Modern Medicine: Dengue Fever and the unseasonable rain


If COVID-19 wasn’t enough to contend with, last week the powers that be are now advising that Dengue fever is on the rise, and the number of deaths is rising with it. Combinations of Covid and Dengue are particularly lethal.

The following scenario is being acted out while you read this and there’s not too much can be done. The rains are followed by floods. Surface water collects at various places and this is the breeding ground for all types of mosquitoes.

It is important that we are aware of, and protect ourselves against, dengue fever and dengue hemorrhagic fever which comes with the mosquitoes during the rainy season. It has been observed that there is an increasing number of deaths from this fever each year. We have become so aware of Covid that we have been somewhat lax in protecting ourselves against other infestations such as Dengue.

Dengue is transmitted to humans by two types of mosquito carriers: Aedes aegypti and Aedes albopictus. They breed in clean, stagnant water and bite during the day. After biting, the Dengue virus in the mosquito’s saliva is transferred into the victim’s body.

People infected with dengue fever will have a sudden onset of fever for 2-7 days, severe headache, muscle and joint pain, etc. The symptoms are similar to those of influenza except there is no stuffy nose, sore throat or cough. Some may experience nausea, vomiting, abdominal pain, diarrhea, cold hands and feet.

The most serious symptoms include reddening of the face and bleeding into the skin appearing as small red or purplish dots on the body, arms and legs 2-3 days after becoming aware of the illness. The dots will disappear within 3-4 days. Severe cases may have bleeding through the nose, bleeding from the gum, vomiting blood, and the passage of black stools.  For cases showing Dengue shock syndrome, the patient will not have a high fever but will be lethargic with low urination, cold and clammy skin, and even go unconscious. These symptoms are very serious and can lead to death. These patients should be taken to see the doctor right away.

It is very important for those who are infected by dengue fever to avoid aspirin, Ibuprofen or non-steroidal anti-inflammatory (NSAID) medications. These drugs are often used to treat pain and fever, but in this case, they may actually aggravate the bleeding in the stomach or cause liver failure.

Initial treatment for dengue fever is to reduce the body temperature by applying wet towels. Paracetamol is the drug of choice to bring down fever and relieve joint pain. Some sources advocate fruit juice with a little bit of salt instead of water and should eat only liquid food. I am not convinced of this treatment regimen (basically sugar and salt).

Today the diagnosis of dengue is simple, using PCR and Dengue NS1 Antigen. Both methods give accurate results within 1 day which helps reduce the risk of death in these patients.

The best way of avoiding Dengue is to ensure there is no standing water close to your house where the mosquito larvae can grow. This will include water saucers under plants and even animal drinking water. Another favorite source of stagnant water is in discarded car tyres. Personal protection includes wearing long sleeved shirts and trousers, and the use of mosquito repellent incorporating the chemical DEET.