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Last Updated: Feb 05, 2020
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Dengue - Symptom, Treatment And Causes

Overview Facts Symptoms Causes Precautions Diagnosis Treatment Home Remedies Incubation Period Complications

About Dengue Fever:

Dengue fever is a disease caused by the mosquito-bite carrying the dengue virus. The female Aedes mosquito is the carrier of this virus. The symptoms of the fever typically begin from three to fourteen days after the mosquito bite infection. The symptoms may include a very high fever, complains of headache, vomiting, muscle pain, joint pains, and a type of skin rash.

Interesting Facts About Dengue

  • Dengue does not spread through human contact, rather it spreads when bitten by the carrier mosquito, the female Aedes mosquito. This mosquito is known to bite during the daytime and its favourite spots to bite are below the elbow and the knee.
  • Dengue is not fatal if identified early and treated well.
  • Dengue is found in most parts of the world, but it is more commonly reported in tropical and subtropical regions. Severe dengue is one of the leading causes of serious illnesses and death in children in Asia and Latin America.
  • Dengue Hemorrhagic Fever is caused by a certain strain of the dengue virus. It causes the platelet count to drop drastically resulting in severe bleeding and a drop in blood pressure. This may also lead to shock and death.
  • When a pregnant woman is infected with dengue fever, she can pass on the infection to the baby during childbirth.
  • When infected with dengue, the patient should not take aspirin or other painkillers. Both dengue and aspirin have deleterious effects on the platelet counts and so the hemorrhagic process may get hastened.
  • The best way to treat dengue at home is to maintain the temperature and to keep the patient hydrated with plenty of water and electrolyte fluids. Nutritional foods are also recommended to fight the disease.
  • Emergency care of dengue hemorrhagic fever includes intravenous hydration, pain management, blood transfusions, electrolyte and oxygen therapies, careful monitoring of blood pressure levels.
  • Prevention of dengue fever includes control or eradication of dengue carrying mosquitoes. The Aedes mosquito is known to breed in clean, stagnant and still water.
  • There is no vaccine to protect against dengue fever.

What are the Initial Symptoms of Dengue Fever?

The initial symptoms of the Dengue fever are as follows:

  • High fever: Temperatures ranging anywhere between 101-104 degree Fahrenheit usually occurs between 3-15 days of exposure to the virus, severe chills add to the discomfort.
  • Aches and Pains across the body: These may occur in the muscles, bones or even the joints. This happens because the viral presence causes vitamin and mineral deficiency leading to aches and pains. Infact dengue haemorrhagic fever is famously termed as break bone fever.
  • Nausea and vomiting: This is because if the virus is potent and the patient’s immunity is poor then the virus progresses to the gastric tract. This should not last for more than a couple of days and should not occur very frequently. If it does, then the patient suffers from severe dengue. Dehydration is another concern with vomiting.
  • Skin Rash: This is a fairly common symptom of mild to moderate dengue. The fever mostly occurs 3-4days after the fever. Initially affects the face giving the skin a spotty, flushed look with a patch of redness. Second site for the rash is the trunk where it may spread out in all directions. Another type of dengue rash is characterised by clustered dots which may appear anywhere across the body once the fever has subsided. Mostly it is not itchy. They may get better by themselves for a couple of days and then resurface unexpectedly.
  • Loss of Appetite
  • Headache: Headaches, lower back-pains and pain behind the eyes are commonly encountered in dengue.
  • Abdominal pain: Severe abdominal pain is a common symptom of dengue fever. Usually develops in the right upper quadrant of the abdomen.
  • Bloody Gums and Nose: Most of the times, these are benign but recurrent. Sometimes, may become profuse to be termed as Epistaxis.
  • Blood in stools: Occurs 3-5 days after fever. Black stools like coal-tar may become noticeable for dengue patients. This is termed as MELENA. This occurs primarily due to bleeding in the alimentary tract.
  • Symptoms of complication: In such cases, blood vessels may get damaged and become leaky, and the platelet count of the bloodstream may drop acutely. Organ dysfunctions in the form of lungs, heart and liver may occur in some cases. Persistent bloody vomits, bruise-like formations on the skin may add on alongside typical dengue discomforts. This constitutes a medical emergency.

Dengue Fever Causes

Dengue fever is caused by any one of four types of dengue viruses spread by mosquitoes that thrive in and near human lodgings. When a mosquito bites a person infected with dengue virus, the virus enters the mosquito. When this mosquito bites another person, the virus enters that person’s bloodstream. The female Aedes mosquito responsible for dengue fever usually grows in clean but stagnant water so avoiding stagnancy should be of concern to lower the risk of infection.

