What is dengue fever?
Dengue fever is an ailment transmitted through the bite of a mosquito carrying one of four types of the dengue virus (DENV). This virus is predominantly present in tropical and subtropical regions, encompassing Central and South America, Africa, as well as parts of Asia and the Pacific Islands.
Contrary to common misconceptions, dengue isn’t transmissible from person to person, except in cases where it can be passed from a pregnant individual to their child. Initial infections typically manifest with mild symptoms. However, if a subsequent infection involves a different version of DENV, the risk of severe complications escalates.
What does dengue fever affect?
Dengue fever is predominantly prevalent in Central and South America, Africa, specific regions of Asia, and the Pacific Islands. While some parts of the U.S. also contend with dengue, the primary risk exists for individuals residing in or traveling to these regions, encompassing more than half of the world’s population. Notably, children and the elderly face a heightened risk of experiencing more severe illness.
How commomn is dengue fever?
Research suggests that approximately 400 million people contract dengue each year, yet the majority, around 80%, experience no symptoms.
Can you stay safe from dengue?
Yes, gaining immunity to a specific version of the dengue virus is possible after an initial infection, but here’s where it gets a bit complex—there are at least four different strains of the virus (DENV).
Your immune system operates like a skilled toolbox, recognizing infections and becoming more adept at combating them. When facing a virus, your body scans through its tools, searching for the right antibody, which acts like a key to a lock, designed to fit a specific threat. Once your body learns how to combat a particular virus, the likelihood of falling ill to that specific strain diminishes.
Post-infection with one of the four DENV strains, you’re generally protected against that specific strain. However, the antibodies formed might not perfectly fit other versions. In a phenomenon known as antibody-dependent enhancement, if you later get infected by a different DENV strain, the imperfect fit can deceive your immune system.
Here’s how it works: The antibody from the initial strain may grab onto the new strain, pulling it into your cells. Surprisingly, the new strain isn’t immediately destroyed, residing inside your cells without being recognized as harmful. This scenario makes it easier for the virus to infect you and potentially lead to more severe illness, though the exact reasons behind this process remain not fully understood.
Symptoms and Causes:
What are the symptoms of dengue fever?
While a significant number of dengue infections unfold without noticeable symptoms, those who do experience symptoms often grapple with a high fever (104°F/40°C) coupled with:
- Rash.
- Intense pain behind the eyes.
- Nausea or vomiting.
- Muscle, bone, and joint pain.
Dengue fever symptoms typically manifest four to 10 days after a mosquito bite and persist for three to seven days. It’s noteworthy that about 1 in 20 individuals with dengue may progress to severe dengue, also known as dengue hemorrhagic fever, after their initial symptoms start to fade.
Severe dengue presents a life-threatening exacerbation of dengue symptoms, with warning signs typically emerging 24 to 48 hours after the fever diminishes. Recognizing the gravity of these symptoms is crucial, as severe dengue constitutes a medical emergency that can be fatal. If you have dengue or reside in an area where dengue is prevalent, head to the nearest emergency room promptly if you experience any of the following symptoms:
- Stomach/abdominal pain.
- Frequent vomiting.
- Vomiting blood or observing blood in stool.
- Nosebleeds or bleeding gums.
- Extreme fatigue, restlessness, or irritability.
What causes of dengue fever?
Dengue fever stems from the infection with one of four dengue viruses. When a mosquito carrying the dengue virus bites, the virus infiltrates your bloodstream, initiating a replication process. The presence of the virus and your immune system’s reaction to it can induce a sense of illness.
The virus has the capacity to damage components of your blood responsible for clot formation and providing structure to your blood vessels. Combined with specific chemicals generated by your immune system, this can result in the leakage of blood from your vessels, triggering internal bleeding. These mechanisms underlie the development of severe dengue, characterized by life-threatening symptoms.
How does dengue fever spread?
Dengue is transmitted through the bites of Aedes mosquitoes, which also harbor viruses such as Zika and chikungunya. The process unfolds when a mosquito bites an individual already afflicted with dengue fever and subsequently bites another person, thus transmitting the infection. This intricate cycle underscores the potential for the mosquitoes to serve as vectors for multiple viral diseases, emphasizing the importance of effective prevention measures.
Diagnosis & Tests
How is dengue fever diagnosed?
Diagnosing dengue fever involves a blood test conducted by your healthcare provider. During this process, a blood sample is drawn from a vein and sent to a laboratory for meticulous analysis, aiming to detect signs of the dengue virus. This diagnostic procedure not only confirms the presence of the virus but also has the capability to identify the specific version among the four.
Management & Treatement
How is dengue fever treated?
Currently, there is no specific medication designed to treat dengue fever. Your healthcare provider will offer guidance on symptom management and provide recommendations on when it might be necessary to seek emergency care. This personalized approach ensures that you receive professional advice and support in managing the impact of dengue on your well-being.
How do manage the symptoms of dengue fever?
Effectively addressing dengue fever revolves around managing your symptoms, following the tailored recommendations provided by your healthcare provider. These may encompass:
- Hydration: Ensure adequate fluid intake by drinking plenty of water and other fluids to stay well-hydrated.
- Rest: Prioritize rest to support your body in its recovery process, allowing it to combat the infection more effectively.
- Pain Management: Use acetaminophen, such as Tylenol®, to alleviate pain. It’s crucial to avoid ibuprofen (e.g., Advil®) or aspirin, as these medications can elevate the risk of life-threatening internal bleeding.
