The Dengue fever is a viral disease that can occur both as an epidemic and sporadically. Due to its transmission route, it occurs only in tropical and subtropical areas.
What is dengue fever?
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Dengue fever is also called bone breaker or dandy fever. It is caused by the dengue virus. This is transmitted through bites of certain mosquito species when they are infected with the virus. Dengue infection is similar to severe flu or illnesses with similar symptoms, so diagnosis is not easy.
The main ranges of dengue fever are South and Central America, some parts of Africa, Southeast Asia and some islands in the Pacific. Dengue fever is one of the most commonly imported diseases in the US and Europe. This fact is due in particular to the increased travel activity of Europeans and North Americans.
Dengue fever has four subtypes, which can also occur locally at the same time. Patients who have been infected with one of the subspecies are immune to other diseases of this subspecies. However, infection with one of the other three subtypes can still occur. This is usually worse than the first illness with dengue fever.
causes
Dengue fever is caused by the so-called dengue viruses, which are transmitted by bites of infected mosquitoes of the “Aedes” species. However, only primates and mosquitoes are known to be carriers of the dengue virus.
The female mosquito ingests the virus while sucking blood from an infected victim. With a sufficiently high concentration of the virus in the blood, it can multiply in the mosquito's stomach.
The virus then enters the mosquito's blood system and saliva. If the sting occurs again, the virus is transferred with the saliva into the bloodstream of the primate or human.
Symptoms, ailments & signs
The first symptoms of dengue fever show up about 2 to 14 days after the affected person was bitten by an Aedes mosquito. Initially, unspecific signs that are reminiscent of the flu develop.
It is typical of dengue fever that the first symptoms are unspecific. Most sufferers initially suffer from pain in the head and joints. Some people also experience a rash on the skin that looks like rubella. They also feel itchy all over their bodies. However, some people also have no symptoms at all, which is especially true in children.
In most cases, the symptoms of dengue fever last about seven days. If there is loss of appetite and nausea, these can even extend over several weeks. As a rule, however, the symptoms of the disease subside without any serious effects. However, dengue fever can sometimes be much more severe.
The symptoms are much more pronounced if there is another flare-up. Doctors differentiate between dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Dengue hemorrhagic fever can cause serious bleeding complications because the number of platelets in the body decreases.
As a result, there is a risk of life-threatening bleeding. If a dengue shock syndrome is present, it is possible that the blood pressure derails, which in turn means that the heart can no longer guarantee sufficient blood flow in the organism. This affects essential organs such as the kidney and brain.
Diagnosis & course
An infection with dengue fever initially leads to a high fever, which is often accompanied by chills. There are also pain in the limbs, head, muscles and joints. The incubation period is about three to fourteen days.
A red rash on the face or a rash on the arms and legs is also possible in the first few days of infection. Other flu-like symptoms include a sore throat, runny nose, cough, dizziness, and nausea. After a few days there is initially a short fever-free period, followed by a few days with a fever that is no longer quite as high.
In a more severe form of dengue fever, there is a disruption of blood clotting. This leads to internal bleeding, especially in the gastrointestinal tract, major fluid loss and circulatory collapse. This form of the disease is called dengue hemorrhagic fever.
A diagnosis of dengue fever is initially possible based on the symptoms and anamnesis. The diagnosis is confirmed by an antigen test, whereby certain pathogens are detected in the blood. When diagnosing dengue fever, it is important to exclude other tropical diseases such as malaria, yellow fever or Lassa fever.
Complications
Dengue fever usually goes through without any further complications. If medical care is guaranteed and the patient is treated properly, the disease will heal in 99 out of 100 people without further damage. The risk of complications is increased if patients are not adequately hydrated.
Children under the age of twelve are also more prone to complications than older people. Dengue fever can be particularly dangerous if the affected patient has suffered from this disease one or more times. For reasons that have not yet been confirmed, the course of dengue fever is more severe if the patient is already carrying the dengue virus.
The combination of dengue shock syndrome, DSS for short, and dengue hemorrhagic fever, DHF for short, is particularly dangerous. These patients must be treated in the intensive care unit. If left untreated, the death rate is over fifty percent. With dengue hemorrhagic fever, it is possible that the patient develops meningitis.
However, this complication is rather rare. Inflammation involving the heart and coronary arteries is just as unlikely but cannot be ruled out. Complications that can occur with DSS are shock symptoms and circulatory failure.
When should you go to the doctor?
Dengue fever is a tropical viral infection transmitted by the Aedes mosquito. Anyone who becomes infected and ill after a mosquito bite initially develops symptoms like those of a harmless cold. Headache, joint pain and pain in the limbs are typical.
Since dengue fever can have much more serious complications than a normal cold, those affected should see a doctor immediately if they develop flu symptoms after returning from a risk area. This is all the more true if the typical symptoms are accompanied by a rash and itching.
