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What is Dengue? Understanding the Virus and its Impact.
Dengue is the name of the virus that causes dengue fever, or “dengue.” It is in the spotlight due to the increased incidence of dengue fever in Africa, the Caribbean, Central America, the Middle East, the Western Pacific, Southeast Asia, and South America in 2024. Please keep reading for an overview of dengue fever, including causes, symptoms, risk factors and prevention, diagnosis, and treatment options.
What is Dengue Fever? A Brief Overview
When a mosquito carrying the dengue virus bites a human, the virus can travel from the mosquito to the human. Many people who are infected this way may not develop dengue fever or any symptoms at all. About 20% of people who are infected develop the fever, headache, and body aches of dengue fever for about a week (this is called the first phase of dengue). Most patients who go through the first phase then notice 1-3 days of dramatic improvement (called the recovery phase) but may experience itching and a low heart rate. Less than 5% of patients do not improve after the first phase. Instead, they develop SEVERE DENGUE (called the critical phase), with difficulty breathing, severe stomach pain, bleeding in the nose/mouth/stool, internal bleeding, and very low blood pressure. Severe dengue is a medical emergency.
What Causes Dengue Fever?
Dengue fever is caused by the dengue viruses (DENV-1, DENV-2, DENV-3, and DENV-4), members of the Flavivirus genus, which also includes the RNA viruses that cause yellow fever, West Nile viral disease, and Zika viral disease. Mosquitoes of the Aededs genus, such as Aedes aegypti, can carry dengue viruses and infect humans by biting them. Virus-carrying mosquitoes can also bite and infect other mammals, but the primary host is the human.
The most common way humans become infected with dengue virus is from mosquito bites. Blood products or organs from donors with dengue virus can infect the patients who receive those donations. Transmission from mother to child around the time of birth has been reported.
Are There Dengue Cases in Bangladesh?
The incidence of dengue in Bangladesh, like many countries in Asia, is “high or continuous.” However, the US CDC and WHO have NOT detected or been informed that the incidence of dengue fever in Bangladesh is higher than expected. The increased incidence in other countries around the world underscores the need for a robust response involving prevention, surveillance, and testing.
What Are the Symptoms of Dengue Fever?
After being bitten by a mosquito carrying dengue virus, most patients experience no symptoms or only mild symptoms and fever for about a week.
FIRST “FEBRILE” PHASE: Approximately 20% of people who have been infected experience a febrile phase around 4-7 days after the mosquito bite; although in some cases, symptoms might not begin until 14 days after the bite. The symptoms of this first febrile phase include sudden fever, headache behind the eyes, bone/muscle/joint pain, nausea, vomiting, swollen glands, and rash. The first phase usually lasts about a week.
SECOND “CRITICAL” PHASE: In rare cases, symptoms requiring emergency care develop in the second critical phase. These symptoms include decreased mentation, rapid or labored breathing, severe abdominal pain or swelling, low blood pressure, bleeding, fatigue, weakness, and changes in color or temperature of the skin. Patients who have these symptoms must receive emergency medical care. This condition is also called SEVERE DENGUE and it is very rarely fatal.
THIRD “RECOVERY” or “CONVALESCENT” PHASE: After the first or second phases, patients notice a dramatic improvement in symptoms. During this 1-3 day recovery phase, patients may experience a low heart rate and itching.
AFTER DENGUE: After recovering, some patients continue to have fatigue, headache, decreased concentration, memory problems, or sleep disturbances.
Women who are infected during pregnancy may have a higher risk of miscarriage. Babies born to mothers who become infected during pregnancy may be born prematurely or at low birth weights.
If you think you may be experiencing symptoms of dengue fever, request an appointment with a Global doctor today.
What Are the Risk Factors and Causes of Dengue Fever?
Several factors contribute to the risk of dengue virus infection:
- Geographic Location: People living where the dengue is endemic, the population density is high, sanitation is poor, or standing water is common are at higher risk of being bitten by an infected mosquito
- Chronic Conditions: People with chronic conditions such as asthma, diabetes, and sickle cell anemia seem to be at higher risk for severe dengue
- Females and People with Elevated Body Mass Index: People who were born female or who have a high body mass index may also be at higher risk for severe dengue
- Travel and Trade: Global travel and trade can facilitate the spread of dengue to new regions.
