Dengue Fever

Dengue Fever

Dengue is a viral infection that can lead to fever (Dengue fever syndrome) and can sometimes result in severe bleeding (Dengue Haemorrhagic Fever) and shock (Dengue Shock Syndrome).

The Aedes mosquito spreads the dengue virus. This mosquito bites humans during daytime and breeds in relatively clean water stored for drinking or washing purposes and in rainwater that collects in various containers (e.g. tyres, bottles, tanks, shallow wells, plastic bottles.)

People of all ages and both sexes who are exposed to mosquito bites can get this disease. Children usually have a milder disease than adults.

There are basically four ways in which a patient – with Dengue presents himself:

1. Mild uncharacteristic fever.

2. “Break-bone” fever characterized by chills, high fever, severe headache, rash spreading from trunk to extremities, muscle and joint pains preventing all movements lasting for nearly 5 days.

3. DHF or Dengue Hemorrhagic Fever abrupt onset, high continuous fever lasting for 2-7 days with bleeding patches under skin, nose bleeding, gum bleeding, blood vomit, black tarry stool, capillary leakage ( ascites and pleural effusion), low platelet count and around 20% rise in haemotocrit.

4. DSS or Dengue Shock Syndrome shows all the signs and symptoms of DHF with cold clammy skin, weak and rapid pulse, hypotension and narrow pulse pressure.

Treatment

There is no specific drug or vaccine available that acts against the Dengue virus. Management follows general principles: –

  • Bed-rest under a mosquito net.
  • Sponge for fever.
  • Paracetamol for pain and fever.

Avoid Asprin and other NSAIDs that can reduce platelet count and increase bleeding

Cheek vital signs, haematocrit, urine output for signs of dehydration and electrolyte imbalance. Rapid intravenous replacement of fluids and electrolytes to sustain patient till recovery occurs. Plasma or plasma colloid preparations should be given if the haematocrit remains elevated. Care should be taken to avoid over hydration and pulmonary oedema (should this occur, diuretics may be used) Benzodiazepines (eg. diazepam) may be given to calm patients. Platelets concentrate needs to be given in those with low platelet count.

The disease cannot be spread by direct contact. It spreads only via Aedes mosquito bite. The transmission route is ‘Man-Mosquito- Man’.

This spread of the disease can be achieved by protecting individuals from mosquito bite (sleeping under a mosquito net, using insect repellants) and by controlling the Aedes mosquito population in the area.

The anti mosquito measures include:

  • Reduce Aedes mosquito breeding ground by getting rid of water holding containers such as discarded tins, empty pots, broken bottles etc.
  • Destroy larvae by adding oil to water collected in small ponds etc.
  • Kill adult mosquitoes by spraying insecticides.

Difference between Dengue Fever complicated by bleeding from DHF

Dengue Fever with Bleeding

  • Bleeding from pre-existing lesion like peptic ulcer.
  • Ascites and Pleural Effusion not seen.
  • Liver usually not enlarged.
  • Haematocrit falls.
  • Leucopaenia (fall of WBC)
  • Mild fall in Platelets count (rarely less than 1,00,000/cumm.

DHF – Dengue Hemorrhagic Fever

  • Bleeding under skin and from all mucosal surfaces.
  • Ascites and pleural effusion seen.
  • Liver enlargement seen in 1-2 days.
  • Haematocrit rises by 20% or more.
  • Leucocytosis (rise in WBC count)
  • Severe fall in Platelets count (usually less than 1,00,000/ cumm.)
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About Manbir & Gurpreet

Gurpreet Kaur’s journey in this world .... Gurpreet Kaur was a Musician. She was a singer and a composer of music. Her interest was composing and singing Gurbani Shabads in Indian Classical style. She sang Shabads in All the Raags mentioned in Sri Guru Granth Sahib Ji. She also taught Gurmat Sangeet at Gurmat Gian Missionary College, Jawadi, Ludhiana. Elder child to Pushpinder Kaur and Dr. Brig. Harminder Singh, was born in Amritsar on 13th Jan 1962. She attended various convent schools as a child because her father would get frequent Army postings as a dental surgeon. She graduated with Music Honors from Govt. College for Women, Chandigarh. Music was her hobby and she composed and sang Raag based Gurbani Shabads. Doing Kirtan was part of growing up nurtured by her parents. She learned music from her father Dr. Brigadier Harminder Singh who was a dental surgeon in Indian Army and a very good singer himself. Gurpreet’s Bhua (father’s sister), Ajit Kaur retied as a Head of Department of Music from Govt. College for Women Ludhiana, and was a renounced Punjabi singer of her time. Gurpreet Kaur also learned nuances of Indian Classical Music from Pandita Sharma. She was a mother of three children, and a grandmother. Her daughter Keerat Kaur is a Computer Engineer. Her two sons Gurkeerat Singh and Jaskeerat Singh are doctors in USA. Her daughter Keerat Kaur too was part of her group ~ Gurmat Gian Group. Gurpreet Kaur left this world at the age of 54yrs on 12th Sept 2016 in Baltimore USA. She had recorded around 25 cds of Gurbani Keertan. 'Raag Ratan' Album (6 CDs) is a Compilation of Shabads in All the 31 Sudh Raags of Sri Guru Granth Sahib Ji. 'Gauri Sagar' Album (3 CDs) is a Compilation of All forms of Raag Gauri in Sri Guru Granth Sahib Ji. 'Nanak Ki Malhaar' ~ ((3 CDs) is an album of Raag Malhar Shabads in various forms of Malhar. 'Gur Parsaad Basant Bana' ~ (3 CDs) is an album of Shabads in Raag Basant sung in various forms of Raag Basant. Har Ki Vadeyai Sarni Aayea Sewa Priya Kee Preet Piyaree Mohan Ghar Aavho Karo Jodariya Mo Kao Taar Le Raama Taar Le Tere Kavan Kavan Gun Keh Keh Gawan Mera Baid Guru Govinda Saajanrraa Mera Saajanrraa

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