Dengue: In August 2018, Iloilo City was declared in a “state of calamity” due to dengue. July 2019, Health Secretary Francisco T. Duque III has ordered an intensified response in Western Visayas as cases increased 259% to 18,834 from January 1 to July 13. In this article, we will talk about the disease, its etiology, symptoms, treatment, and prevention.
What is Dengue
Dengue, according to the World Health Organization, is a mosquito-borne viral disease that has rapidly spread in all regions in recent years. The virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. These mosquitoes are also vectors of chikungunya, yellow fever, and Zika viruses. It is widespread throughout the tropics, with local variations in risk influenced by rainfall, temperature, relative humidity, and unplanned rapid urbanization.
Dengue causes a wide spectrum of diseases. This can range from subclinical disease (people may not know they are even infected) to severe flu-like symptoms in those infected. Although less common, some people develop severe dengue, which can be any number of complications associated with severe bleeding, organ impairment, and/or plasma leakage. Severe dengue has a higher risk of death when not managed appropriately.
Signs and Symptoms
Dengue is caused by a virus of the Flaviviridae family and there are four distinct, but closely related, serotypes of the virus that cause the disease (DENV-1, DENV-2, DENV-3 and DENV-4). Dengue is a severe, flu-like illness that affects infants, young children, and adults, but seldom causes death. Symptoms usually last for 2–7 days, after an incubation period of 4–10 days after the bite from an infected mosquito. Related: The Real Danger in Dengue.
The World Health Organization classifies dengue into 2 major categories: dengue (with/without warning signs) and severe dengue. The sub-classification (with or without warning signs) is designed to help health practitioners triage patients for hospital admission, ensuring close observation, and minimize the risk of developing the more severe type. Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms during the febrile phase:
- Severe headache
- Pain behind the eyes
- Muscle and joint pains
- Swollen glands
Severe dengue: A patient enters what is called the critical phase normally about 3-7 days after illness onset. It is at this time when the fever is dropping (below 38°C/100°F) in the patient, that warning signs associated with severe dengue can manifest. It is a potentially fatal complication, due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.
Warning signs that doctors should look for include:
- Severe abdominal pain
- Persistent vomiting
- Rapid breathing
- Bleeding gums
- Blood in vomit
If patients manifest these symptoms during the critical phase, close observation for the next 24–48 hours is essential so that proper medical care can be provided, to avoid complications and risk of death.
- Prevention of mosquito breeding: Preventing mosquitoes from accessing egg-laying habitats by environmental management and modification; Disposing of solid waste properly and removing artificial man-made habitats that can hold water; Covering, emptying, and cleaning of domestic water storage containers on a weekly basis;
Applying appropriate insecticides to water storage outdoor containers;
- Personal protection from mosquito bites: Using personal household protection measures, such as window screens, repellents, insecticide-treated materials, coils, and vaporizers. These measures must be observed during the day both inside and outside of the home (e.g.: at work/school) because the primary mosquito vectors bite throughout the day; Wearing clothing that minimizes skin exposure to mosquitoes is advised;
According to the Philippine Department of Health, it is important to: seek and destroy breeding places, secure self-protection, seek early consultation, and support spraying to prevent an impending outbreak. It was also indicated that persons more susceptible to bleeding include persons with low blood pressure, persons taking non-steroidal anti-inflammatory medication such as mefenamic, persons with peptic ulcer disease, and persons taking anticoagulants.
Safety tips prescribed by DOH: