Dengue fever

 


Dengue is a virus that is transmitted to humans through the bite of infected mosquitoes. The main germs that transmit the disease are Aedes aegypti mosquitoes and, to a lesser extent, Ae. albopictus. The virus that causes dengue is called dengue virus (DENV). Dengue fever (called DENgee) is a painful, debilitating mosquito-borne disease caused by any of the four closely related dengue parasites. These viruses are related to the viruses that cause West Nile infection and yellow fever. It is estimated that some 400 million cases of dengue worldwide occur each year, some 96 million of which cause illness. Many incidents occur in tropical and subtropical regions of the world, with the greatest risk occurring: Indian subcontinent, Southeast Asia, Southern China, Taiwan, Pacific Islands, Caribbean (excluding Cuba and Cayman Islands) in Mexico, Africa, and Central and South America (excluding Chile, Paraguay, and Argentina) Many cases in the United States occur in people who are infected with the virus while traveling abroad. But the danger is increasing for people living near the Texas-Mexico border and in other parts of the southern United States. In 2014, an outbreak of dengue fever appeared in Hawaii with another outbreak in 2013 in Brownsville, Texas, and Key West, Fla. Dengue fever is transmitted by the bite of the Aedes mosquito infected with the dengue virus. A mosquito can get infected by biting a person who has the dengue virus in his blood. It cannot spread directly from person to person.

Symptoms of Dengue Fever usually starting 4 to 6 days after infection and lasting up to 10 days, may include suddenly a high feververy painful headachepain behind the eyessevere pain in the jointsfatiguenauseavomitingskin rash which occurs two to five days after the onset of the flu and minor bleeding (nosebleed, bleeding gums, or easily scratched).  Sometimes, the symptoms become mild and can be mistaken for flu or other viral infections. Young children and people who have never had the virus before are more likely to have milder conditions than older children and adults. However, serious problems may arise. These include dengue hemorrhagic fever, a rare complication characterized by high fever, damage to the lymph and blood vessels, bleeding from the nose and gums, increased liver function, and dysfunction of the circulatory system. Symptoms may include severe bleeding, shock, and death. This is called dengue shock syndrome (DSS). People with weakened immune systems and those with secondary or subsequent dengue infections are believed to be at greater risk of developing dengue fever.

Transmission of mosquitoes to humans; mosquitoes can be transmitted to people with the viremic disease by DENV. This could be a person with symptomatic dengue infection, a person who will still have symptoms of infection (they are pre-symptoms), but also people who do not show any signs of illness and (no symptoms). Human-to-mosquito-borne transmission can occur 2 days before a person shows symptoms, up to 2 days after the fever has been resolved. The risk of mosquito infection is positively associated with high viremia and high fever in the patient; in contrast, high levels of DENV-specific antibodies are associated with a reduced risk of mosquito infection (Nguyen et al. 2013 PNAS). Most people have viremic for about 4-5 days, but viremia can last as long as 12 days. Maternal transmission; the main method of transmitting DENV between humans involves mosquito vectors. There is evidence, however, of the possibility of maternal infection (from a pregnant mother to her baby). Although direct transmission rates appear to be below, the risk of direct transmission seems to be linked to the duration of dengue infection during pregnancy. If the mother has DENV during pregnancy, the children may suffer from premature birth, low birth weight, and fetal stress.

Diagnosis of Dengue Fever; Doctors can diagnose dengue by taking a blood test to check for the virus or antibodies in it. If you get sick after a tropical visit, tell your doctor. This will allow your doctor to evaluate the possible symptoms of dengue.

Treating Dengue Fever; there is no prescriptive drug that will stop the flow of emotions. If you think you may have dengue fever, you should use painkillers with acetaminophen and avoid aspirin-containing medications, which can make bleeding worse. You should also rest, drink plenty of fluids, and see your doctor. If you start feeling worse within the first 24 hours after your fever subsides, you should rush to a hospital for a checkup.

Dengue vaccination; the first dengue vaccine, Dengvaxia® (CYD-TDV) developed by Sanofi Pasteur was licensed in December 2015 and has now been approved by regulatory authorities in 20 countries. In November 2017, the results of further analysis to detect serostatus during vaccination were released. The analysis showed that a subset of study participants who were considered seronegative at the time of the first vaccination had a higher risk of severe dengue and hospitalization from dengue compared to the uninvolved participants. Therefore, the use of the CYD-TDV vaccine is targeted at people living in permanent habitats, aged 9-45 years, who have had at least one episode of dengue virus infection in the past. Many other dengue vaccine candidates are being tested.

Preventing Dengue Fever; the best way to prevent this disease is to prevent the bite of infected mosquitoes, especially if you live in a tropical area or travel to a tropical area. This involves self-defense and efforts to keep mosquitoes at bay. In 2019, the FDA approved a vaccine called Dengvaxia to help prevent the disease in young people aged 9 to 16 who are already infected with dengue. However, there is currently no vaccine that prevents the general public from getting it. Use mosquito repellent, even indoors. When outdoors, wear long-sleeved shirts and high-waisted trousers. If you are indoors, use a fan if available. Make sure window and door screens are secure and free of holes. If sleeping areas are not inspected or ventilated, use mosquito nets. If you have symptoms of dengue, talk to your doctor. To reduce the number of mosquitoes, remove areas where mosquitoes can breed. These include old tires, cans, or flower pots that collect rain. Regularly change the water in the baths of outdoor birds and the water containers of pets. If someone in your family suffers from dengue, be especially careful about your efforts to protect yourself and the rest of your family from mosquitoes. Mosquitoes that bite an infected family member can spread the virus to others in your home.

Risk factors; Pre-infection with DENV increases a person's risk of developing severe dengue. Going to cities (especially informal) is associated with the transfer of dengue through many social and environmental factors: overcrowding, human mobility, access to a reliable water source, the practice of water retention, etc. The social risks of dengue infection also depend on people's knowledge, attitude, and how people respond to dengue, as well as the implementation of general vector control activities in the community. Therefore, the risks of the disease may change and change with climate change in tropical and subtropical climates, and germs may adapt to new environments and climate.

 Samina Zaheer (Health Tips, Health Care)

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