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Dengue caused by four viruses; no specific cure (The Times of India-30 August 2010)

What is dengue fever?

Dengue is a mosquito-borne seasonal viral infection caused by four closely related viruses
(DENV 1-4) transmitted by the bite of a female mosquito of the genus Aedes. These domestic
mosquitoes thriving around human habitations typically bite in daylight hours. They are easily
recognized by their peculiar white spotted body and legs. In India, the outbreak of the disease
usually occurs in the postmonsoon season when the mosquito population reaches its peak.
Dengue cases are predominantly reported in urban and semi-urban areas. A more severe
infection, known as dengue haemorrhagic fever, caused by same virus, can be fatal if not
detected at an early stage.

What are the symptoms of the disease?

After the virus enters the human body, it takes 4-6 days for the symptoms to become visible. The
main symptoms of dengue are high fever (103-105 degrees fahrenheit), severe headache, severe
pain behind the eyes, joint pain, muscle and bone pain, rash, and mild bleeding from nose or
gums. Because of severe joint pain, dengue is also known as break-bone fever.

While the initial symptoms are similar to those in dengue, in dengue haemorrhagic fever, small
purplish spots appear on the skin, which is caused by blood leaking out of the vessels. This is
caused by the decrease in platelets, the cells in blood that help to stop bleeding. The smallest
blood vessels (capillaries) become excessively permeable (leaky) allowing the fluid component
to escape from the blood vessels to organs of the body. As the disease progresses, large bruises
appear on the patient’s body and bleeding happens in the stomach with the patient vomiting
blood. Severe haemorrhage may lead to failure of the circulatory system and shock, which might
also cause death.

What is the treatment for dengue?

Like most viral diseases, there is no specific cure for dengue. Antibiotics do not help and
generally paracetamol is the drug of choice to bring down fever and joint pain. Other medicines
like aspirin and Brufen or any medicine that can decrease the platelet count should be avoided,
since they can increase the risk of bleeding. As it has no specific medication, most patients with
dengue fever can be treated at home. It is advised to take rest, drink plenty of fluids and eat
nutritious diet and stay in constant touch with a physician.

DHF, however, requires hospitalization. Apart from this, it is also possible to get dengue more
than once, as the disease is caused by four different but related strains of the virus and being
affected by one strain offers no protection against the others.
What can be done to reduce the risk of acquiring dengue?

Infected humans are the main carriers and multipliers of the virus, serving as a source of the
virus for the mosquitoes. The viruses are transmitted from human to human through the bites of
the female Aedes mosquitoes, which acquire it while feeding on the blood of an infected person.
Hence the only way to prevent the outbreak of the disease is community-based mosquito control
by eliminating the places where the mosquito lays her eggs. The mosquito primarily breeds in
manmade containers like earthenware jars, metal drums and concrete cisterns, discarded plastic
food containers, used automobile tyres and other items that collect rainwater. The best way to
prevent the disease is by not allowing the mosquito to breed and using repellents for decreasing
the risk of being bitten by mosquitoes.