Dengue fever is a mosquito-borne viral infection that affects millions of people worldwide, particularly in tropical and subtropical regions. The disease is characterized by flu-like symptoms, and in severe cases, it can lead to life-threatening complications. Early detection and proper management are crucial in reducing the risk of severe illness and mortality. In this article, we will explore the symptoms, warning signs, and treatment options for dengue fever.

Dengue fever can be suspected in individuals who present with fever and at least two of the following symptoms: nausea, vomiting, rash, myalgia (muscle pain), headache, retro-orbital pain (pain behind the eyes), arthralgia (joint pain), and hemorrhagic manifestations. It is important to consider dengue fever if the person lives in or has traveled to a dengue-endemic area.

While most cases of dengue fever are mild and self-limiting, certain warning signs indicate the need for immediate medical attention. These warning signs include abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation (such as pleural effusion or ascites), mucosal bleeding (e.g., gum bleeding, epistaxis, or melena), liver enlargement, and signs of shock (Dengue Shock Syndrome - DSS).

For individuals with probable dengue fever who do not exhibit warning signs, symptomatic ambulatory treatment is recommended. This includes the use of paracetamol to reduce fever (avoiding NSAIDs), daily monitoring of clinical symptoms, packed cell volume (PCV), and platelet count. Additionally, ensuring proper airway, breathing, and circulation is essential.

Referral to a healthcare facility is necessary when certain conditions arise, such as cold extremities and restlessness, acute abdominal pain, decreased urine output, bleeding with hemoconcentration, rising PCV with thrombocytopenia but without clinical symptoms, or if there is no improvement in the patient's condition.

Assessment of Shock and Fluid Management:

In cases where shock is present, prompt assessment of vital signs is crucial. Intravenous fluid therapy is initiated, aiming to achieve specific goals based on the patient's response. Repeated assessments and adjustments in fluid management are made to ensure stability. Platelet transfusion and packed red cells may be indicated in cases of severe bleeding or shock.

Platelet transfusion may be necessary in cases of prolonged shock, prophylactic transfusion for platelet count less than 10,000/cumm, or systemic massive bleeding. Packed red cells are given in situations involving significant blood loss, refractory shock, or fluid overload. Fresh frozen plasma or cryoprecipitate may be used to manage coagulopathy with bleeding.

Dengue fever is a prevalent mosquito-borne viral infection with potentially severe consequences. Recognizing the symptoms, understanding the warning signs, and seeking appropriate medical care are vital for successful management. Early detection and proper treatment can significantly reduce the risk of complications associated with dengue fever. If you or someone you know experiences symptoms or warning signs, it is crucial to seek medical attention promptly. Stay informed, protect yourself from mosquito bites, and help prevent the spread of dengue fever in your community.

By following the guidelines provided by healthcare professionals and raising awareness about dengue fever, we can work together to mitigate the impact of this disease. Stay informed, protect yourself from mosquito bites, and help prevent the spread of dengue fever in your community.

Remember, early detection and proper management are key to minimizing the complications of dengue fever. Stay vigilant, seek medical attention when necessary, and take steps to prevent mosquito breeding grounds to protect yourself and your loved ones.

References:

World Health Organization. Integrated Management of Childhood Illness: distance learning course. 

Mahajan P, et al. Consensus Guidelines on Evaluation and Management of the Febrile Child Presenting to the Emergency Department in India. Indian Pediatrats 2017; 54: 652-60.

World Health Organization 2015. Government of India National Guidelines for Clinical Management of Dengue Fever.

Kliegman RM (ed). Nelson Textbook of Pediatrics 20th edition, 2016.