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Dengue alert: Precaution and prevention

Md Rajib Hossain
The rainy season provides a fertile environment for Aedes mosquito to grow faster and transmit the dengue virus more rapidly. The incidence of dengue fever has reportedly increased in the country alarmingly. But simple protective measures and following proper guideline can reduce the occurrence, mortality and morbidity caused by the disease.
Dengue (pronounced den-gay) fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, muscle and joint. The severity of the joint pain has given dengue the name "breakbone fever.” Nausea, vomiting, and loss of appetite are common. The rash typically begins on the arms or legs three to four days after the beginning of the fever. The peculiar nature of the fever is that it lasts up to 7 days and then a
afebrile period of 2-3 days stays when patients feel better and after that the temperature rises again. Complete recovery may take in a variable period from 15 days to one month.
Dengue fever has several categories like dengue undifferentiated fever (similar to viral fever), classical dengue fever, and dengue haemorrhagic fever with or without shock.
Most dengue infections result in relatively mild illness, but some can progress to dengue hemorrhagic fever. With dengue hemorrhagic fever, the blood vessels start to leak and cause bleeding from the nose, mouth, and gums. Bruising can be a sign of bleeding inside the body. Without prompt treatment, the blood vessels can collapse, causing shock (dengue shock syndrome). Dengue hemorrhagic fever is fatal in about 5 percent of cases, mostly among children and young
adults.
Dengue fever is diagnosed by clinical symptoms and specific blood tests (PCV, platelet count, white blood cell count, isolation of virus and serological tests).
Blood tests is usually advised after 3 days when it becomes positive.
As dengue is caused by a virus, there is no specific medicine or antibiotic to treat it. The
mainstay of treatment is supportive therapy. Increased oral fluid intake is recommended to prevent dehydration. Supplementation with intravenous fluids may be necessary to prevent dehydration and significant concentration of the blood if the patient is unable to maintain oral intake. A platelet transfusion is indicated in cases if the platelet level drops significantly (below 10,000) or if there are significant bleeding.
Prof. Dr. Khaja Nazimuddin, professor of medicine, BIRDEM advised to take paracetamol only for fever and pain. He warned not to take any aspirin and or other non-steroidal anti -inflammatory drugs (NSAID) or antibiotic during high-grade fever, because intake of these drugs can aggravate the condition of the patient.
Patients with symptoms of high-grade fever, vomiting,
abdominal pain, rashes on body and headache are strongly recommended to consult physicians before taking any drug as self-medication may result in fatal outcome of the patient. Hospital care is necessary for all patients with dengue haemorrhagic fever.
The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue. We should empty stagnant water from old tires, trash cans, and flower pots and from air conditioner where the mosquito breeds. Government should step up their efforts to reduce the number of mosquitoes to keep the disease in check.
For personal protection, use mosquito net, repellant sprays that contain DEET. The Aedes aegypti mosquito bites more during daytime i.e. between sunrise and sunset. So be careful more in the day.