Punjab and in particular Lahore is being crippled by increasing number of Dengue fever patients. We all know it is an illness caused by a virus. This virus is spread by Dengue mosquito. Without going into details of types and kinds of the mosquito, viruses and irrelevant data, I will endeavor to present here some basic facts so that if you or anyone near and dear to you has a fever these days, you should know what to do.
SYMPTOMS OF DENGUE FEVER:
How can you diagnose Dengue fever.
Dengue virus infections cause a spectrum of illness ranging from asymptomatic, mild undifferentiated fever to classical dengue fever (DF), and dengue fever with haemorrhagic manifestations, or dengue haemorrhagic fever (DHF) and the dengue shock syndrome (DSS). Keep the following in mind when dealing with Dengue fever. The symptoms generally are:
1. High continuous fever of 3 days or more
2. Abdominal pain
3. Small haemorrhages under the skin.
4. Rash. The skin rash of Dengue fever is mostly itchy and mostly occurs on the back.
5. Abdominal pain due to enlargement of Liver.
6. Fall in platelet count that precedes or occurs simultaneously with a rise in haematocrit
7. Normal WBC or leucopaenia with increase in Lymphocyte count.
8. Normal ESR (< 20mm per hour) It tends to increase in fevers caused by most of the infections in our region. Some less common but very significant symptoms are: • Acute abdominal pains, diarrhoea, severe gastrointestinal haemorrhage • Severe headache, • Inflammation of brain (Encephalitic) signs associated with or without intracranial haemorrhage • Irregular pulse and heart rate • Respiratory distress / difficulty in breathing. PLATELETS:
In normal person the platelet count is 150,000 to 25,000 / cu.mm. Platelets are the particles in blood which help in coagulation. If the platelet count is BELOW 100,000/ cmm, it should be considered emergency and patient should be hospitalized immediately. Remember the duration of fever is 5 – 7 days after which there is afebrile (fever less) phase which lasts for 2 to 4 days but is very important as most of the complications (including bleeding) occur in this period of time. So absence of fever in diagnosed case of Dengue does not mean that the patient should be allowed to move about.
If there is no bleeding and the platelet count is not going below 100,000 /cmm, majority of treatment consists of correcting the fluid balance, giving antipyretic medication (NEVER USE ASPIRIN as it can further complicate bleeding disorder), rest, good protein diet and antibiotics to reduce the chance of secondary infection. As such antibiotics (Tarivid, Ofloxacin, Leflox, Ofloxin, Cephradine, Septran, Vibramycin, etc.) have no role in the treatment of Dengue fever. They are only used for any secondary infection in the body and in its absence should NOT be used.