How Can I Avoid Dengue Fever?
- Geographic Location: People living where the dengue is endemic, the population density is high, sanitation is poor, or standing water is common are at higher risk of being bitten by an infected mosquito
- Chronic Conditions: People with chronic conditions such as asthma, diabetes, and sickle cell anemia seem to be at higher risk for severe dengue
- Females and People with Elevated Body Mass Index: People who were born female or who have a high body mass index may also be at higher risk for severe dengue
- Travel and Trade: Global travel and trade can facilitate the spread of dengue to new regions.
What Dengue Virus Vaccines Are Available in Bangladesh?
Currently, NO dengue virus vaccines are available in Bangladesh. Two vaccines are used in some countries. DENGVAXIA (previously called CYD-TDV) is used to protect ONLY PREVIOUSLY – INFECTED individuals between the ages 6 and 45 years old from all four serotypes of dengue virus. QDENGA (previously called TAK-003) can be used to protect individuals over the age of 4 years old, who HAVE NEVER BEEN INFECTED with dengue virus.
In Bangladesh, the government and health authorities are working on strategies to study the safety and effectiveness of vaccines for dengue fever. Major efforts to control the disease include treatments to eradicate the mosquitoes that carry the dengue viruses.
How Is Dengue Fever Diagnosed?
Testing for dengue virus typically involves thorough discussion of travel and exposure history, clinical examination and diagnostic tests that include:
- Polymerase Chain Reaction (PCR) Testing: This is the primary method for detecting dengue viral RNA in blood or other bodily fluids.
- Serological Testing: Antibodies against the dengue virus can be detected in the blood to confirm infection around 5 days after exposure. A dengue virus antigen can be detected in the blood as early as 3 days after exposure, but it is produced by other viruses including those that cause yellow fever and zika. Commonly known in Bangladesh as Dengue NS1 Antigen Test.
Is Dengue Fever Testing Available in Bangladesh?
Testing for dengue fever in Bangladesh includes the following approaches:
- If you think you may have dengue fever then there are various tests available
- If you have a fever of 5 days or less the doctor will do a Dengue NS1 Antigen Test and a Complete Blood Count (CBC)
- If you have a fever of more than 5 days then the doctor may do a Dengue NS1 Antigen test and a Dengue IgM antibody test as well as the CBC.
- A Dengue IgG antibody test is also available but this can indicate a current or past infection so this is usually done with IgM antibody test.
- Once Dengue fever has been confirmed then the doctor may ask you to do further tests like daily CBCs, Liver function test, Albumin level and Urine Routine test.
- All of these tests can be done at Global Diagnostic & Consultation Centre
How Is Dengue Fever Treated?
There is no specific anti-viral treatment for dengue fever, but supportive care can help manage symptoms and prevent complications. Treatment approaches include:
- Symptom Management: Acetaminophen or paracetamol can alleviate pain and fever, but aspirin, ibuprofen, Naprosyn, and any other “non-steroidal anti-inflammatory” medicine should NOT be used because these medicines may increase bleeding. Antihistamines and topical treatments may help with itching and skin lesions. Maintaining good fluid intake and resting in bed as much as possible are also recommended.
- Severe Dengue: In severe cases or high-risk individuals, emergent hospitalization and intensive care are required with frequent close monitoring of all signs and symptoms of disease.
How Can I Learn More?
Dengue continues to pose a significant public health concern, particularly in regions where it is endemic. Understanding its causes, symptoms, risk factors, and treatment options is crucial for managing and controlling outbreaks. As global surveillance and research continue, staying informed and practicing preventive measures can help mitigate the impact of dengue virus.
The prevalence of dengue in Bangladesh highlights the need for ongoing vigilance and preparedness. Though vaccine development and testing are on-going, the continued collaboration of health authorities, international partners, and the public is crucial to manage this health challenge. By staying informed and adhering to public health guidelines, Bangladesh can effectively control dengue and protect its population.
As the situation evolves, it is essential for everyone to stay updated through reliable sources and follow recommended preventive measures. Together, we can work towards a safer and healthier future.
For the most up-to-date information and guidelines, refer to trusted health organizations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).
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