A complete details of dengue fever

A viral disease spread by mosquitoes. Dengue fever is caused by flaviviruses belonging to arbovirus group 'B'. This disease is more common in warm and temperate regions. A. D. Although a disease with symptoms very similar to dengue fever was reported from China in 992, the first recorded dengue fever was an epidemic in the French West Indies in 1635. Al Jabarti, Cairo in 1779, David Baylon, Batavia (Jakarta) in the same year, and Benjamin Rush, Philadelphia, Philadelphia in 1780 are the most notable studies on this disease. Subsequently, from other parts of the world, diseases with symptoms very similar to dengue appeared in epidemic form in the 18th century. In the 1930s there were frequent outbreaks of the disease among the Spanish-speaking population of the Caribbean. The Spanish word 'dengue' was given to the disease because patients were careful to walk with their legs crossed so as not to feel pain. Also called Dandy Fever in English. The disease is known in different regions by different names such as break bone fever, dengue, dunga, seven day fever, Bonon, Chapennonada, Homa Mguu.

A viral disease spread by mosquitoes. Dengue fever is caused by flaviviruses belonging to arbovirus group 'B'. This disease is more common in warm and temperate regions. A. D. Although a disease with symptoms very similar to dengue fever was reported from China in 992, the first recorded dengue fever was an epidemic in the French West Indies in 1635. Al Jabarti, Cairo in 1779, David Baylon, Batavia (Jakarta) in the same year, and Benjamin Rush, Philadelphia, Philadelphia in 1780 are the most notable studies on this disease. Subsequently, from other parts of the world, diseases with symptoms very similar to dengue appeared in epidemic form in the 18th century. In the 1930s there were frequent outbreaks of the disease among the Spanish-speaking population of the Caribbean. The Spanish word 'dengue' was given to the disease because patients were careful to walk with their legs crossed so as not to feel pain. Also called Dandy Fever in English. The disease is known in different regions by different names such as break bone fever, dengue, dunga, seven day fever.

Hospitals in Kerala are filled with fever patients every year. The same thing happened this time. Different types of fevers from common cold to dengue fever. Dengue, which claimed many lives in Kerala, could have been prevented if a little more attention had been paid. Mosquitoes are remarkably resilient species. Although there are more than 3000 of them, the main ones found in our country are four types. Anopheles which spreads malaria, Culex which spreads Japanese fever and filariasis, Aedes which causes dengue fever and chicken pox, Man anoides which causes Brugian filariasis etc.

India ranks first in the world with over 21,000 dengue cases per year. Industrialization, changing lifestyles and unscientific use of japa are the main reasons for the increase in mosquitoes.

Pathogens .

Flaviviruses belonging to the Flaviviridae family are pathogens. 4 serotypes (dengue 1, dengue 2, dengue 3 and dengue 4) have been identified. They are microscopic viruses that contain single-stranded ribonucleic acid, only about 50 nanometers in size. Dengueviruses are among the flavivirus genus that have the most unique biological characteristics. In addition to infected humans and vector-carrying mosquitoes, such viruses have also been found in some species of monkeys. Infection with one serotype of dengue viruses confers lifelong immunity to that serotype in humans. But it does not protect against other serotypes.

Dengue fever causes three types of symptoms.

Common dengue fever (classic dengue fever),

Dengue hemorrhagic fever,

Dengue fever is classified as dengue shock syndrome.

When female Aedes mosquitoes feed on the blood of a dengue patient, the pathogenic viruses enter the mosquito. Within 8-10 days, the viruses enter the mosquito's salivary gland. These mosquitoes feed on the blood of a healthy person and introduce pathogens into the body through wounds. Symptoms begin to appear 3-14 days after the pathogen enters the human body (3-4 days on average).

Sudden high fever, excruciating headache, pain behind the eyeballs, joint and muscle pain, loss of appetite, loss of taste, nausea and vomiting are common symptoms of dengue fever. The disease is also known as 'break bone fever' because of the 'bone-crushing pain'. Another feature of this disease is that after three to four days of high fever, there are no symptoms for a few days and then the fever reappears. For this reason, this disease is also called 'saddle bag syndrome'

Dengue fever usually occurs in people infected with any type of dengue virus. Dengue hemorrhagic fever occurs when multiple species of dengue virus infect the same person. This is a very deadly form of dengue fever. In addition to normal dengue symptoms, symptoms such as bleeding from the nose, mouth and gums, frequent vomiting with or without blood, restlessness, insomnia, excessive thirst, decreased pulse rate, difficulty breathing and blood spots on the skin are seen at this stage. Bleeding is caused by a decrease in the number of platelets in the blood.

