Dos and Donts of Dengue Viral Fever

DOS AND DONTS FOR

MANAGING DENGUE FEVER/

DENGUE AEMORRHAGIC FEVER CASES

 

Issued by National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health & Family Welfare.

 

HOW TO RECOGNIZE DENGUE FEVER/DENGUE HAEMORRHAGIC FEVER

 

Dengue Fever (DF) is an acute febrile illness of 2-7 days duration (sometimes with two peaks) with two or more of the following manifestations:

• Headache
• Retro-orbital pain
• Myalgia/arthralgia
• Rash
• Haemorrhagic manifestation (petechiae and positive tourniquest test) and
• Leucopenia

 

In children, the dengue fever is usually mild. In some adults, DF may be the classic incapacitating disease with severe bone pain and recovery may be associated with prolonged fatigue and depression.

 

Dengue Haemorrhagic Fever (DHF) is a probable case of dengue and haemorrhagic tendency evidenced by one or more of the following:

 

• Positive tourniquet test
• Petechiae, ecchymosis or purpura
• Bleeding from mucosa (mostly epistaxis or bleeding from gums), injection sites or other sites
• Haematemesis or melena
• Thrombocytopaemia (platelets 100,000/cu.mm or less) and

 

Evidence of plasma leakage due to increased capillary permeability manifested by one or

more of the following:

 

A > 20% rise in haemotocrit for age and sex

A > 20% drop in haemotocrit following treatment with fluids as compared to baseline

 

Signs of plasma leakage (pleural effusion, ascites or hypoproteinaemia)

 

Dengue Shock Syndrome (DSS) All the above criteria of DHF plus signs of circulatory failure manifested by rapid and weak pulse, narrow pulse pressure (< or equal to 20 mm Hg); hypotension for age, cold and clammy skin and restlessness.

 

The above descriptions of DF/DHF/DSS are adequate for guiding doctors to treat the disease. However, for reporting of the disease, cases should be classified as suspected DF/DHF/DSS on the basis of above the criteria. Added serological evidence would categorize them into probable and confirmed cases.

 

DOS AND DONTS FOR PATIENTS

 

If you or any family member is suffering from suspected dengue fever, it is important to carefully watch yourself or relative for the next few days, since this disease can rapidly become very serious and lead to a medical emergency.

 

The complications associated with Dengue Fever/Dengue Haemorrhagic Fever usually appear between the third and fifth day of illness. You should therefore watch the patient for two days even after fever disappears.

 

WHAT TO DO:

 

Keep body temperature below 39oC. Give the patient paracetamol (not more than four times in 24 hours) as per the dose prescribed below:

 

Age Dose (tablet 250 mg) Mg/dose

<1 year ¼ tablet 60

1-4 years ½ tablet 60-120

5 and above 1 tablet 240

 

Give large amounts of fluids (water, soup, milk, juice) along with the patient’s normal diet.

 

The patient should take complete rest.

 

Immediately consult a doctor if any of the following manifestations appear:

 

• Red spots or points on the skin;
• bleeding from the nose or gums;
• frequent vomiting;
• vomiting with blood;
• black stools;
• sleepiness;
• constant crying;
• abdominal pain;
• excessive thirst (dry mouth);
• pale, cold or clammy skin;
• Difficulty in breathing.

 

WHAT NOT TO DO:

 

• Do not wait in case the above symptoms appear. Immediately consult a doctor. It is crucial to quickly get treatment in case of these complications.

 

• Do not take Aspirin or Brufen or Ibubrufen.