Early symptoms of dengue
The early symptoms of dengue fever usually appear 4 to 10 days after the patient has been bitten by an Aedes aegypti or Aedes albopictus mosquito, a vector known for transmitting several diseases; in addition to dengue it can spread chikungunya and yellow fever. The main symptom of this condition is a high fever of up to 106 degrees Fahrenheit, or 41 degrees centigrade. While people more often than not recover in about a week –sometimes even without treatment-, the symptoms can take a turn for the worse and progress to dengue hemorrhagic fever. In addition to fever, dengue is typically accompanied by at least two of the following symptoms:
· Severe headache.
· Severe pain behind the eyes.
· Joint pain.
· Pain in muscles and/or bones.
· Widespread rash
· Mild bleeding from the nose or gums.
· Easy bruising.
· Low white cell count.
· Nausea and vomiting.
Even as fever drops 3 – 7 days after the appearance of symptoms, it’s crucial to keep an eye out for warning s
igns such as:
· Severe abdominal pain.
· Persistent vomiting.
· Red spots or patches on the skin.
· Bleeding from nose or gums.
· Vomiting blood.
· Black, tarry stools.
· Drowsiness or irritability.
· Pale, cold, or clammy skin.
· Difficulty breathing.
· Lungs, liver and heart problems.
The above can be considered the early symptoms of dengue hemorrhagic fever, which is a fever that can last anywhere between 2 and 7 days, after which a 24 – 48 hour period ensues, during which the capillaries become extremely permeable and allow the fluid component to spill into the peritoneum and pleural cavity. This has the potential to cause circulatory system failure and shock, as well as death without urgent and proper medical care. People who live in or travel to tropical and subtropical countries, particularly urban and semi-urban areas of Southeast Asia, Latin America, and the Caribbean, are at an increased risk of contracting dengue fever. Dengue is endemic to many countries, including:
· Burkina Faso.
· Central African Republic.
· Democratic Republic of the Congo.
· Republic of the Congo.
· Costa Rica.
· The Ivory Coast.
· Dominican Republic.
· El Salvador.
· Equatorial Guinea.
· The Gambia.
· Papua New Guinea.
· Sao Tome and Principe.
· Sierra Leone.
· South Sudan.
· Sri Lanka.
In countries where dengue is endemic the fever usually returns every year, most likely after the rainy season has created favorable conditions for breeding, significantly increasing the mosquito population. Furthermore, these regions are at risk of periodical epidemics during which large amounts of people are infected in a short period of time. Between 21 March 2002 and 17 October 2012 there were dengue/ dengue hemorrhagic outbreaks in Brazil, El Salvador, Honduras, Ecuador, India, Indonesia, Cape Verde, Pakistan, and Portugal.
However, the fact that a country is not considered an endemic dengue region does not mean it can be deemed dengue-free. As a matter of fact, the majority of cases in the continental United States of America is reported by travelers or immigrants, or took place in unincorporated U.S. territories that are endemic, such as Puerto Rico, Guam, American Samoa or the U.S. Virgin Islands. The World Health Organization advises travelers to:
· Use insect repellent.
· Sleep under an insecticide-treated bed net.
· Wear light-colored shirts with long sleeves and trousers.
· Install window screens.
Using the right insect repellent can be an effective method for keeping insects from biting you. Repellents should be applied to exposed skin or clothing, but not under clothing or on cuts, wounds, or irritated skin. According to the EPA, insect repellents made with the active ingredients:
· DEET (Off!, Cutter, Sawyer, Ultrathon).
· OLE or PMD. (Repel, Off! Botanicals).
· IR3535 (Skin So Soft Bug Guard Plus Expedition, SkinSmart).
offer fairly long-lasting protection.
Other preventive measures include staying in air-conditioned and/or well screened housing, and rescheduling outdoor activities so that they don’t coincide with dawn, dusk, or early evening, which is when more mosquitoes are out. Dengue fever is a great example of prevention being the best medicine, especially are there is no vaccine or specific treatment other than taking pain relieving drugs – mainly acetaminophen, since aspirin, ibuprofen, and naxopren sodium may worsen bleeding complications- and drinking plenty of fluids. More serious cases may warrant supportive hospital care, intravenous fluid and electrolyte replacement, blood pressure monitoring, and blood transfusion.
The closest that we are to having dengue vaccination is a chimeric tetravalent vaccine that is being evaluated in phase III clinical trials. In the meantime, the best way to prevent the spread of the fever and the onset of early symptoms of dengue is to destroy mosquito habitats. Mosquitoes breed in stagnant water; thus, containers in and around homes that hold clean water, such as pet and animal watering containers, flower planter dishes or cover water storage barrels are potential places for the mosquitoes to lay eggs.