DENGUE FEVER

Dengue fever is a disease transmitted by Aedes mosquitoes, which every household tries to prevent, especially during the rainy season when stagnant water and heavy rainfall increase mosquito populations. Being bitten by an infected mosquito can transmit the virus. Dengue fever can be quite severe and potentially life-threatening. Let’s take a look at the symptoms and the stages that can be dangerous to life.

What causes dengue fever?

Dengue fever is caused by infection with the dengue virus, which has four serotypes: DEN-1, DEN-2, DEN-3, and DEN-4, transmitted by Aedes mosquitoes. People who have been infected develop lifelong immunity to the serotype they were infected with and short-term immunity to the other serotypes, lasting approximately 3–12 months.

Symptoms of dengue fever

Dengue fever usually causes a high fever lasting 2–7 days, which may reach up to 40°C. Other symptoms include loss of appetite, headache, body aches, and facial flushing.

In cases with low platelet counts, small red spots may appear on the skin due to bleeding under the skin, which is the origin of the name ‘dengue fever.’ Some patients may also experience abdominal pain due to an enlarged liver, often tender when pressing on the right rib area.

Most patients experience mild symptoms and recover on their own. However, a small number may develop severe symptoms, such as significant bleeding—particularly in the gastrointestinal tract—or fluid leakage from blood vessels leading to low blood pressure, shock, and loss of consciousness.

Stages of dengue fever

Febrile phase

Febrile Phase
During this phase, patients experience a sudden high fever lasting 2–7 days, which may reach up to 40°C. Most patients do not have a runny nose or cough, unlike with the common cold. Extremely high fever may lead to seizures. Other symptoms include severe headache and eye pain, loss of appetite, nausea, and vomiting.

Some patients may have a red throat or facial flushing. Small red spots may appear on the arms, legs, armpits, and torso, and nosebleeds may occur. Abdominal pain and black stools may be present, and an enlarged liver can cause tenderness under the right ribcage.

It is important to go to the hospital during the febrile phase to be closely monitored by a doctor.

Critical phase

Critical Phase
This phase involves plasma leakage and occurs in all patients during the critical stage, or shock. It is a short period that happens just before or concurrently with a rapid drop in fever.

Patients experiencing shock may appear restless, sweat excessively, and have cold hands and feet, with a weak and rapid pulse. Most patients remain conscious, able to communicate, and feel thirsty. If shock is treated promptly, most patients recover quickly. However, prolonged shock can lead to severe gastrointestinal bleeding.

Death can occur within 12–24 hours after shock if it is not treated properly and immediately.

Recovery phase

Recovery Phase
This phase occurs relatively soon after the fever subsides, typically 24–48 hours later. A white rash on a red background may appear, causing itching, and usually lasts 2–4 days.

Increased urination may be observed, and a slower pulse can sometimes be detected. Patients begin to drink and eat more during this phase.

Patients who have passed the danger stage will show reduced fever, remain alert, and have good consciousness.

Management of dengue fever

Drink enough water or oral rehydration solution. To check if you are drinking enough, observe the color of your urine: it should be light yellow. Dark yellow or tea-colored urine indicates that your body is still dehydrated.

Take antipyretic medication as prescribed. Use paracetamol according to the doctor’s recommended dose. Do not exceed the recommended dose, as this may cause paracetamol-induced liver inflammation.

You should see a doctor immediately if you vomit blood, have black stools, vomit excessively, are unable to drink enough fluids to meet your body’s needs, or have cold hands and feet. These symptoms are warning signs that the patient may have low blood pressure and be in shock.

When you have a fever, if you want to bathe, use warm water or wipe your body with warm water. Using cold water may cause excessive heat loss from the body and can lead to shivering.

Treatment

Treatment of dengue fever is mainly supportive and symptomatic, as there is currently no antiviral or specific cure. However, early diagnosis and close monitoring can help reduce the risk of death. The recommended supportive care includes:

Cooling the body and giving antipyretics: Paracetamol is recommended. Aspirin should be avoided, as it can affect platelet function and irritate the stomach.
Providing adequate fluids: Patients often become dehydrated due to high fever and vomiting. For those who can drink, oral rehydration solutions should be given frequently. In cases of severe dehydration, bleeding, or vomiting/black stools, hospitalization is required.
Close monitoring: Pay attention to symptoms such as abdominal pain, decreased urination, restlessness, or cold hands and feet, especially during the period when the fever is subsiding.