Dengue is a mosquito-borne viral disease that has rapidly spread to all regions of Nepal in recent days. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent. Dengue is widespread throughout the tropics, with local variations in risk influenced by climate parameters as well as social and environmental factors.
Dengue causes a wide spectrum of disease. 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. Severe dengue was first recognized in the 1950s during dengue epidemics in the Philippines and Thailand. Today, severe dengue affects most Asian and Latin American countries and has become a leading cause of hospitalization and death among children and adults in these regions.
Severe dengue can occur in adults and children and is potentially life-threatening.
Dengue fever, an mosquito-borne viral disease, is widespread in Singapore, but its more lethal forms, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), referred to as severe dengue, are much less common.
Severe dengue can occur in both adults and children and is life threatening. Children are especially at risk. Early detection and proper medical care lower fatality rates below 1 per cent, according to the World Health Organization (WHO).
Severe dengue initially presents with the common symptoms of dengue fever such as fever, intense headache, aches and pains, loss of appetite, nausea, vomiting, skin rashes and leukopenia (reduction in white blood cells). A positive tourniquet test is also a sign of dengue fever.
After several days, usually 3-7 days after the onset of symptoms, the patient may display the warning signs of severe dengue.
If the patient develops severe dengue, there will be bleeding spots on the skin and other parts of the body and leakage of blood plasma. Severe dengue fever can damage the lungs, liver or heart. Blood pressure can drop to dangerous levels, causing shock and, in some cases, death.
The symptoms of severe dengue include:
Patients who develop warning signs (in particular lethargy and persistent vomiting) and those with a low platelet count and high hematocrit (elevated red blood cell count) are at very high risk of developing very severe dengue, organ failure or even death.
Elderly patients with multiple comorbidities (medical conditions) are more likely to develop severe dengue. Severe dengue may also occur when a person who has developed immunity to one strain of the virus become infected with another strain.
However, since there are four different strains of the dengue virus, a person can potentially get dengue fever more than once.
There is no known cure for severe dengue. A person suffering from this form of dengue fever may need to be treated in an intensive care unit (ICU). Treatment will focus on the symptoms and includes the following: