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23. What should the doctors treating dengue do? Patients suspected to be suffering from dengue haemorrhagic fever or dengue shock syndrome should be admitted to a hospital without delay. The progress of these patients should be monitored regularly at 1-2 hours interval. Platelet counts and haematocrits should be monitored repeatedly to review the progress of patients. If the haematocrit levels fall dangerously then a blood transfusion should be considered. A fall of more than 20 % as compared to previous levels may be an indication for transfusion. If the haematocrit values rise, the patient should be given fluids intravenously and the fluids carefully monitored to ensure that the patient does not get excess fluids. A rise of more than 20 % as compared to previous levels may be an indication for IV fluids. The doctor should decide based on best 24. What should the doctors treating dengue avoid? Do not prescribe Aspirin and Brufen or any other medicine that reduces the platelets or increases the tendency to bleed. Avoid giving IV (Intra Venous) fluids unless the patient is bleeding or the haematocrit level is rising progressively. Avoid rushing into giving blood transfusion unless the haematocrit is falling dangerously. Do not give platelet transfusion unless the platelet count is very low or unless there is 25. What is your advice regarding reporting of dengue? All suspected or probable dengue cases should be reported to the health authorities. The health authorities do further confirmation of the cases. Seek their guidance on blood collection and transportation of samples from suspected/probable cases of dengue.
26. What can the community do to prevent dengue? In fact, the community participation is the key factor in dengue prevention. As elaborated above, prevention of dengue relies heavily on preventing the mosquito (Aedes aegypti and Aedes albopictus) that transmits dengue from breeding inside and in the vicinity of homes. Every household can undertake the very simple measures to prevent existing water collections from becoming places for breeding of Ae. aegypti by draining out water from various containers, by regular changing of water plus cleaning flower vases and other items or, in the case of unused items, by discarding/destroying them. Since the mosquito does not travel far, “house cleaning” by all members of a community will ensure that no breeding places exist, preventing dengue from occurring. The main strategy in the prevention and control of dengue is “source reduction”, or prevention of breeding places, http://www.searo.who.int/EN/Section10/Section332/Section1026.htmContact: Dr.U.S.N. MURTY, Center Co-ordinator, Head Biology Division, IICT, in blood haematocrit. Patients with dengue may not have a high haematocrit if the person was anaemic to start with.
6. Can you get dengue again after suffering from it once? Dengue infection is caused by a virus, often manifests as dengue It is possible to get dengue more than once. Dengue can occur because fever. Occasionally the patient suffering from dengue may develop of 4 different but related strains of dengue virus. If a person has bleeding from sites like nose, gums or skin. Sometimes, the patient suffered from one virus, there can be a repeat occurrence of dengue may have coffee ground vomiting or black stools which indicates if a different strain is involved subsequently. Being affected by one bleeding in gastro intestinal tracts. Rarely the patient suffering from strain offers no protection against the others. A person can suffer dengue may develop shock, then it is called dengue shock syndrome from dengue more than once in her/his lifetime.
2. Is dengue an emerging infectious disease? Dengue fever occurs following the bite of an infected mosquito Aedes Yes. All types of Dengue viruses are re-emerging worldwide and aegypti ((Tiger mosquito) )and Ae.albopictus which is characterized causing larger and more frequent epidemics, especially in cities in by a peculiar white spotted body and legs and is easy to recognize the tropics. Several factors are contributing to the resurgence of even by layman. It breeds in clean water and has a flight range of only 100 – 200 metres. The mosquito gets the Dengue virus after · No effective mosquito control efforts are underway in most biting a human being infected with dengue virus.
8. Can I get dengue fever from another person? Public health systems to detect and control epidemics are Dengue does not spread directly from person to person. It is only spread through the bite of an infected mosquito.
Rapid growth of cities in tropical countries has led to overcrowding, urban decay, and substandard sanitation, allowing more 9. When does dengue develop after getting the infection? mosquitoes to live closer to more people.
After the entry of the virus in the person, it multiplies in the lymph · The increase in non-biodegradable plastic packaging and glands in the body. The symptoms develop when the virus has discarded tyres is creating new breeding sites for mosquitoes.
multiplied in sufficient numbers to cause the symptoms. This happens · Increased air travel is helping people infected with dengue viruses generally about 4-6 days after getting infected with the virus.
10. Can people suffer from dengue and not appear ill? Yes. There are many people who are infected with the virus and do Dengue viruses occur in most tropical areas of the world. Dengue is not suffer from any signs or symptoms of the disease. For every common in Africa, Asia, the Pacific, Australia, and the Americas. It is patient with symptoms and signs there may be 4-5 persons with no widespread in the Caribbean basin. Dengue is most common in cities symptoms or with very mild symptoms.
but can also be found in rural areas. It is rarely found in mountainous 11. Is it possible to treat dengue at home? Most patients with dengue fever can be treated at home. They should take rest, drink plenty of fluids that are available at home and eat Dengue should be suspected when you have sudden onset of fever.
nutritious diet. Whenever available, Oral Rehydration Salt/ORS The fever is high 103-105 degrees F or 39-40 degrees C. It is (commonly used in treating diarrhoea) is preferable. Sufficient fluid accompanied with severe headache (mostly in the forehead), pain intake is very important and becomes more important in case DF behind the eyes, body aches and pains, rash on the skin and nausea progresses into DHF or DSS where loss of body fluid / blood is the or vomiting. The fever lasts for 5-7 days. In some patients, fever most salient feature.It is important to look for danger signs and contact comes down on 3rd or 4th day but comes back. All the above symptoms the doctor as soon as any one or more of these are found.
and signs may not be present in the patient. The patient feels much discomfort after the illness. The severity of the joint pain has given 12. What is the possible treatment for Dengue? dengue the name “breakbone fever”.