This comprehensive approach, guided by your healthcare provider’s expertise, ensures a supportive and effective strategy for managing dengue symptoms.
Prevention
How can reduce the risk of dengue fever?
The two main ways to protect yourself from dengue are through avoiding mosquito bites and vaccination.
Mosquito protection:
The most effective strategy to minimize your risk of dengue fever involves safeguarding yourself from mosquito bites. Consider the following recommendations:
- Insect Repellents: Utilize EPA-registered insect repellents containing 20% to 30% DEET or alternative ingredients proven to deter Aedes mosquitoes.
- Clothing Coverage: When outdoors, particularly during the evening when mosquitoes are more active, cover exposed skin to reduce the likelihood of mosquito bites.
- Eliminate Standing Water: Mitigate breeding grounds for mosquitoes by removing standing water from containers like buckets, bird baths, and old tires. Fill in low spots where water can accumulate.
- Home Protection: Prevent mosquitoes from entering your home by repairing screen holes and, if possible, keeping windows and doors closed.
- Mosquito Netting: In regions where dengue is prevalent, consider using mosquito netting at night for an additional layer of protection.
- Pregnancy Precautions: If pregnant, consider avoiding travel to areas where dengue is common whenever possible.
- Travel Awareness: Prior to traveling, consult the CDC to stay informed about potential outbreaks of illness at your destination.
By incorporating these measures into your routine, you can create a proactive and effective defense against the risk of contracting dengue fever.
Dengue vaccine:
The dengue vaccine, Dengvaxia™, is recommended exclusively for individuals who have previously experienced dengue. Its purpose is to diminish the risk of severe dengue, specifically dengue hemorrhagic fever, in the event of encountering a different strain of the dengue virus in the future.
For those who have never had dengue, vaccination is not advised. Initial exposure to dengue increases the likelihood of more severe symptoms upon encountering another strain (antibody-dependent enhancement). Therefore, receiving the vaccine before experiencing dengue for the first time could heighten the risk of severe dengue.
Your healthcare provider will conduct a blood test to confirm a past dengue infection before considering the vaccine. It’s important to note that not everyone is eligible for vaccination, and travelers from the U.S. currently do not fall within the eligible group. Consult with your healthcare provider to determine your eligibility for dengue vaccination and receive personalized guidance.
Outlook / Appraisal
What can you expect if you have dengue fever?
In the majority of dengue fever cases, symptoms may be absent or mild. However, there are instances where a more serious presentation occurs, necessitating prompt medical attention. It’s crucial to be aware that while many cases are asymptomatic or result in mild symptoms, there is a possibility of encountering a more severe scenario. If you experience any concerning symptoms, seeking immediate medical assistance is advised for a thorough evaluation and appropriate care.
How long does dengue fever last?
The initial symptoms of dengue typically persist for a duration of three to seven days. While the majority of individuals start to experience improvement during this period, it’s essential to recognize that a subset may develop severe dengue, warranting treatment in a medical facility. Rest assured, with prompt and appropriate care, individuals facing severe dengue can receive the necessary medical attention for a smoother recovery.
Can you survive dengue fever?
The majority of individuals recover from dengue fever without enduring any lasting complications. For those experiencing symptoms of dengue fever, there exists approximately a 1 in 20 chance of the condition progressing to severe dengue. However, it’s important to note that if severe dengue is promptly addressed and treated at a hospital or medical facility, the likelihood of a successful recovery surpasses 99%. This reassuring statistic underscores the effectiveness of timely medical intervention in ensuring a positive outcome for those facing the challenges of severe dengue.
Complications of dengue fever in pregnancy:
For pregnant individuals, dengue fever presents potential risks, including the possibility of miscarriage, low birth weight, or premature birth. Taking proactive measures to prevent dengue during pregnancy is crucial to safeguard both yourself and the developing fetus. Prioritizing preventive strategies becomes paramount in ensuring the well-being of both the expectant parent and the unborn child. If you have any concerns or questions regarding dengue during pregnancy, seeking guidance from your healthcare provider is advised for personalized advice tailored to your unique situation.
What questions can you ask your doctor?
- Is the dengue vaccine available to me?
- What medicines can I take for my symptoms?
- What symptoms should I go to the ER for?
Additional common questions:
Is dengue deadlier than malaria?
While both malaria and dengue result in a relatively small percentage of fatalities among those infected, it’s important to recognize that globally, malaria holds a higher fatality rate than dengue. Approximately 0.3% of the estimated 271 million people contracting malaria each year succumb to the disease, whereas around 0.01% of the approximately 400 million annual dengue cases result in fatalities.
It’s crucial to bear in mind that the severity and impact of any disease can vary significantly based on geographical locations. In particular, children in Africa face a disproportionate risk of succumbing to malaria, while individuals in Asia are predominantly affected by dengue.
A note from Cleveland Clinic emphasizes the widespread occurrence of dengue, with hundreds of millions of cases each year. Although many cases are mild or symptomless, the specter of severe dengue can be daunting. Taking proactive measures to reduce the risk of mosquito bites and staying vigilant for severe dengue warning signs are key strategies. Additionally, being aware of available emergency medical care resources while traveling is crucial. The reassurance provided is that with prompt medical treatment, individuals facing severe dengue are likely to recover.