In dengue fever with shock, the patient's blood pressure is very low and the pulse is disturbed. Death occurs due to loss of plasma and blood from the body. Dengue with hemorrhagic disease and dengue with shock are more likely to re-infect a person once infected with dengue.

There is no effective vaccine for dengue fever. It is customary to understand the symptoms and give treatment. Replenishment of body fluids and transfusion of blood or platelets are methods used to reduce the severity of the disease and prevent death. Aspirin, which is given to heart patients and others to prevent blood clots, should not be used by patients. This is because they increase the risk of bleeding. Dengue-prone areas tend to have more hemorrhagic dengue cases over time. Therefore, the public health system may become more vigilant in the coming years

Disease-carrying mosquitoes        

Aedes Aegypti mosquitoes, commonly known as tiger mosquitoes, are the main vectors of dengue fever. Studies indicate that 'Aedes albopictus' mosquitoes also play an important role in the spread of the disease. Aedes nivius mosquitoes transmit dengue fever in Malaysia and Vietnam. Aedes samoans and Aedes fijiensis mosquitoes are suspected of spreading the disease in Samoa and Fiji. Aedes polynesianes and Aedes scutellaris mosquitoes have been shown to transmit the disease in the Pacific Islands. 'Aedes rotume', 'Aedes hybridius', 'Aedes obe', 'Aedes kuki', 'Aedes pseudoscotullaris', Mosquitoes of the 'Aedes hackansoni' species are thought to spread the disease in different parts of the world. In India, Aedes aegypti mosquitoes play a major role in the transmission of dengue fever. Through studies conducted in various districts of Kerala from 1998 to 2002, it has been found that Aedes aegypti mosquitoes are breeding in Thiruvananthapuram, Ernakulam and Kozhikode. It can be said that all 14 districts of Kerala are breeding grounds for Aedes albopictus mosquitoes. With the arrival of the rainy season (intermittent rains), the increase in the number of this species of mosquito and the spread of disease accelerates. House/premises index, container index, The probability of disease transmission in an area is understood based on the source-household ratio index or Breteau index. These indices are helpful in estimating the density of Aedes mosquitoes in an area, predicting the risk of disease transmission and taking prompt measures for mosquito control and thus disease eradication. From 1999 to 2002, it has been found that Aedes albopictus mosquitoes are the main breeders in Alappuzha district. Aedes aegypti mosquitoes do not breed here. This indicates that Aedes albopictus mosquitoes are the main vectors here.

Aedes mosquitoes, which feed on blood during the day, prefer to lay their eggs at night. Instead of laying eggs on the surface of the water, they tend to lay their eggs on wet surfaces above the water surface. The eggs of this species of mosquito can survive in the absence of water for months without any disturbance. The characteristic of these mosquitoes is that the eggs that are laid once hatch according to the availability of water. Eggs that have survived dry weather are frequently submerged in water to encourage hatching. These mosquitoes lay their eggs in fresh water while resting inside or near the house. Pot, bottle, bottle, tire, barrel, water tank, earthen pot, ram stone, flower pot, water cooler, They spawn and multiply in the water collected in the tap/pot attached to the tree to collect the rubber. This species of mosquito also lays its eggs in water in banana leaves, cement roofs, bottle caps attached to walls, pits in unused cement blocks, cement tanks, shallow wells, and tree trunks. Mosquitoes, which carry the disease, transmit the disease to humans throughout their lives. Through a process called 'transovarian transmission', they are able to maintain the disease-carrying capacity for generations. Therefore, they can become disease carriers without drinking the blood of infected people. Factors influencing the transmission capacity of Aedes mosquitoes in an area include the number of mosquitoes, their lifespan, and the number of pathogens in their bodies. Aedes mosquitoes can travel 50 seconds per second. m. Can fly far. In urban areas where houses and other buildings are congested, their movement is 100-400 m. up to But with the development of transportation facilities, it has become clear that these species of mosquitoes are spreading diseases by traveling through planes, ships, trains and other vehicles and reaching faraway places.