After you recover, you develop immunity to the virus that infected you but not to the other three types of dengue virus. The risk of developing severe dengue fever-also termed dengue haemorrhagic fever actually increases if you are infected with second, third or fourth time.

RISK FACTORS:

  • Living or travelling in tropical areas: High-risk areas are South-east Asia, the Western Pacific Islands, Latin America and the Caribbean.
  • Prior infection with Dengue fever virus: This increases your risk of having severe symptoms and developing Dengue Haemorrhagic Fever.
  • Low immunity-People with low immunity contact the infection quicker than normal population.

What Precautions to Be Taken in Dengue Fever?

As a mosquito-borne disease, preventing dengue is as good as preventing mosquito bites. There is no approved vaccine for dengue fever. Following steps are suggested to prevent you from dengue:

  • Wear long-sleeve shirts and long pants especially at day time so as to cover yourself from mosquito bite. The dengue mosquito bites in the morning.
  • Treat clothes with repellents like permethrin.
  • Use EPA-registered mosquito repellent like DEET.
  • Consider mosquito-netting if you will be living in areas with many mosquitoes.
  • Make sure windows and doors are closed to avoid mosquitoes into closed spaces.
  • Avoid areas with standing water especially at times of high mosquito activity like dawn and dusk.
  • Preventing mosquitoes from accessing egg-laying habitats by environmental management and modification. Ensure there are no open holes with water logged in, no utensils with water left uncovered. Dispose the water and spray kerosene oil on water at open areas so that it prevents mosquitoes to breed.
  • Disposal of solid waste properly and removing artificial man-made habitats.
  • Covering, emptying and cleaning of domestic water storage containers on a weekly basis.
  • Applying appropriate insecticides to outdoor water-storage containers.
  • Improving community participation and mobilisation for sustained vector control.
  • Applying insecticides as space spraying during outbreaks as one of the emergency vector-control measures.
  • Active monitoring and surveillance of vectors should be carried out to determine the effectiveness of control interventions.
  • Careful clinical detection and management of dengue patients can significantly reduce the mortality rates from severe dengue.

What are the Ways of Diagnostic For Dengue Fever?

Diagnosis of dengue fever may not be very easy and hence history especially travel and contact history is essential. Accurate and early laboratory diagnosis is essential for appropriate management.

Laboratory diagnosis methods for confirming dengue virus infection may involve detection of the virus, viral nucleic acid, antigens or antibodies, or a combination of these techniques. After the onset of illness, the virus can be detected in serum, plasma, circulating blood cells, and other tissues for 4-5 days. During the early stages of the disease, virus isolation,nucleic acid, or antigen detection can be used to diagnose the infection. At the end of the acute phase of infection, serology is the method of choice for diagnosis.

Antibody response to the infection differs depending on the immunity of the host. IgM antibodies are the first immunoglobulins to appear. These antibodies are detectable in 50% of patients by 3-5 days of illness, increasing to 80%by day 5 and 99% by day 10.IgM levels peak by about 15 days of illness that decline to negligible amounts by about 2-3 months later. Anti-dengue serum IgG are detectable in low titres by the end of the first week of illness, increasing slowly thereafter, IgG still being detectable after months and sometimes even for life.

During a secondary dengue infection, the antibody titres rise rapidly and react broadly against most flaviviruses. Dominant immunoglobulin is IgG which is detected at high titres even in the acute phase and lasts for a period between 10 months to life. Early convalescent stage IgM levels are very low when compared to primary infections and may not even be detectable in many cases. To distinguish primary and secondary infections,IgG/IgM ratios are commonly used than the haemagglutination-inhibition test.

Virus isolation and nucleic acid detection are more labour intensive and costly but are also more specific than antibody detection using serologic methods.

What is Treatment of Dengue Fever?

There is no cure or specific treatment for dengue. Treatment involves relieving your symptoms while the infection runs its course.

Following methods of treatment can help combating dengue fever:

1. If the dengue is mild or at initial stages:

  • Taking paracetamol to relieve pain and fever-avoid aspirin or ibuprofen as these can cause bleeding in dengue patients. It is advised to not to use aspirin and ibuprofen as these may increase risk of internal bleeding in the body.
  • Drink plenty of fluids to prevent dehydration. Due to fever and vomiting there may be dehydration. Thus, drinking plenty of clean water, rehydrated salts is essential to keep the proper fluid balance in the body.
  • Get plenty of rest.

