5 min readJul 21, 2023 04:35 PM IST
First published on: Jul 21, 2023 at 12:42 PM IST
With the monsoon showers leading to flooding in Delhi, which has now become a big breeding ground of mosquitoes and microbes, the government is suspecting an uptick in cases of dengue and has advised medical stores not to sell pain-killers such as diclofenac, ibuprofen and aspirin without prescription. Dr Suranjit Chatterjee, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospital, Delhi talks about why it is important not to take these medicines in this season even if one has very high fever and body ache.
Why is it important not to consume these medicines without a prescription?
We have started seeing cases of dengue in the hospital and the numbers are likely to go up during the next two weeks. This is because during extreme rainfall, the water does not stagnate for long and the mosquitoes cannot breed. Now that the rains have stopped, they will breed wherever water has pooled up.
If a person has high grade fever, body ache, and headache in the coming days, they could be having dengue. We see other respiratory and gastrointestinal viral infections also during this season. However, in case a person does have dengue, consuming these pain medicines can increase their risk of internal bleeding. Certain strains of dengue are known to cause internal bleeding and a drop in blood pressure, which may be fatal.
These pain medicines are known to prevent clotting of the blood and hence can lead to worsening of the symptoms. One of the tell-tale signs of internal bleeding is red splotches on the skin. But these rashes appear only on the fourth or the fifth day. They are also not as prominent on Indian skin as they are on say Caucasian skin.
What medicines can be safely consumed during this season if one has fever and aches?
The fever, body ache and headache with dengue can be very bad and may not always resolve with paracetamol. This is the reason people self-medicate with ibuprofen and diclofenac. When one does not know the cause of a fever, paracetamol is really the safest medicine.
It is important, however, not to overdo paracetamol as well. The dosage depends on the age and body weight of an individual, but an average adult may have the 650 mg tablet every six hours, meaning four tablets a day. Normally, the dengue fever resolves in three to five days.
When should one go to the hospital?
Most people with dengue do not need to go to a hospital. It is a self-limiting disease and they can get better at home. However, it is a good idea to stay in touch with your physician, maybe on the phone, so that they can recommend treatment with your other conditions in mind.
What is important when you stay at home, however, is to remain well-hydrated. Do not take any unnecessary pain-killers or antibiotics. Dengue is a viral illness and antibiotics are not needed for its treatment.
You should visit the doctor, however, if your fever does not subside after three days. There is a chance of a secondary infection happening at the same time. The initial symptoms of typhoid may also look like dengue.
You should go to a hospital if you are vomitting constantly and are unable to keep any food, water or medicine down. You should also go if you see the red splotches on your skin or there is bleeding from the nose or gums or anywhere else. You might need hospitalisation if your blood pressure drops. Some people also experience breathing difficulty because of accumulation of fluid within the body.
Are you seeing these severe cases? Could there be an outbreak this year?
We have just started seeing these cases. I have two patients admitted at the moment. And, one of them did need platelet transfusion. Not everyone needs platelet transfusion as long as their BP and blood count are stable and there is no active bleeding.
The number of cases is very few at the moment to determine which serotype of dengue is in circulation. But that will determine whether there could be severe disease due to dengue in the coming months.
The rains, flooding, and subsequent dry days have created the perfect condition for the mosquitoes to breed and spread the infection.
Why Dr Chatterjee? Dr Chatterjee has worked in the field of general medicine for over 25 years, treating both communicable and non-communicable diseases.
These pain medicines are known to prevent clotting of the blood and hence can lead to worsening of the symptom (Source: Getty Images) 
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