The Dangers of Dengue

(By: Mary A

Turalba MD)

We hear it in the news. With the rainy season officially here, dengue cases are on the rise again. The Department of Health recently warned the public about the rising number of dengue cases in the country, which reached 11,803 cases from January 1 to March 27, 2010 alone. The DOH said the number of dengue cases was 61% higher than the 7,335 cases recorded during the same period last year.

In Iloilo, there were 258 reported cases of Dengue with four deaths since January this year. In Negros Occidental, the incidence of dengue fever went up by 145 percent compared to the same period last year with 400 registered dengue fever cases. During the rainy season, we expect more and more people to be diagnosed with Dengue Fever. Dengue can kill! But just what is Dengue?

Dengue is an acute mosquito-borne infectious disease which manifests initially with fever and sometimes may lead to a potentially lethal complication called Dengue Hemorrhagic Fever (DHF). Dengue Hemorrhagic Fever (DHF) was first recognized in the 1950s during dengue epidemics in the Philippines and Thailand. Today Dengue Hemorrhagic Fever is a leading cause of serious illness and death among children in the Philippines and some other Asian countries.

Dengue viruses are transmitted to humans through the bites of infective Aedes mosquitoes. These mosquitoes are day-biting and generally acquire the virus while feeding on the blood of an infected person. The Aedes mosquitoes lay their eggs in clear and stagnant water found in flower vases, cans, rain barrels, old rubber tires, etc.

There are four distinct, but closely related dengue virus stereotypes that cause dengue. Recovery from infection by one provides lifelong immunity against that virus but confers only partial and transient protection against subsequent infection by the other three viruses. In fact, there is good evidence that sequential infection increase the risk of developing DHF.

Dengue virus infections are common in tropical and sub-tropical areas of the world. Symptoms appear 3-14 days after the infective bite. Dengue fever can affect anyone at any time including infants, adults and the elderly.

The signs and symptoms of dengue fever include sudden onset of fever which may last 2-7 days, prostration, severe muscle and joint pain (victims of dengue often have contortions due to the intense joint and muscle pain, hence the nickname “breakbone” fever), pain behind the eyes, headache, weakness, skin rashes, and nose bleeding when fever starts to subside. The classic dengue rash is a generalized macular-papular rash with islands of sparing. A hemorrhagic rash of characteristically bright red pinpoint spots, known as petechiae can occur later during the illness and is associated with thrombocytopenia (low platelet count). It usually appears first on the lower limbs and the chest. In some patients, it spreads to cover most of the body.

Dengue Hemorrhagic Fever (DHF), on the other hand, is a potentially deadly complication that is characterized by high fever, vomiting, abdominal pain, often with enlargement of the liver, bleeding or other evidence of hemorrhage in the body. Petechiae (small red or purple blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. Frequently, the illness begins with a sudden rise in temperature accompanied by facial flush and other flu-like symptoms. The fever usually continues for two to seven days and can be as high as 41 degrees Celsius, possibly with convulsions and other complications. It can lead to fatal shock (dengue shock syndrome) and eventually death.

With the rainy season already begun, it is very important for everyone to take precautions against the killer disease dengue. But what can we do? Get rid of the breeding places of the Aedes mosquito. Get rid of items that can collect rain or run-off water such as old rubber tires or tin cans. Accumulated water form trees and flowers should be drained. Regularly change the water in flower vases and pet water containers. Make sure water containers are properly covered. It is important to keep surroundings clean, dry and free from stagnant water, where dengue-carrying mosquitoes breed. When outdoors during times when mosquitoes are biting, one should wear long-sleeved shirts and long pants. Know the signs and symptoms of dengue. If you or someone you love have symptoms of Dengue like high-grade fever for 2 or more days, consult your doctor. Presently, there is neither available vaccine nor specific treatment for dengue, but appropriate medical care frequently saves the lives of patients with the more serious Dengue Hemorrhagic Fever.

For more information, call our hotline at 751-(HWAY) 4929.

*Dra. Mary A

Turalba holds her clinic at Healthway-SM the Block in North Edsa on Tuesdays and Thursdays from 9:00 AM - 6:00 PM and on Wednesdays from 8:00 AM - 2:00 PM.