2. Severe dengue is a medical emergency and needs urgent medical attention or hospitalisation. For serious condition there is a need of hospitalization which may need:

  • Intravenous fluids, IV medicines and injections, drips
  • Platelets transfusion
  • Rest and monitoring

Home Remedies For Dengue and Diet Tips

Some of the home remedies suggested to overcome mild cases of dengue fever are as follows:

  • Giloy: An important herb in Ayurveda. It helps in maintaining the metabolic rate, strengthening the immune system and protects your body against infections. Stems of this herb need to be boiled and served as an herbal drink and Tulsi may be needed as well.
  • Papaya Leaves: helps in increasing the platelet count and reduces the symptoms of fever like body ache, chills, feeling low, getting tired easily and nausea. You can crush the leaves and consume or make a juice which helps in flushing the toxins.
  • Fenugreek Leaves: They are known to reduce fever and act as a sedative to ease pain and promote more restful sleep. Soaking the leaves and drinking the water is the way to consume them.
  • Goldenseal: It is an herb whose dried root is used to make medicines. It has the ability to clear off the dengue symptoms and eliminate the virus. It acts like the papaya leaves. Using them is by crushing and chewing them or by juicing them.
  • Turmeric: It is also known to boost metabolism and helps in making the healing process faster. You can consume turmeric along with milk.
  • Tulsi leaves and Black pepper: It is also suggested to make a drink by boiling Tulsi leaves and adding 2 grams of Black pepper to it .This drink is known to boost one’s immunity and acts as an antibacterial element.

How Long Does it Take For Symptoms of Dengue Fever to Show?

Symptom Presentation and Last Stage Of Dengue

Symptoms of dengue usually develop suddenly between 4-10 days after becoming infected. The symptoms normally pass in about a week although you may feel weak, tired and slightly unwell for several weeks afterwards. In rare cases, severe dengue may develop after the initial symptoms. Last stage of Dengue may be further divided into three stages:

  • The critical stage: 5% of people with dengue fever get into this stage which lasts for 1 to 2 days. During this stage, plasma leaks out of the body’s small blood vessels. The plasma can build up in the chest and abdomen. This is a serious problem for a few reasons. If too much plasma leaks out of the blood vessels, then there will not be enough plasma to carry glucose, electrolytes and blood cells to the body’s most important organs. Without these things, the organs won't work normally. This is termed as Dengue shock syndrome. Plasma also carries platelets which help the blood clot. If a person doesn't have enough platelets, they may have dangerous bleeding. With dengue fever, this bleeding usually occurs in the gastrointestinal tract. When a person has bleeding, leaking plasma and not enough platelets, they have Dengue Haemorrhagic fever.

  • The Recovery Stage: This is when the patient’s body is overcoming the disease process. In this stage, the plasma that leaked is taken back up into the bloodstream. This stage usually lasts 2-3 days. People often feel better in this stage even though they may have a bad itch and a slow heart rate. Serious problems may also take place in this stage. If a person’s body takes lot of fluid back up into the bloodstream, it is termed as fluid overload. This can cause fluid to build up in the lungs and cause breathing problems. Fluid overload can also cause seizures and an altered mental status.

Complications of Dengue

  • Altered mental status-happens in 0.5-6% of patients with very bad dengue fever. It can happen when the dengue virus causes infection in the brain. It can also happen when important organs like the liver don’t work properly because of dengue.
  • Neurological disorders-These are problems with the brain and nerves like the Guillain-Barre Syndrome and Post dengue Acute Disseminated encephalomyelitis.
  • Infection of the heart or severe liver failure (these are very uncommon).

