Fwd: FW: FAQs DENGUE (Understanding Dengue fever DOs & DON'Ts)

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---------- Forwarded message ----------
From: Paramasivam Krishnaswamy <PARAMASIVAM....@lnties.com>
Date: Wed, 31 Oct 2012 06:09:09 +0000
Subject: FW: FAQs DENGUE (Understanding Dengue fever DOs & DON'Ts)
To: "sasig...@gmail.com" <sasig...@gmail.com>



________________________________
From: Arunachalam, Lakshmikandan (L) [Lakshmi...@dow.com]
Sent: Tuesday, October 30, 2012 8:24 PM
Subject: FW: FAQs DENGUE (Understanding Dengue fever DOs & DON'Ts)






As Received…..useful information…..





What is Dengue fever (DF)?

Dengue infection is caused by a virus. It occurs commonly as dengue
fever. Occasionally the patient suffering from dengue may develop
bleeding. Common sites for bleeding are nose, gums or skin. Sometimes,
the patient may have coffee ground vomiting or black stools. This
indicates bleeding in gastro intestinal tracts and it is serious. The
patient with dengue who has bleeding has dengue haemorrhagic fever
(DHF). Rarely the patient suffering from dengue may develop shock,
then it is called dengue shock syndrome (DSS).



When should I suspect Dengue?

Dengue should be suspected when you have sudden onset of fever. The
fever is high 103-105 degrees F or 39-40 degrees C. It is accompanied
with severe headache (mostly in the forehead), pain behind the eyes,
body aches and pains, rash on the skin and nausea or vomiting. The
fever lasts for 5-7 days. In some patients, fever comes down on 3rd or
4th day but comes back. All the above symptoms and signs may not be
present in the patient. The patient feels much discomfort after the
illness.



There are several types of fever, when should dengue be suspected?

The characteristics of dengue that make it different from other causes
of fever are the pain behind the eyes, severe pains in the muscles,
severe joint pains, and skin rashes. These features make the diagnosis
of suspected Dengue likely. The severe joint pains caused by DF are
the reason why DF is also called break-bone fever.



What is the difference between suspected and probable case of dengue?

If a patient suspected to be having dengue has reduced platelets or an
increase in blood haematocrit, then the patient has probable dengue.
These additional findings make dengue more likely. Patients with
dengue may not have a high haematocrit if the person was anaemic to
start with.



(Platelets are cells in blood that help to stop bleeding. Haematocrit
indicates the thickness of blood).



Can you get dengue again after suffering from it once?

It is possible to get dengue more than once. Dengue can occur because
of 4 different but related strains of dengue virus. If a person has
suffered from one virus, there can be a repeat occurrence of dengue if
a different strain is involved subsequently. Being affected by one
strain offers no protection against the others. A person could suffer
from dengue more than once in her/his lifetime.



Can the diagnosis of dengue be confirmed?

There are laboratory tests that provide direct or indirect evidence
for dengue fever. These tests provide evidence for the occurrence of
dengue infection. There are some additional tests that can help to
identify the type of dengue infection. The tests for confirmation of
Dengue should be done in reliable laboratories.



How can someone get dengue fever?

Dengue fever occurs following the bite of an infected mosquito Aedes
aegypti. This type of mosquito has a peculiar white spotted body and
legs and is easy to recognize even by laymen. It breeds in clean water
(see Question 20) and has a flight range of only 100 – 200 metres. The
mosquito gets the Dengue virus after biting a human being infected
with dengue virus.



Can I get dengue fever from another person?

Dengue does not spread directly from person to person. It is only
spread through the bite of an infected mosquito.



When does dengue develop after getting the infection?

After the entry of the virus in the person, it multiplies in the lymph
glands in the body. The symptoms develop when the virus has multiplied
in sufficient numbers to cause the symptoms. This happens generally
about 4-6 days (average) after getting infected with the virus.



Can people suffer from dengue and not appear ill?

Yes. There are many people who are infected with the virus and do not
suffer from any signs or symptoms of the disease. For every patient
with symptoms and signs there may be 4-5 persons with no symptoms or
with very mild symptoms.



Can dengue fever be treated at home?

Most patients with dengue fever can be treated at home. They should
take rest, drink plenty of fluids that are available at home and eat
nutritious diet. Whenever available, Oral Rehydration Salt/ORS
(commonly used in treating diarrhea) is preferable. Sufficient fluid
intake is very important and becomes more important in case DF
progresses into DHF or DSS where loss of body fluid / blood is the
most salient feature. It is important to look for danger signs and
contact the doctor as soon as any one or more of these are found.



What is the treatment? Is it curable?

Like most viral diseases there is no specific cure for dengue fever.
Antibiotics do not help. Paracetamol (can be purchased without
prescription) is the drug of choice to bring down fever and joint
pain. Other medicines such as Aspirin and Brufen should be avoided
since they can increase the risk of bleeding. Doctors should be very
careful when prescribing medicines. Any medicines that decrease
platelets should be avoided.



Can dengue fever become dangerous?

The infection can become dangerous since it may cause damage to the
blood vessels. The damage may range from increased permeability of the
blood vessels, causing leakage of blood fluid/plasma into various
organs to completely broken blood vessels that causes bleeding.The
symptoms and signs of dengue haemorrhagic fever and dengue shock
syndrome are related to damage to the blood vessels and derangement in
functioning in components of blood that help it to clot.



When should a patient suffering from Dengue go to the hospital or
consult a doctor?

