Break the dengue outbreak

During my stay at the hospital as a nurse, I’ve seen those patients from pediatrics to adults affected by the so called Dengue Hemorrhagic Fever “Dengue”, a hemorrhagic febrile disease caused by dengue viruses, which are carried and transmitted by the female, day-biting, Aedes aegypti mosquito (day biting, 2 month lifespan ,low flying and legs with white stripes, gray wings)

It is a life threatening condition for a patient who suffered it. Many have died because of late diagnosis or even wrong diagnosis.

What are the signs and symptoms?

1. Fever/severe headache

Noticed the pattern of fever… if it’s more than 2-3 might go to the nearest hospital for a check-up. Severe headache is a cause of too much high fever.
Sometimes the pattern of fever is on and off. Be very careful, because sometimes absence of fever is the most crucial.

2. Flu-like syndrome
This is the most common seen in our patients. Cough and colds that is viral. The confirmatory tests are in your blood tests.

3. Pin-point Rashes (petechiae)
If you will see some pin-point rashes in your skin (measles-like rashes).
It is usually seen in lower limbs and chest. You better go to your doctor. Sometimes, it is seen after 3 days or more, so don’t wait before it appears just for you to have a check-up.

4. Body pain/weakness
The feeling of you can’t get up off your bed and your body is so weak. You feel muscle and joint pain.

5. Poor appetite
You don’t like to eat because you are too weak and you just like to lie on your bed. Even drinking water, you don’t like the taste because of being irritable and not feeling well.

6. Abdominal Pain
Sometimes it’s mistaken as gastritis because you didn’t eat anything, but there’s internal bleeding going on.

7. Bleeding
It could be nose bleeding (epistaxis), coffee-colored stool (melena) dark colored stool means there is a blood present, gum bleeding and even vomiting of blood (danger signs)

..these are the common signs and symptoms seen in a patient.
What to do?

1. We always instruct the patient to increase oral fluid intake. Drink plenty of water at least 2-3 liters a day.
Why? In doing so, it can help you hydrate and to prevent blood viscosity
2. Avoid dark colored foods and drinks.
Red and black colored foods can be mistaken as blood if seen in your laboratory workups.. It could be mistaken as blood if seen in urine, vomitus or stool.
3. Go to a clinic/ hospital
The doctor will ask you to undergo laboratory workups such as CBC, Platelet count, urinalysis, stool exam. This is to check if there is a deviation from normal values.

Common laboratory routines:
CBC or complete blood count
consists the number of your Red blood cells, White blood cells, lymphocytes, thrombocytes, hemoglobin and hematocrit and the like. This will help the doctor see and interpret if these blood result, if it is viral or bacterial infection, if your blood count is low, if your dehydrated. This are the routine management of doctors and these will help them to prescribed you the right drug.

Platelet count
This is the most important basis in dengue patients because Low platelet count considered low clotting factor in the blood. If the clotting factor is low therefore there is bleeding then if bleeding persists it will result to Hypovolemic shock if not treated it will lead to Death.

Mid-stream clean catch urine also helps to see if there is a presence of RBC (blood) in urine

Fecalysis (stool exam)
Clean catch or non-contaminated stool specimen also helps to check if there is melena or presence of RBC or blood in stool
If there is presence of blood, there is BLEEDING!

Classification of dengue :
Grade I – flu-like symptoms, abdominal pain, nausea & vomiting
Herman sign: flashes skin with petechiae
? high fever that last 3-7 days
Grade II – grade 1 plus spontaneous bleeding
Grade III – grade II , plus circulatory failure: ? BP rapid but weak pulse
Grade IV – grade III plus shock: hypovolemic

There is no anti-viral medicine for dengue. Only Paracetamol and Hydration.
Aspirin, NSAID’s and ibuprofen drugs is not recommended because it will aggravate bleeding.
The doctor will advise you for admission to give you rapid intervention. These include of hydration by insertion of IV fluids or blood transfusion), vital signs monitoring (check your Blood Pressure, Pulse rate, Respiratory rate and Body Temperature) and monitor your CBC and platelet count twice a day or it depends on the doctors order (to check if it returns to normal range). Admission to a hospital helps you to detect and prevent any danger signs.

What are the danger signs?
Abdominal pain
Ongoing vomiting
How to Break the Dengue Outbreak?
Wearing of long – sleeve shirts and long pants and using mosquito repellants are a must during day time;
Maintain cleanliness. Remove all the sources of stagnant water
Avoid going to places where mosquitoes’ breed
Use mosquito coils and mosquito nets

I hope this will help you and give you some insights based on what I have encountered . Never disregard dengue.
Always pray that you and your family will not be affected by this modern plague.