What starts off as a nagging headache soon turns into excessive joint pain. The fever that follows should not be ignored—it could be dengue. “In its initial stages, dengue tends to mimic viral fever and influenza. If the fever is associated with a runny nose and cough, it goes in favour of a viral flu. Severe body ache and aching legs means you may have dengue,” explains Ashutosh Shukla, head of internal medicine at the Artemis Health Institute, Gurgaon. He adds that there has been a rise in dengue cases this month; last year there was a surge in July.
“Dengue occurs at all ages but is much more severe in children below the age of 15. The paediatric age group requires the maximum caution,” says T.D. Chugh, senior consultant microbiologist at the Dr BL Kapur Memorial Hospital in New Delhi. The symptoms are the same for both children and adults. “High fever, flushed face, joint pain—children with dengue have the same complaints as adults,”says Rajiv Chabbra, consultant paediatric and neonatal intensivist, Artemis Health Institute, Gurgaon.
Dengue fever is caused by the dengue virus, which is triggered by the bite of the Aedes aegypti mosquito. The mosquito breeds in clean water and is usually active early morning or around sunset. Patients may sport a red rash on their legs or chest; and in acute cases the blood pressure may drop. The best way to find out if you have dengue or not is to consult a general physician and not try to self-medicate, says A.K. Bali, consultant, internal medicine, at Moolchand Medcity, New Delhi. A complete blood count and a liver blood test are recommended by doctors after the initial check-up. In case the dengue is in its initial stage, the NS1 antigen (blood test) or dengue serology are recommended, says Suranjit Chatterjee, senior consultant, internal medicine, Indraprastha Apollo hospital, New Delhi. Dengue may not show up in the initial blood test, and it may need to be done again, say doctors.
If a person contracts one of the four types of viruses that cause dengue (which includes dengue fever and the most dangerous, dengue haemorrhagic fever), she/he does not automatically become immune to the other viruses. Repeated infections tend to increase the risk of dengue, which may progress to dengue haemorrhagic fever.
Dengue may affect the platelet count of a patient. “Platelets normally help in blood clotting. When their count falls, the clotting mechanism of the body goes haywire. The dangers of haemorrhagic fever are that a person can bleed to death,” explains Dr Shukla.
You can take a number of precautions. First, the ubiquitous mosquito repellent cream that doctors suggest you use throughout the day during this season. In large spaces such as a clinic or a restaurant, the owners should use an ultra-violet bug-zap machine. If possible, try wearing full-length garments and light-coloured clothes, which tend to reduce the chances of a mosquito bite.
Also, keep your house clean and spray with mosquito and insect repellents. Ensure water does not collect in and around the premises. If there is waterlogging, spray eucalyptus-based mosquito repellents.
Advice for patients
A lot of fluid intake is a must to avoid dehydration. Coconut water, lemonade and chicken soup are good, says Dr Shukla. Although there are no dietary restrictions, patients should avoid spicy food and stick to a low-fat diet since the liver is weak and can get affected, says Dr Chatterjee.
A food supplement that Dr Shukla recommends is vitamin B1. “This is because it excretes through the sweat glands and mosquitoes tend to get repelled by the smell.” Any multi B-complex tablets will do. Up the intake of fresh fruits and green leafy vegetables in this season.
In case you self-medicate an undiagnosed fever in this season, doctors suggest that you should only take paracetamol. Dr Chatterjee advises against combiflam, brufen and ibuprofen, which may further lower the blood platelet count.
Constant high fever without cold or cough
Low blood pressure in acute cases
Bleeding from joints (extreme cases)