Like most viral diseases, there is no specific cure for dengue fever.
Antibiotics do not help. Paracetamol (can be purchased without 5. What is the difference between suspected and probable prescription) is the drug of choice to bring down fever and joint pain.
Other medicines such as Aspirin and Brufen should be avoided since Dengue patients are characterized by reduced platelets or an increase they can increase the risk of bleeding. Doctors should be very careful when prescribing medicines. Any medicines that decrease platelets female mosquito lays her eggs in water containers in and around the homes, and other dwellings. These eggs will develop, become larvae, and further develop into adults in about 10 days.
The infection can become dangerous since it may cause damage to 19. How can the multiplication of mosquitoes be reduced? the blood vessels. The damage may range from increased permeability Dengue mosquitoes breed in stored, exposed water collections.
of the blood vessels, causing leakage of blood fluid/plasma into various Favoured places for breeding are barrels, drums, jars, pots, buckets, organs to completely broken blood vessels that causes bleeding. The flower vases, plant saucers, tanks, discarded bottles, tins, tyres, water symptoms and signs of dengue haemorrhagic fever and dengue shock coolers etc. To prevent the mosquitoes from multiplying, drain out syndrome are related to damage to the blood vessels and derangement the water from desert coolers/window air coolers (when not in use), in functioning in components of blood that help it to clot.
tanks, barrels, drums, buckets etc. Remove all objects containing water (e.g. plant saucers etc.) from the house. Collect and destroy discarded containers in which water collects e.g. bottles, plastic bags, People who suffer from dengue fever have no risk of death but some tins, used tyres etc. In case it is not possible to drain out various of them develop Dengue Haemorrhagic Fever or Dengue Shock water collections or to fully cover them, use TEMEPHOS, an insecticide, Syndrome. In some of these cases death can occur. With proper (brand name Abate) 1 part per million according to the local guidelines treatment, the patients with Dengue haemorrhagic fever and dengue to prevent larvae from developing into adults.
shock syndrome can recover fully. Good treatment provided in time 20. How can I prevent mosquito bites to prevent dengue? 15. When should a patient suffering from Dengue go to the There is no way to tell if a mosquito is carrying the dengue virus.
Therefore, people must protect themselves from all mosquito bites.
Generally the progress towards dengue haemorrhagic fever or dengue Dengue mosquitoes bite during the daytime throughout the day.
shock syndrome occur after 3-5 days of fever. At this time, fever Highest biting intensity is about 2 hours after sunrise and before often comes down. This may mislead many of us to believe that the sunset. Wear full sleeves clothes and long dresses to cover as much patient is heading towards recovery. In fact, this is the most dangerous of your body as possible. Use repellents- be careful in using them on period that requires high vigilance from care-givers. The signs and young children and old people. Use mosquito coils and electric vapour symptoms that should be looked for are severe pain in the abdomen, mats during the daytime also to prevent dengue. Use mosquito nets persistent vomiting, bleeding from any site like, bleeding in the skin to protect children, old people and others who may rest during the appearing as small red or purplish spots, nose bleed, bleeding from day. The effectiveness of these nets can be improved by treating gums, passage of black stools like coal tar. Bring the patient to the them with permethrin (pyrethroid insecticide). This bed-net is called hospital whenever the first two signs, namely, severe pain in the Insecticide Treated Nets and are widely used in the prevention of abdomen and persistent vomiting are detected. Usually it is too late if we wait until bleeding has occurred. The most dangerous type of dengue is the dengue shock syndrome. It is recognized by signs like 21. Is there any advice for the patient with dengue fever to excessive thirst, pale and cold skin (due to very low blood pressure), prevent the spread of the disease to others? restlessness and a feeling of weakness.
The spread of dengue from a patient to others is possible. The patient should be protected from contact with the mosquito. This can be 16. Is there a vaccine to prevent dengue fever? achieved by ensuring that the patient sleeps under a bed-net. Effective A vaccine has been developed to prevent dengue fever but it is still mosquito repellents are used where the patient is being provided under trial. It is not yet available in the market. Scientific progress is care. This will prevent the mosquito from biting the patient and from likely to help in prevention of dengue fever by vaccination in the getting infected and spreading it to others.
17. Are there any long- term ill effects of dengue fever? 22. What is your advice on travel if there is an outbreak of Most people who suffer from dengue fever recover in 1-2 weeks time.
Some may feel tired for several weeks. However, if symptoms persist There is no travel restriction. However, you should be aware of what after this period, consult a doctor.
to do if you are travelling an area where dengue has been reported.
18. Where does the mosquito that spreads dengue live? This includes observing prevention measures described in these The highly domestic mosquito Aedes aegypti rests indoors, in closets frequently asked questions and answers and reporting to the doctor and other dark places. Outside it rests in cool and shaded places. The if you have fever and are worried that it might be dengue fever.

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