The D Spot

About 50 million people in many parts of the world, particularly in the tropics, are already at risk from dengue fever. Worse, there is no cure for the dengue virus since it is a viral disease. But the good news is that there are many things you can do to at least stop the spread of the virus. You can also do something to cure the symptoms. If not, the worst case scenario might happen—death.

Death caused by dengue haemorrhagic fever (DHF), the worst form of dengue fever, is up to 30% of the cases. And this usually occurs in children and infants.

In the Philippines, a dengue epidemic is looming, which could be full-blown in a matter of time.  There is a 75% increase in cases compared to those of last year, which is of national concern. This is why the DOH is undertaking intensive efforts for information campaigns and clean up drives from barangays to cities around the country. It infects people across all sectors–the rich and the poor.

Transmission
There is no way that an infected person can infect another person. The process should be person-mosquito-person for the infection to take effect. Thus, infected humans and mosquitoes are the main carrier of this virus.

Symptoms
Dengue fever is often described as a flu-like illness. But what set it apart from other fever are the skin rashes, pain behind the patient’s eyes, and severe pains on joints and muscles. Other symptoms are headache, swollen glands, rashes, bleeding gums, and redness of the soles and palms.

The fever may also rise to up to 41°C and might last for up to 7 days. Convulsions are possible as well. Sometimes, the fever might suddenly drop and will be followed by circulatory failure. In this case, the patient will either quickly recover after medical treatments or die within 24 hours.

Particularly, the DOH in its advisory enumerates the following symptoms:

- Sudden onset of high fever which may last 2 to 7 days.
- Joint and muscle pain and pain behind the eyes.
- Weakness
- Skin rashes:  maculopapular rash or red tiny spots on the skin called petechiae
- Nosebleeding when fever starts to subside
- Abdominal pain
- Vomiting of coffee-colored matter
- Dark-colored stools

Bring the patient to the nearest health care provider immediately when all the symptoms are present.

In worst cases, dengue shock syndrome occurs—with all the symptoms of DHF plus a weak and rapid pulse, narrow pulse pressure, restlessness and cold clammy skin.

Treatment
As mentioned, dengue has no cure. But patients are relieved using symptomatic medications. These are medications that are aimed to cure the different dengue symptoms, especially fever. You may give acetaminophen, paracetamol and codeine for patients suspected with dengue fever to relieve them of joints pain, muscle pain, and headache. Avoid giving aspirin and non-steroidal anti-inflammatory drugs. These may worsen the bleeding that a patient may experience.

If the case is DHF, the patient is closely monitored for a few days. Cyanotic patients are provided with oxygen while those who experienced vascular collapse are given fluid replacement immediately. If bleeding occurs, doctors usually consider blood transfusion to control it.

Vaccine
DHF has been considered as a “potentially lethal complication” by the World Heath Organization since 1950s after the dengue epidemic in Thailand and Philippines. Today, dengue is already common to tropical and subtropical places. Despite the great concern, there is still no effective vaccine created against this illness.

Experts find it very challenging to develop a vaccine against dengue due to lack of information. But development is on going and two of the possible vaccines are under evaluation. The World Heath Organization estimates the evaluation to be finished by 2012. Until then, prevention will be the most effective measure to control spreading dengue.

Dengue Prevention
The dengue virus is spread through mosquito bites. But only the female Aedes mosquitoes (A. aegypti and A. albopictus) have the capability to carry and spread this virus. These mosquitoes get infected by feeding on the infected person’s blood. The insect becomes capable of infecting only after 8 to 10 days of incubation period. A female mosquito can also infect her eggs, which can also spread the dengue virus.

Infected humans must be protected with mosquito net and advised to cover their skin all the time with long sleeves and pajamas so that they can’t infect more mosquitoes.  Below are more prevention tips to stop the spread of the deadly Dengue virus:

• Remove stagnant water. Mosquitoes breed their eggs in stagnant water. Remove any stagnant water in your house as much as possible. Check everything that is capable of keeping even a cup of water like tires, cans, plastics, pot plates, air-conditioning unit receptacles/trays, and bamboo poles. If you are stocking water, keep them covered all the time.
• Replace water in the flower vase at least every other day. If the vase has stocked up water for so long, remove the water and clean the vase by scrubbing it inside and on its surface. Wash the roots and flowers, too. These can also keep water, enough for breeding mosquitoes.
• Apply insecticides around the house, especially on dark spots. Granular insecticides are very useful for vases, roof gutters, and gully traps. If you will use spray insecticide, make sure that no one is in the house for at least two hours after spraying.
• Keep indoors especially about two hours after the sunrise and two hours before sunset. The female Aedes mosquito bites anytime of the day but those hours are the peak hours.

As the old saying goes, “prevention is better than cure.” So as much as possible, take part in preventing the spread of this disease. You’ll never know how many lives will be saved by doing your part. Your life and those of your children and loved ones might be saved because of these simple efforts.

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• Dengue Alert—Things you need to know about dengue