Dengue: How alarming it is, and other frequently asked questions

“Currently only serotype DENV- 2 is prevalent in Delhi NCR,” said Dr Santosh Kumar Aggrawal, Senior Consultant, Internal Medicine, at Marengo QRG Hospital in Faridabad.

He added that Dengue serotype 2 is considered the most virulent strain and may produce serious illness.

“A very typical feature of dengue infection is that till the patient is in the febrile phase (running fever) he/she doesn’t develop serious complications usually. It’s the afebrile period where most of the patients develop complications like abdominal pain, recurrent vomiting, bleeding, severely low platelets and even shock,” he added.

In the dengue afebrile phase (not feverish), patients’ family members should be vigilant that in case of any warning symptoms or signs including vomiting, abdominal pain, swelling skin rashes, poor oral intake, extreme weakness and lethargic feeling, they should immediately visit the hospital or their physician.

Is Dengue a cause of worry this year?

Cases of dengue fever have been increasing over the years and have now become a normal phenomenon and cases tend to rise every year in the months of July, August and September.

The number of patients coming for hospital care increases has also increased. According to Dr Satish Koul, Director, Internal Medicine, Fortis Memorial Research Institute, many patients have been admitted and at least 5-10 patients are getting admitted on a daily basis in the emergency of our hospital.

“Like every year, the fever in patients is staying for 4-5 days and symptoms like acute signs of dehydration, low platelets, vomiting and pain in the abdomen are being reported. These patients are admitted to the hospital for IV, fluids and hydration and discharged after 3-4 days after being monitored for their vitals. However, the good thing is that this year we have not seen too many cases of dengue hemorrhagic fever,” says Dr Koul.

He further adds that hemorrhagic fever is a fatal form of dengue fever where the patient suffers from shock, and the patient often has liver dysfunction, low blood pressure, multi-organ failure. As of now, we have not seen any severe dengue hemorrhagic fever cases. “The cases have been relatively normal and no surge has been witnessed,” said Dr Koul.

However, according to Dr Shuchin Bajaj, Founder and Director of Ujala Cygnus Group of Hospitals, things can become severe for some patients who are suffering from cerebral edema and loss of consciousness in addition to the routine features of third space fluid collection including ascites and pulmonary fusion with low platelet counts.

“The dengue strain till now appears to be mild among a large number of patients. We do not have any serious hospital admissions yet. We are seeing a lot of OPD patients with fever and body aches. But the fever is settling down in three to five days and the patient is completely recovering in five to seven days,” he adds.

When should a dengue patient be admitted to the hospital?

According to Dr Suranjit Chaterjee, Senior Consultant, Internal medicine, at Indraprastha Apollo Hospital in Delhi, a patient should be hospitalised when he or she has a high-grade fever and blood platelets go down.

He adds that as covid is still around, patients tend to get confused and mix dengue and Covid symptoms. “Patients keep asking as to what are the differentiating points,” he adds.

“Headache, body ache, vomiting, itching, lower abdomen pain, bleeding from rashes, low platelets are some of the common symptoms,” says Dr Suranjit.

How can we prevent mosquito breeding?

During the monsoon season, there is a lot of fresh water collected in the houses and urban areas like tyres, buckets lying on terraces, flower pots, discarded containers, water coolers, and water stranded on the road leads to the breeding of Aedes mosquitos that is responsible for the vector-borne disease.

Dr Jugal Kishore, Director Professor and Head of Community Medicine Department, at Safdarjung Hospital in Delhi says that generally, mosquitoes breed in water accumulated in any form of storage.

“Once a female mosquito has laid eggs, they can remain viable for several months in dry conditions and will hatch when they are in contact with water. All such breeding sites need to be eliminated by physical and engineering methods,” he adds.

He adds that larvae, pupas, and mosquitoes can be killed by various environment-friendly insecticides. “This mosquito is usually a day-biter. Bites of mosquito can be prevented by covering body parts with appropriate clothes and using mosquito repellents and mosquito nets. Windows in houses should be covered with a wire mesh,” he said.

Dr Jugal Kishore says that people often grow plants like citronella, lemongrass, and marigold in their houses as they are mosquito repellents. “However, it is not advisable to increase the number of plants indoors till proper care is taken, else they too can be a source of mosquitoes breeding.”