Dengue, could be a silent killer?



Dengue is becoming a major health problem which is both local and global, mainly among urban and semi urban settings. Dengue fever is now a islandwide, year-round threat in Sri Lanka. Since the beginning of 2023, the National Dengue Control Unit (NDCU) in Sri Lanka has reported 36628 dengue cases (by 24th May). These figures are around three times higher than the cases reported during the same period in  past two years.

 

Key Facts about Dengue;

·         Transmission of the Dengue virus is caused by the female mosquitoes of Aedes aegypti and Aedes albopictus. 

  • Many Dengue infections are asymptomatic or produce mild illness, while occasionally it may cause more severe disease or death.
  • Although there is no specific treatment for dengue, early detection and access to proper management may significantly lower the risk of death.
  • Prevention and control of dengue mainly depend on mosquito control.

 

Be aware ….

If you are infected, you may not have significant symptoms, but still you can transmit the disease.

 

Dengue fever should be suspected if, you are suffering with sudden onset of high fever, severe headache, pain behind the eyes, nausea and pain in muscles and joints.

 

Most patients get better in 1–2 weeks while some people develop severe dengue and need care in-hospital care.

 

In severe disease, you may develop a rash and varying degrees of bleeding from various parts of the body including nose, mouth and skin etc.

 

Dengue Haemorrhagic Fever could be seen only in a small proportion of those infected and is the most severe form with significant bleeding manifestations.

 

If you are suffering with Severe vomiting, abdominal pain, increased thirst, drowsiness and excessive sleepiness, abnormal bleeding manifestations – eg: heavy menstrual bleeding or menstruation starting earlier than usual, and reduced urine output you must seek medical advice even though they don’t have a fever.

 

Seek medical attention immediately, if following features are present

·        cold clammy skin and extremities

·        restlessness and irritability

·        skin mottling

·        decreased/no urine output

·        behaviour changes like confusion.

 

How to confirm that you are infected?

If fever persists for over two days better to seek medical advice.

 

What to do if infected?

Most cases can be treated at home with pain medicine.

There is no specific treatment for dengue.

Supportive treatment could be provided during illness include:

·        Getting adequate amount of fluids (Fruit juice, Kanji, Jeewani, Milk)

·        Avoid dark colour (red or black) fluids

·        Minimum physical exertion

·        Correct dose of Acetaminophen (paracetamol) can be used to control pain

·        Avoid other pain relieving drugs such as Ibuprofen, Aspirin, Diclofenac Sodium, Mefenamic acid as they may increase the risk of bleeding.

 

How to prevent?

Effective mosquito control is the mainstay of dengue prevention and control.

Mosquito breeding sites are present in many premises and in the immediate neighbourhood of patients who are infected.

We can control Dengue by eliminating breeding places

Mosquitoes commonly breed in containers with collection of water (eggs in stagnant water can survive up to one year while eggs can withstand dry environmental conditions and thereafter hatch when water is available, and the environment is favourable).

The dengue mosquito can fly up to 400 meters looking for water collections to lay their eggs, but remains closer to human habitat.

keep neighbourhood clean and free of receptacles which attract mosquitoes.







 Do not allow water to collect in tyres, flower vases, etc.

·        Crush and burry empty tins, coconut shells during disposal

·        Add salt to the water in flower vases and traps; Change water frequently

·        Remove debris and leaves blocking drains and roof gutters

·        Mosquito proof all utensils including water tanks

·        Regularly inspect roof tops of high-rise buildings and work sites

·        Bare lands must be properly cleaned

·        Avoid disposing polythene bags and plastic containers to the open environment

·        Dispose garbage properly and do not throw away those indiscriminately.

 

Since the mosquitoes that spread dengue are active during the day, personal protective measures should be applied especially during the hours of highest mosquito activity (mid-morning and late afternoon).

·        Use protective clothes to cover the body (especially for children in the mornings and afternoons)

·        Use physical barriers such as screening doors and windows of premises using mosquito-proof meshes

·        Use mosquito nets (ideally nets sprayed with insect repellent)

·        Apply natural repellents such as citronella oil, lemon grass oil, neem oil and chemical repellents containing DEET (N, N-Diethyl-m-toluamide). Repellent use must be strictly done in accordance with the instructions noticed on the product label.

 

Travellers, especially children, pregnant women, and people with immune disorders or severe chronic illnesses, should contact their doctor to receive personalized recommendations on the use of repellents and protection before travelling.

Similar protective measures could be applied to symptomatic patients in order to prevent the disease from being transmitted to non-infected mosquitoes.