At times when newspapers are filed with headlines of Dengue cases, around, and the its complications , how should one decide what to do when one develops fever. Its a step wise patient guide to take a informed decision at every cross road.
What is Dengue ?
Step one : DO NOT PANIC
- Every fever is not dengue. Even in the season when lots of Dengue cases are reported, it is not the only cause for fever. Fever is one of the most perplexing clinical signs which is seen in diverse clinical conditions from infections, malignancy ,drug effect to environmental toxicity. In many cases, cause of fever could not be established even after after intensive search. So do not presume that you have Dengue, just because few other cases are been reported it.
- Every patient of dengue is not at risk of serious illness: Dengue fever is a severe and flu-like illness but seldom causes death. India in year 2017 a total of seen 28,702 cases of dengue were reported out of which 46 patients succumbed . It is less that 2 per one thousand patients.
- High risk patients
- elderly ,
- patients presenting with hemorrhagic manifestations.
- patients presenting with altered sensorium/ disorientation.
- patients with associated diseases, diabetes mellitus , hypertension, chronic anemia, congestive heart failure, other cardiovascular diseases,
chronic obstructive pulmonary disease, asthma, renal disease .
Step two: Medical consultation with nearest health facility.
Dengue infection has no specific treatment, but it does not mean that consultation with the nearest health facility is not required.
Dengue infection is dynamic disease involving whole of the body. It has a wide clinical spectrum that includes both severe and non-severe clinical manifestations .
- Phase of fever when patient typically develop high-grade fever suddenly usually last for 2-7 days.
- Critical phase when the temperature drops to 37.5–38 degree C or less usually on days 3–7 of illness. During this period the decrease in platelet count is noticed.
- Recovery phase If the patient survives the 24–48 hour critical phase, patient slowly recovers in the following 48–72 hours.
Severe dengue If one or more of the following is present: (i) plasma leakage (ii) severe bleeding, and/or (iii) severe organ impairment.
Step three: Selecting correct health facility for management :
since there is no specific treatment of Dengue, the only way to prevent death in a case of Dengue is early
recognition of the disease, and its management by the health care personal. when it is not possible to manage that patients, than the referral .
Step four: Prevention is better than cure. Ensure that other family members are protected from mosquitoes so that further spread of disease can be avoided.
key points are
Prevention is better than cure.
Most dengue patients recover without requiring hospital admission.
Only some may progress to severe disease.
Patient with severe disease need hospitalization and/or critical care management.