The risk areas include in particular Thailand, the Philippines, India, Cambodia, Brazil and Cuba as well as the Maldives. The Aedes mosquito is not native to Europe. The only currently known exception is the Mediterranean island of Madeira, which belongs to Portugal.
If dengue fever has been diagnosed, those affected should observe the course of the disease and immediately consult the treating doctor or a hospital as soon as the first signs of complications appear, as these can be life-threatening. The first signs that the disease is severe include stomach pain and vomiting, and a sudden drop in body temperature or blood pressure.
Dengue fever is not contagious, so those affected do not have to fear infecting their social environment. The latter does not have to consult a doctor as a precaution. However, the disease must be reported. The attending physician will take care of that.
Doctors & therapists in your area
Treatment & Therapy
Treatment for dengue is tailored to the patient's condition. There is no special therapy. Rather, the doctor tries to alleviate the symptoms and thereby facilitate the patient's recovery.
The use of agents that lower the fever and have an analgesic effect comes into consideration. However, pain relievers based on acetylsalicylic acid should not be used because they inhibit blood clotting. This can be dangerous if dengue hemorrhagic fever occurs.
The patient should keep strict bed rest during the illness, then healing can be expected after about two weeks.
In the case of severe disease and massive circulatory collapse, an inpatient hospital stay may be necessary. In this case, the patient is given an isotonic solution via an infusion to compensate for a severe lack of fluids and to prevent further fluid loss. If you are seriously ill with dengue fever, it is also possible to give blood plasma or blood protein.
Outlook & forecast
Dengue fever is a very serious disease that must be treated by a doctor. In the worst case, death can result if dengue fever is left untreated.
Those affected primarily suffer from the symptoms of flu or a cold, which can lead to severe pain in the limbs and nausea. The disease also leads to internal bleeding and consequently to circulatory collapse in the further course. The patient can also lose consciousness and injure himself. Due to the disturbed blood clotting, heavy bleeding occurs even with injuries.
In most cases, dengue fever will develop positively if the disease is treated properly. Those affected are dependent on treatment with the help of medication that support recovery. In most cases, simple bed rest is enough to overcome dengue fever. There are no particular complications or long-term damage, so that the life expectancy of the patient remains unaffected by this disease. Usually recovery takes about two weeks.
prevention
To prevent dengue fever, mosquito bites must be prevented. This can be done by wearing long clothing or by using insect repellants and mosquito nets. A vaccination against dengue fever is currently in clinical trials, but is not yet available.
Aftercare
After completing medical treatment and regular blood tests during dengue fever, the patient must take special care to replenish his fluid balance sufficiently. It was badly affected during the infection and will lead to fewer complications and a tendency to bleed if it is infected again. Another dengue fever infection can lead to an increased risk of complications in most patients.
It is therefore extremely important to protect yourself from this from the start. Before traveling to regions at risk from the virus, you should obtain detailed information and, if necessary, seek medical advice. During your stay in these areas and countries you should urgently take all available protective measures to avoid being stung.
These include insect repellent spray, long clothes that cover your arms and legs, and mosquito nets for the bed to prevent mosquito bites at night. The transmitting mosquito is active around the clock, so you have to protect yourself adequately from its bite at any time of the day or night.
If you were already infected and suffered dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) in the course of the disease, which were treated in intensive care, you should weigh up whether you are at high risk of a renewed infection and thus would like to expose the risk of a complicated course of illness or avoid those endangered travel destinations entirely in the future.
You can do that yourself
Dengue fever is a very serious viral infection, the symptoms of which should not be treated independently by sick people. If dengue fever is suspected, a doctor must be consulted immediately.
No vaccination protection is available against dengue fever pathogens. Preventive measures therefore consist in particular in avoiding the bite of the Egyptian tiger mosquito (Aedes aegypti), which transmits the pathogen. The precautions here are the same as for other blood-sucking insects.
Anyone staying in a risk area should prefer light-colored clothing that covers arms and legs. In addition, highly effective chemical insect repellants should be used. Since the protective effect of such preparations usually only lasts a few hours, they have to be applied several times a day. A mosquito net can be helpful at night.
People who have developed the disease should definitely take it easy, not do any strenuous physical work and also not do sports. This also applies if only mild symptoms emerge. In addition to the measures prescribed by a doctor, acute attacks of fever can also be treated with mild household remedies. Cold leg compresses are particularly effective for fever.
Under no circumstances should acetylsalicylic acid (ASA) be taken without consulting a doctor, which is contained in many over-the-counter drugs for headaches and fever and also in natural drugs made from willow bark. Those affected should only use painkillers that have been prescribed by a doctor or given to them in the pharmacy after they have been given explicit reference to dengue fever.
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