Intermittent rainfall in tropical countries and air temperatures ranging from 20-32° are favorable for the growth and survival of Aedes mosquitoes. At the same time, even when the air temperature is below 10°, the disease can be transmitted. Aedes albopictus mosquitoes in the Americas and Europe have been found to have developed the capacity.

Disease spread globally.

Since 1827, such epidemics had occurred sporadically in the Caribbean-Gulf and Atlantic regions, but it was only in 1941–42 that the viruses responsible for the disease were discovered in an epidemic that appeared in Panama.

In 1897, an epidemic of hemorrhagic fever closely resembling dengue fever was reported in North Queensland (Australia). Hemorrhagic disease with similar symptoms has been reported in Hawaii in 1903, in Greece in 1928, and in Taiwan in 1931.

About forty years ago in the Caribbean and South. There are reports that dengue fever has also spread in the northern regions of America. Aruba, Barbados, Brazil, Colombia, Dominican Republic, El Salvador, French Guiana, Guatemala, Guatilupe, Honduras, Trinidad, Jamaica, Mexico, Nicaragua, Cuba and Venezuela are places where dengue is at risk.

The tropical regions of North Africa and the Eastern Mediterranean are areas that are susceptible to dengue fever. Since 1967, dengue has been endemic in Angola, Burkina Faso, Comoros, Djibouti, Ethiopia, Guyana, Guinea, Kenya, Madagascar, Mauritius, Mozambique, Nigeria, Pakistan, Saudi Arabia, Senegal, Seychelles, Somalia, Sudan, and the United Republic of Tanzania.

The Western Pacific countries such as Singapore, Cambodia, China, Laos, Malaysia, New Caledonia, Palo, the Philippines, Tahiti, Vietnam, and Fiji and the South-East Asian countries such as India, Indonesia, Maldives, Myanmar, Sri Lanka, and Thailand are dengue-threatened areas.

Dengue fever has become an international public health problem today. Statistics indicate that the severity of dengue fever has increased annually in South-East Asian countries since World War II. Over the last thirty years, the disease has spread to more places, surpassing all other mosquito-borne diseases in terms of morbidity and mortality. Today, this disease is wreaking havoc in more than 100 countries. About 40 per cent of the world's population (250-300 crores) are at risk of dengue fever. About 10 crore people are infected every year. Out of this, about 5 lakh people are suffering from hemorrhagic dengue fever. Global studies indicate that more than 95 percent of dengue cases are children under the age of fifteen. The average death rate due to dengue fever is 5 per cent.

Epidemic in India

Although an epidemic with symptoms closely resembling dengue fever was reported in India in 1813, the disease was first confirmed in India in 1945 when a medical researcher named Dabbin isolated the causative virus from infected soldiers in Calcutta. After 1960, the disease appeared as an epidemic in various parts of India and claimed many lives. A dengue outbreak in Delhi in 1996 infected 10,252 people and resulted in 423 deaths.

Kerala, Karnataka and Tamil Nadu. The threat of dengue fever is common in the states of Orissa, Gujarat, Maharashtra, Uttar Pradesh, Punjab, Haryana, Delhi and Rajasthan.

Disease spread in Kerala.

Researchers at the Poona-based National Institute of Virology have reported the presence of arboviruses, including dengue viruses, in Kerala (1973). It is worth noting that the disease appeared in the form of an epidemic in the districts of Thrissur and Palakkad in 1974 and it was possible to isolate the causative agent, Dengue-2 viruses. Although many studies on such viruses have been conducted in various parts of India, opportunities for such studies have been limited in Kerala. The observations made by researchers at Thiruvananthapuram-based Sreechithira Tirunal Medical Center regarding dengue viruses in southern Kerala are noteworthy. In this study, Japanese encephalitis, West Nile, chicken pox,

Although mosquito-borne diseases, including malaria, have killed many people in Kerala, dengue was not a major threat until recently. In 1997, 14 people were infected with dengue fever in Kottayam district and 4 people died. In 1998, in Kottayam district, when blood was collected from patients presenting with symptoms such as severe fever and excruciating headache and tested at the National Institute of Virology, Pune, 57.2 percent of them were infected. People have been confirmed to have dengue fever. It must be assumed that the disease-carrying mosquitoes and disease-carrying viruses were silently preparing for another war in Kerala until 1997. In 2003, under ideal conditions, the disease spread to all districts of Kerala, infecting 1560 people and causing 35 deaths (report received up to 21 Jul. 2003). Information about this disease which has appeared in Kerala since 1997 is given in Table II.

