As the monsoons hit Bangalore quenching the thirst of a parched landscape, the heavenly waters also bring with it the burden of deadly diseases like dengue.

As industrial revolution and rapid scientific advancement made life easy for human life on this planet, it also brought in unforeseen challenges with regard to health and hygiene. Dengue fever, from being present in small pockets around the tropical earth, has now become a pandemic putting almost one third of the world population at risk.

It is a flu-like viral fever spread by mosquito bites. The severe form potentially kills 1 in 5 affected patients: however with early recognition and treatment, the fatality may drop to 1 in 100.

In Bangalore city, the number of dengue cases in the past one month has crossed more than 300 in our own hospital, that is Narayana Hrydayalaya Multispecialty Hospital. Unfortunately in most cases, the affected persons are presented to hospital at a later stage in the disease, where the best chance for successful treatment is lost.

Children are the most-affected by dengue

Dengue occurs primarily in April to October and affects all ages, but more severe in children and elderly. Unfortunately, unlike other viral illnesses, it can recur and the repeat infections are much more severe – making it unique in a way that it will stay and become worse over the years.

Younger children primarily have fever and sometimes rash or facial flush. Adults may have fever, severe headache, pain behind the eyes, body aches and rash.

Severe dengue is characterised by high fever and malfunction of certain key organs in the body. It makes blood vessels very ‘leaky’, leading to loss of body fluids, swelling of the body and very low blood pressure. Lungs, liver and brain often get affected. The illness is characterised by lowering of the blood component called ‘platelets’ which normally function to help prevent bleeding, thus patients tend to bleed from anywhere; skin, nose, stomach etc.

There is no specific drug. The key in treatment is to recognise it early, monitor judiciously and get treated in an experienced and well-equipped centre. Mild cases require adequate fluids, fever control and monitoring the blood counts. Severe cases in addition require Intensive Care therapy.

Early recognition saves trouble

The emphasis is on early recognition. To differentiate dengue from other common ‘viral fevers’ –parents and patients need to contact their doctor whenever DANGER SIGNS are present. Danger signs are:

• High temperature
• Fever not subsiding in 3-5 days
• Bleeding
• Puffiness of face
• Cold limbs
• Severe stomach pain
• Persistent vomiting
• Rashes
• Lethargy
• Drowsiness
• Refusal of food.
• Check all fevers for dengue

However, during the peak season, it is better to check for dengue, in any fever in a sick child. Blood tests are required mainly to make the diagnosis and subsequently frequently to monitor the falling blood counts. Other tests like X- rays and scans may be used based on the clinical condition to access the severity of the disease.

Awareness, recognition, prevention

The three most important steps to tackle Dengue menace are – awareness of the condition, early recognition and prevention of mosquito exposure.

Dengue mosquito breeds primarily in man-made containers like open water storage drums, discarded plastic food containers or any items that collect water. Bangalore, with its growing construction sites, has many such mosquito breeding areas.

The first thing to do is, remove these water containers or cover them with a lid/sand or spray appropriate chemicals. To reduce exposure at home, measures like nets, barrier creams, aero sprays and repellents can be used. Adequately clothing for children during play, especially in day time when mosquitoes are most active is also important.

Taking on dengue has to be a mass movement on a continuous basis. Its just lurking inside that tiny mosquito inside your sweet home. Beware.

With inputs from Dr Supraja C

Dr Chetan G and Dr Supraja C are consultants – Pediatric Intensive Care Unit at Narayana Hrudayalaya Multispecailty Hospitals