Dengue: A Deadly Epidemic That Should Be Combated Right Now

 

Dengue fever is a viral infection. It spread through virus named Flavivirus (Flaviviridae Family). Actually, it's a RNA virus. The virus carry through mosquitoes named Aedesagyptiand Aedesalbopictus.

First, Dengue fever was spread in Chennai in 1780. Later, it was pandemic in 1963-64 in Kolkata. Now, it is introduced not only in South Asia countries but also in all over the World. It transmitted through mosquitoes to humans. But it's not possible through man to man.
In a recent research, Approximately 400 million cases and 22,000 people deaths occur in a worldwide due to dengue fever.

Sign & Symptoms

Incubation period: 4-10 days.
Young and children are more affected in Dengue fever.
There are two types of dengue fever.
1) General Dengue
2) Hemorrhagic Dengue
For General Dengue Fever,
1) Fever (104°F - 106°F)
2) Severe Headache
3) Pain behind the eye
4) Muscle and Joint Pain
5) Nausea & Vomiting
For Hemorrhagic Dengue Fever,          
1) Severe abdominal pain.
2) Breathing abnormally.
3) Nose & Gum Bleeding
4) Presence blood in Vomit and Stool.
Dengue fever also manifests in three stages:

1. Febrile Phase: This stage begins with a sudden onset of high fever (up to 104°F or 40°C) and is often accompanied by severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands, and rash. The fever typically lasts for 2-7 days.

2. Critical Phase: Following the initial fever, the disease may progress to a critical phase lasting 24-48 hours. During this period, fever subsides, but the patient may experience severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, and restlessness. In severe cases, this can lead to dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), which are potentially fatal due to plasma leakage, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.

3. Recovery Phase: After the critical phase, patients enter the recovery phase where fluid resorption occurs, and the general condition improves. However, the recovery phase can also be marked by severe itching and a slow heart rate.

If the patient can't be treated within 48 hours, eventually it becomes too hard to save the patient.

Diagnosis

Serology Test: Presence of IgM antibody in blood can detect the Dengue fever. But if serious conditions, then the IgM antibody will rise in 3 or 4 times.

Platelet Count: In CBC (Combined Blood Count), if the platelet is less than 1,50,000 per cubic millimeter of blood, then we can identify that he/she is suffering from dengue fever.

PCR (Polymerase Chain Reaction): To detect RNA of dengue virus.

Treatment

There is no specific treatment for dengue fever. But we can decrease the symptoms
1) Patient need to drink lot of pure water.
2) Patient need to prevent from Aspirin type of drug.
3) Patient need to eat lot of fruits and vegetables.
4) Patient need to intake Paracetamol for decreasing the fever.
5) Patient need full bed rest at least one week.
6) Sometimes, patients need to take Platelet infusion.
Most of the time, patients recover from dengue fever
Prevention

Sometimes, people need preventive measure to protect from dengue fever.

Vector Control: Reducing the population of Aedes mosquitoes is essential to prevent the spread of dengue. This can be achieved through environmental management, such as eliminating breeding sites (e.g., stagnant water), using insecticides, and implementing community-based interventions.

Personal Protection: Individuals can reduce their risk of mosquito bites by using insect repellent, wearing long-sleeved clothing, and using mosquito nets or screens, especially during peak mosquito activity times.

Vaccination: The Dengvaxia vaccine, developed by Sanofi Pasteur, is the first licensed vaccine for dengue. It is approved for use in individuals aged 9 to 45 who have had a previous dengue infection. However, its use is restricted due to concerns about the risk of severe dengue in those who have not been previously infected. Ongoing research is focused on developing more effective and safer vaccines.

Public Health Campaigns: Public health education and awareness campaigns are vital for promoting preventive measures and encouraging early medical consultation in case of symptoms. Community involvement is crucial in maintaining clean environments and reducing mosquito breeding sites.

Epidemiology in Dhaka City

Today, Dhaka is populated city in Bangladesh. Every year around 60,000 cases of dengue was admitted in hospital in Bangladesh. Moreover, 200 people died in Bangladesh every year. This number is gradually increasing.

According to WHO, Dhaka is the most affected for dengue fever. More than 58% cases and 79% deaths occur in Dhaka.

The epidemic of this dengue fever in July to October. During this month, Rain mostly occurs. Moreover, the drainage system of Dhaka City is poor. That's why, water is totally accumulate in main roads, parking place, garbage site. Those site are breeding place for Aedes mosquito.

Dhaka is the most developing city in Bangladesh. They need to construct new building for official or residential work. During this process, they need large amount of water to construct the building. So, the workers accumulate the water in a well. This well also breeding place for Aedes mosquito.
Conclusion

Dengue fever remains a significant public health challenge, particularly in tropical and subtropical regions. The rising incidence of the disease underscores the need for effective prevention, control, and management strategies.

While progress has been made in understanding the disease and developing interventions, the complexity of dengue transmission and the lack of a universal vaccine continue to pose challenges.Efforts to combat dengue must involve a multi-pronged approach, including vector control, public health education, vaccine development, and international collaboration. Only through sustained and coordinated actions can the global burden of dengue be reduced, ultimately improving the health and well-being of millions of people at risk.

 
SMM Musabbir Uddin is a
student of Universal
 Medical College, Dhaka.