Ways to prevent the spread of disease

It is preferable to treat infected people by placing them inside a mosquito net. This will help prevent mosquitoes from becoming disease carriers by drinking blood from them. Mosquito nets, mosquito-proof screens, and mosquito nets that are not harmful to humans are personal protective measures.

Comprehensive mosquito control and elimination of mosquito breeding sites is the only way to control dengue fever. Destruction of such sources is an effective way to eliminate the species of mosquitoes that like to breed in standing water in plastic containers, tins, cans, etc., which are discarded in the open, as well as wooden crates and pieces of utensils.

Insecticide application, fogging, and biological control are useful in controlling the pest. Practical preventive measures implemented by the health department, local self-government institutions, voluntary organizations and public health workers with emphasis on awareness will be an asset for disease control.

Credit: Dr. R. Rajendran

Precautions against dengue fever

During the rainy season, the number of people who come to the hospital due to dengue fever is more. The number of people seeking medical help due to dengue fever is increasing in the capital and nearby districts. There are four types of dengue virus namely dengue 1, 2, 3 and 4. Dengue fever is spread by Aedes aegypti mosquitoes. Symptoms begin two to seven days after a mosquito bite.

Symptoms

Symptoms include sudden onset of high fever, headache, pain behind the eyes, body aches and back pain. Dengue fever is characterized by severe bone-chilling pain. Symptoms include red spots on the limbs and body, vomiting and loss of appetite.

As the severity of the fever increases, the platelets in the body decrease. The function of platelets is to help blood clot. Therefore, there is a risk of bleeding when the platelets are low. Bleeding can be life-threatening anywhere, such as in the internal organs, brain, or intestines. A decrease in platelets is seen for 2–3 days after fever. If this happens, the patient will need to be given platelets.

Do not self-medicate

Do not self-treat fever with the above symptoms. Drink plenty of water. Avoid dehydration. Fruits and fruit juices can be used.
Avoid painkillers. Bleeding, incessant vomiting, very low platelet count, shortness of breath, and decreased urine output are more severe. Treat in hospital.

Antibiotics and antivirals are ineffective against dengue fever. Dengue vaccine is not yet available in India. If you live in an area with dengue fever, there are likely dengue-carrying mosquitoes in that area.

Let's see without coming back

A person who has been infected with dengue once, several days later, gets dengue again due to another virus and becomes more serious. This is called dengue hemorrhagic fever and dengue shock syndrome. In such people, excessive bleeding can occur and blood pressure can become very low and severe. 

Precaution

Since the disease is spread only by mosquitoes, the most effective preventive measures are killing the mosquito and avoiding mosquito bites. Also, keep the house and its surroundings clean, and if there is water standing around the house such as logs, husks, tires and containers, during the rainy season, keep them under water. Because dengue mosquitoes lay their eggs in them. That is why every rainy season mosquitoes increase and dengue patients increase. So our goal is to destroy the mosquito and prevent dengue fever

Credit: Dr. Dhanya V Unnikrishnan

Symptoms

• 
  
• If the early symptoms of the disease are not recognized and treated, things can turn serious.
• Dengue fever is mostly seen in older children and middle-aged people.
  
• Symptoms start to appear within 5-8 days after the pathogen enters the body.
• High fever, headache, muscle and bone pain, skin discoloration, pain behind the eyes, loss of appetite, constipation, black stools, abdominal pain, and sore throat are the main symptoms.
• Fever can last up to ten days.
• In addition to these symptoms, dengue hemorrhagic fever also presents with a progressive decrease in platelets in the blood, bleeding gums, nosebleeds, and red lumps on the shoulder.

Diagnosis

The patient's external symptoms (fever, headache, body aches) were assessed

ELISA (Enzyme Linked Immuno Sorbent Assay) Virus Antigen Detection

PCR (Polymerac Chain Reaction)

Treatment

Prevention methods