Popular Questions & Answers

Hi sir ,my daughter is suffering from fever, cold and cough. Actually it came on jan-19 I was consult doctor he had choose to admit I his hospital after that my baby was recovered after 1 week again fever has came. Then doctor referred to consult rainbow hospital in kerala in rainbow hospital doctor told to me admission 2 days doctors says it's normal fever not a malaria, viral or dengue in this hospital do test on blood culture it also negative after that 8 days agi again fever came we used normal syrups like p-250, meftal. Again on feb 15 fever came doctor choose to do urine culture the report was positive he given some injection using for 5 days. On feb 25 again fever has come I admitted on another hospital in pulivendula she also choose urine culture. The report was positive she also given some antibiotic injection for 7 days injections: artesunate zostum amicin rantac after we used this 45 days my daughter was free from fever 5 days bak again fever came again conduct on urine culture it was positive wat should I do presently we using monotax 500 hi sir ,my daughter is suffering from fever, cold and cough. Actually it came on jan-19 I was consult doctor he had choose to admit I his hospital after that my baby was recovered after 1 week again fever has came. Then doctor referred to consult rainbow hospital in kerala in rainbow hospital doctor told to me admission 2 days doctors says it's normal fever not a malaria, viral or dengue in this hospital do test on blood culture it also negative after that 8 days agi again fever came we used normal syrups like p-250, meftal. Again on feb 15 fever came doctor choose to do urine culture the report was positive he given some injection using for 5 days. On feb 25 again fever has come I admitted on another hospital in pulivendula she also choose urine culture. The report was positive she also given some antibiotic injection for 7 days injections: artesunate zostum amicin rantac after we used this 45 days my daughter was free from fever 5 days bak again fever came again conduct on urine culture it was positive wat should I do presently we using monotax 500 hi sir ,my daughter is suffering from fever, cold and cough. Actually it came on jan-19 I was consult doctor he had choose to admit I his hospital after that my baby was recovered after 1 week again fever has came. Then doctor referred to consult rainbow hospital in kerala in rainbow hospital doctor told to me admission 2 days doctors says it's normal fever not a malaria, viral or dengue in this hospital do test on blood culture it also negative after that 8 days agi again fever came we used normal syrups like p-250, meftal. Again on feb 15 fever came doctor choose to do urine culture the report was positive he given some injection using for 5 days. On feb 25 again fever has come I admitted on another hospital in pulivendula she also choose urine culture. The report was positive she also given some antibiotic injection for 7 days injections: artesunate zostum amicin rantac after we used this 45 days my daughter was free from fever 5 days bak again fever came again conduct on urine culture it was positive wat should I do presently we using monotax 500 hi sir ,my daughter is suffering from fever, cold and cough. Actually it came on jan-19 I was consult doctor he had choose to admit I his hospital after that my baby was recovered after 1 week again fever has came. Then doctor referred to consult rainbow hospital in kerala in rainbow hospital doctor told to me admission 2 days doctors says it's normal fever not a malaria, viral or dengue in this hospital do test on blood culture it also negative after that 8 days agi again fever came we used normal syrups like p-250, meftal. Again on feb 15 fever came doctor choose to do urine culture the report was positive he given some injection using for 5 days. On feb 25 again fever has come I admitted on another hospital in pulivendula she also choose urine culture. The report was positive she also given some antibiotic injection for 7 days injections: artesunate zostum amicin rantac after we used this 45 days my daughter was free from fever 5 days bak again fever came again conduct on urine culture it was positive wat should I do presently we using monotax 500.

MS - ENT, MBBS Bachelor of Medicine and Bachelor of Surgery
ENT Specialist, Ghaziabad
You have not mentioned the age and reports of the investigations done so far. Your child seems to be suffering from recurrent urinary tract infection which would need detailed evaluation like ultrasound whole abdomen including kuv and plane and co...

My grand ma is suffering from dengue, her platelets was 451 when initial test was done, now the platelets are 260, she is undergoing treatment for it now is the third day, do we need to admit her in hospital or need to complete the dose, please suggest.

MBBS, MD - Internal Medicine, MRCP (UK), DM - Clinical Haematology
Hematologist, Kolkata
You do not need to admit her right now. However, ​you MUST consult a physician and get her examined asap. Repeat the platelet counts on alternate days for the next week. Also watch out for skin rash, headache, chest pain, pain abdomen ad any evide...
1 person found this helpful

Doctor, three days back I developed sore throat. Two days back had fever (100.5) took only one paracetamol and after that body temperature till today (3rd day) is Normal .but I am having joint pains ,heavy legs and very mild cramp .i went MD doc. He did CBP. He told everything is normal. Platelets are adequate, lymphocytes 36% .can this be dengue? I don’t have fever .i have only joint pain in left elbow and legs are heavy.

MBBS, Craniosacral Balancing, Quantum Touch, Visceral manipulation
Pain Management Specialist, Panchkula
It's a viral type of infection. It may take 5 to 7 days for recovery. No need to worry. You should have more of liquid diet like milk, fresh fruit juice, coconut water etc. Wishing you a healthy life.
3 people found this helpful

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