance, children in Africa are disproportionately affected by malaria, with higher mortality rates, while dengue is more prevalent in Asia, affecting people in those regions more significantly. Understanding the risks and taking preventive measures is crucial for both diseases, especially in areas where they are common.

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