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Dengue Fever

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It is the familiar story line of a small David felling the giant Goliath to the ground; this time it is the small Dengue virus challenging the might of the government and bringing it down to its knees.
Dengue is having a free run this autumn, thank
s to the rampant water logging and unrestricted breeding of mosquitoes.
Recognising Dengue Fever (DF): It is a viral infection transmitted by mosquitoes and presents as a sudden febrile illness of 2-7 days’ duration, with 2 or more of the following:
1. Headache
2. Pain behind the eye balls
3. Severe body aches
4. Pain in the joints
5. Rash
One of the main concerns in Dengue is the fall in platelet counts from its normal range of above 150,000. Platelets play a vital role in preventing or stopping bleeding from small blood vessels. Infusion of platelets is required only if they drop to below 20,000 or when there is active bleeding. Remember transfusions have their own risk of transmitting other infections, of allergic reactions, and their effect lasts barely a few hours.
The other concern is shock. Dengue sometimes causes fall in blood pressure due to leakage of plasma from capillaries with loss of blood volume. The Haemoglobin level paradoxically rises and urination may become less. Some patients show liver involvement (Serum ALT/AST, Bilirubin) or kidney dysfunction (increase in serum creatinine). These usually settle down with good intake of fluids and calories.
Tests for Fever: It is important to remember that all fevers may not be due to other infections such as Enteric Fever (Typhoid), malaria, and common flu that appropriate blood tests will show. It is important to get them done if fever persists for more than 2 days, because Dengue being a viral illness has no specific medicines, while typhoid and malaria have.
Tests should include Haemoglobin, PCV, white blood cell and platelet estimations, and tests for malaria, typhoid, and Dengue.
When to worry: If you have contracted Dengue, lie in bed and take rest for at least a week, drink lots of liquids (water, juices, soups, nimboo paani or ORS), take paracetamol tablets (up to 3 a day), avoid aspirin and ibuprofen as they may trigger bleeding, apply balms on your head and listen to soothing music. Consult your family physician but do not panic. Remember that there is no specific medication for Dengue and yet recovery is the rule.
Critical phase: Contrary to popular belief, the danger phase in dengue is not the 1st 2-3 days of high fever, but around the 5th to 7th day, when the fever begins to settle. Many people who are in a hurry to get back to their normal lives often crash during this phase with low BP and shock. It is therefore crucial to relax at home for a couple of days more.
And do what I am sure, the government is doing; tell yourself “This phase too shall pass”.

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