Dengue is caused by a virus. The virus is spread from person to person by mosquitos. The best way to prevent dengue is to prevent getting bitten by a mosquito. Only about 50% of people who get infected show symptoms. Treatment of dengue consists of treating symptoms (pain and fever) - with paracetamol (Aspirin should NOT be used) and giving plenty of fluids. Platelet count should be monitored. A decrease in platelet count to about 10000 - 20000 per microL may lead to bleeding.
There is NO widely available/effective vaccine for dengue.
Severe dengue (see below) has a mortality rate of 2-5%
"Severe dengue" has the following symptoms; must be seen immediately by a doctor, and may require hospitalisation:
Stomach or belly pain, tenderness
Vomiting (at least 3 times in 24 hours)
Bleeding from the nose or gums
Vomiting blood, or blood in the stool
Feeling tired, restless, or irritable
The NS1 antigen test should be done as soon as symptoms start. IgG will become positive later and IgM will be positive in anyone who has had dengue in the past.
Dengue NS1 test costs about Rs600-Rs1100. Ex: Dengue NS1 at lalpathlabs.com costs Rs600, Add-on Labs, Sarjapur road - Rs1100(panel), Narayana Hrudayala - Rs1800(panel). During the early stage of infection (< 5 days since onset of fever) it is sufficient to do the NS1 antigen test.
Risk of serious bleeding is only below 20k. Doctor may admit for other considerations at levels above this.
(i) At Household Level:
Ae aegypti mosquito bites during daytime. Adult mosquitoes should be killed by using of commercially available safe aerosols (Pyrethroid-based). Rooms including closets, bathrooms and kitchens should be sprayed (by removing/covering all food items properly) for a few minutes and closing the room for 15-20 minutes. The timing of the spray should coincide with the peak biting time of the Ae aegypti mosquito, e.g., early morning or late afternoon.
Taking personal protection measures like wearing protective clothing (full sleeved shirts & full pants during day time) and using mosquito nets, preferably insecticide treated ones, while sleeping, even during day time. Using commercially available repellents during day time.
Using mosquito repellents or burning neem leaves, coconut shells and husk to kill or repel the mosquitoes. Using tight-fitting screens/wire mesh on doors and windows. Intensifying efforts to reduce actual or potential larval habitats in and around houses by: Covering all water containers in the house to prevent fresh egg laying by the vector. Emptying, drying water tanks, containers, coolers, bird baths, petsí water bowls, plant pots, drip trays at least once each week.
Regularly checking for clogged gutters and flat roofs that may have poor drainage. Introducing larvivorous fishes (e.g., Gambusia / Guppy) in orrnamental water tanks/garden. These small fishes eat mosquito larvae.
(ii) At Community Level:
People should form groups to supplement and reinforce efforts at household level. Such groups can identify commercial activities such as traders dealing in used tyres or small construction projects, etc, which may be creating larval habitats for the vector.
The Groups should launch awareness campaigns on Dengue and seek cooperation for prevention of mosquito breeding and protection from mosquito bites. Community activities against larvae and adult mosquitoes can include: o Cleaning and covering water storage containers. o Keeping the surroundings clean and improving basic sanitation measures. NVBDCP, Delhi 7
o Burning mosquito coils to kill or repel the mosquitoes/burning neem leaves, coconut shells and husk to repel mosquitoes and eliminating outdoor breeding sites. o Aiding in screening houses. o Making available hand aerosols for killing mosquitoes.
o Cleaning weeds and tall grass to reduce available outdoor resting places for adult mosquitoes near houses. o Promoting use of mosquito nets to protect infants and small children from mosquito bites during day time and also insecticide treated nets and curtains to kill mosquitoes attempting to bite through the nets or resting on nets and curtains. Organizing camps for insecticide treatment of community owned mosquito nets/curtains.
o In case water containers cannot be emptied, applying Temephos (1 ppm) on weekly basis in coordination with the Health authorities. o Mobilizing households to cooperate during spraying / fogging.
(iii) At Institutional Level (Hospitals, Schools, Colleges, Other Institutions, Offices, etc):
Weekly checking for Aedes larval habitats especially overhead tanks, ground water storage tanks, air coolers, planters, flower pots, etc Ensuring source elimination by:
Covering all water tanks with mosquito proof lids.
Emptying, drying water containers, coolers, plant pots at least once each week.
Checking for clogged gutters and flat roofs that may have poor drainage.
Introducing larvivorous fishes (e.g., Gambusia / Guppy) in orrnamental water tanks/garden.
Carrying out Indoor Space spraying with Pyrethrum 2%. The timing of the spray should coincide with the biting time of the Ae aegypti mosquito, e.g., early morning or late afternoon.
Carrying out fogging or Ultra Low Volume (ULV) spray by using 95% or pure technical malathion.
Promoting personal protection measures like wearing protective clothing (full sleeved shirts & full pants during day time), using commercially available repellents during day time as well as mosquito nets, preferably insecticide treated ones, while sleeping, particularly during day time.
Putting tight-fitting screens/wire mesh on doors / windows.
In addition, notification of fever cases (suspected/confirmed) to concerned Health authorities and appropriate case management.