Generally the progress towards dengue haemorrhagic fever or dengue
shock syndrome occurs after 3-5 days of fever. At this time, fever has
often come down. This may mislead many of us to believe that the
patient is heading towards recovery. In fact, this is the most
dangerous period that requires high vigilance from care-givers. The
signs and symptoms that should be looked for are severe pain in the
abdomen, persistent vomiting, bleeding from any site like, bleeding in
the skin appearing as small red or purplish spots, nose bleed,
bleeding from gums, passage of black stools like coal tar. Bring the
patient to the hospital whenever the first two signs, namely, severe
pain in the abdomen and persistent vomiting are detected. Usually it
is too late if we wait until bleeding has occurred.



The most dangerous type of dengue is the dengue shock syndrome. It is
recognized by signs like excessive thirst, pale and cold skin (due to
very low blood pressure), restlessness and a feeling of weakness.



Is there a vaccine to prevent dengue fever?

A vaccine has been developed to prevent dengue fever but it is still
under trial. It is not yet available in the market. Scientific
progress is likely to help in prevention of dengue fever by
vaccination in the years to come.



Are there any long term ill effects of dengue fever?

Most people who suffer from dengue fever recover in 1-2 week’s time.
Some may feel tired for several weeks. However, if symptoms persist
after this period, consult a doctor.



Where does the mosquito that spreads dengue live?

The highly domestic mosquito Aedes aegypti rests indoors, in closets
and other dark places. Outside it rests where it is cool and shaded.
The female mosquito lays her eggs in water containers in and around
the homes, and other dwellings. These eggs will develop, become
larvae, and further develop into adults in about 10 days.



How can the multiplication of mosquitoes be reduced?

Dengue mosquitoes breed in stored, exposed water collections. Favoured
places for breeding are barrels, drums, jars, pots, buckets, flower
vases, plant saucers, tanks, discarded bottles, tins, tyres, water
coolers etc.



To prevent the mosquitoes from multiplying, drain out the water from
desert coolers/window air coolers (when not in use), tanks, barrels,
drums, buckets etc. Remove all objects containing water (e.g. plant
saucers etc.) from the house. Collect and destroy discarded containers
in which water collects e.g. bottles, plastic bags, tins, used tyres
etc.



In case it is not possible to drain out various water collections or
to fully cover them, use insecticide to prevent larvae from developing
into adults.



How can I prevent mosquito bites to prevent dengue?

There is no way to tell if a mosquito is carrying the dengue virus.
Therefore, people must protect themselves from all mosquito bites.

Dengue mosquitoes bite during the day time throughout the day. Highest
biting intensity is about 2 hours after sunrise and before sunset.

Wear full sleeves clothes and long dresses to cover as much of your
body as possible.



Use repellents



Use mosquito coils and electric vapour mats during the day time also
to prevent dengue.



Use mosquito nets to protect children, old people and others who may
rest during the day.



Is there any advice for the patient with dengue fever to prevent the
spread of the disease to others?

The spread of dengue from a patient to others is possible. The patient
should be protected from contact with the mosquito. This can be
achieved by ensuring that the patient sleeps under a bed-net.
Effective mosquito repellents are used where the patient is being
provided care. This will prevent the mosquito from biting the patient
and from getting infected and spreading it to others.

If the haematocrit levels fall dangerously then a blood transfusion
should be considered. A fall of more than 20 % as compared to previous
levels may be an indication for transfusion.



If the haematocrit values rise the patient should be given fluids
intravenously and the fluids carefully monitored to ensure that the
patient does not get excess fluids. A rise of more than 20 % as
compared to previous levels may be an indication for IV fluids. The
doctor should decide based on best judgement of patient's condition.



What should the doctors treating dengue avoid?

Do not prescribe aspirin and brufen or any other medicine that reduces
the platelets or increases the tendency to bleed.



Avoid giving IV fluids unless the patient is bleeding or the
haematocrit level is rising progressively.



Avoid rushing into giving blood transfusion unless the haematocrit is
falling dangerously.



Do not give platelet transfusion unless the platelet count is very low
or unless there is bleeding.



What can the community do to prevent dengue?

In fact, the community is the key to dengue prevention. As elaborated
above, prevention of dengue relies heavily on preventing the mosquito
(Aedes aegypti) that transmits dengue from breeding inside and in the
vicinity of homes. Every household can undertake the very simple
measures to prevent existing water collections from becoming places
for breeding of A.aegypti by draining out water from various
containers, by regular changing of water plus cleaning flower vases
and other items or, in the case of unused items, by
discarding/destroying them.



Since the mosquito does not travel far, "house cleaning" by all
members of a community will ensure that no breeding places exist,
preventing dengue from occurring.



The main strategy in the prevention and control of dengue is "source
reduction", or prevention of breeding places, mentioned above.



In the case of a dengue outbreak or epidemic what are our strategies?

Prevention of mosquito breeding places remains our mainstay. However
to stop or to slow down the transmission it may be supplemented by
"thermal fogging", using fogging machines. In fogging, we use an
insecticide that has an immediate knock-down effect on adult
mosquitos. When fogging is undertaken after an epidemic occurs, it is
unfortunately too late. Fogging, to be effective, should be done at
about 3-4 days interval. It is expensive and time consuming.
Therefore, measures undertaken by the community, for the community, to
prevent the breeding of mosquitoes is far more cost-effective than
containment measures once an outbreak occurs.



Larsen & Toubro Limited

www.larsentoubro.com

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