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  • Dengue Treatment and Prevention Measures

    With a lot of stagnant water caused by the recent floods, Dr. Rosanne Sugay shares how to spot dengue and how to avoid this illness that has no vaccine.

    by Rosanne Sugay, M.D. .
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    What is dengue?
    Dengue is a febrile infection (or an infection that is marked by fever) caused by the dengue virus. There are four serotypes (types of microorganisms or strains of the virus). It is transmitted by the Aedes aegypti mosquito. Fever, a rash, body aches and flu symptoms usually start three to ten days after being bitten by the mosquito. There is no specific antibiotic to treat dengue. The treatment is supportive:

    • Paracetamol for fevers (avoid aspirin or ibuprofen)
    • Increased fluids
    • Watching out for dengue hemorrhagic fever


    Dengue hemorrhagic fever symptoms
    Dengue hemorrhagic fever is a severe form of dengue that frequently requires hospitalization. This form of dengue is defined by the WHO (World Health Organization) as having the following:

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    • Fever lasting 2 - 7 days (or history of fever)
    • Bleeding tendencies (increased bruising, overt signs of blood in stool or vomit, a positive tourniquet test)
    • Thrombocytopenia (platelet counts less than 100,000 cells per cubic millimeter)
    • Evidence of plasma leakage (tests that your doctor does to check your hematocrit and look for signs of fluid build-up in your lungs, belly, etc.)


    Dengue hemorrhagic supportive care

    Although the name suggests that bleeding is a common complication, the worry is also the development of shock. This is when there is not enough fluid circulating in your blood vessels. Again, there is no direct treatment for the dengue virus, only supportive care. In the hospital, this will consist of intravenous fluids and sometimes blood or platelet transfusions as needed.


    A tourniquet test is a test done by your healthcare provider. They will put a blood pressure cuff on your arm and inflate it for five minutes. They will then look for petechiae on your arm (small red dots on your skin). If they find more than 20 petechiae in one square inch of skin, then it is positive.


    How do you avoid dengue?

    • There is no vaccine for dengue. A previous infection will give you immunity for that specific strain, but remember that there are four different strains of the virus. It has also been noted that if you have had a previous infection with one strain you are at higher risk for developing dengue hemorrhagic fever with an infection with a different strain.
    • Avoid getting bitten by mosquitoes. Easier said than done in the Philippines. Try mosquito repellents. Also remember that the Aedes aegypti mosquito is typically a daytime mosquito. So don't be overly paranoid by night time mosquito bites.
    • Keep areas around you clean. Try to avoid stagnant water build-up which is the breeding ground of mosquitoes. This may be difficult to do with all the floods, but be mindful of the amount of mosquitoes you will be exposed to in areas where there is a lot stagnant water and be prepared.



    About the Author:
    Rosanne Sugay, M.D., Internist and Pediatrician, University Medical Center, Las Vegas , Nevada



    Photography by James Gathany for PHIL (Public Health Image Library)

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