Dengue fever diagnosis, treatment, and prevention tips

Dengue fever has become endemic in many parts of India, with major outbreaks occurring approximately once or twice per decade. Reported case fatality rates for Southeast Asia are approximately 1%, but in India, Indonesia, and Myanmar, focal outbreaks away from urban areas have reported case-fatality rates of 3–5%.

mdCurrent Pearl: Successful diagnosis and treatment of patients with dengue fever results from sufficient community awareness and early healthcare seeking behavior.

Diagnosis and treatment:

  • A probable diagnosis of dengue fever in an endemic area is based on the findings of fever plus two of the following: nausea and vomiting, rash, generalized pains, low white blood cell count, positive tourniquet test, or any warning sign (abdominal pain, vomiting, liver enlargement, mucosal bleeding, high hematocrit with low platelets, lethargy or restlessness, clinical fluid accumulation).
  • Treatment for dengue focuses on fluid replacement and antipyretics for fever reduction.

A recently published study by Dr. Palanivel Chinnakali and coworkers from the Indira Gandhi Medical College and Research Institute suggests that general awareness of dengue fever by the Indian population is good; however, specific information related to disease symptoms, transmission, and prevention are lacking. The report concluded that efforts to increase patient awareness of dengue fever need to be implemented by healthcare personnel to ensure timely diagnosis and treatment and effective...

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This entry was posted in Infectious Disease, Primary Care and tagged , , , .

10 Comments

  1. N.P. viswanathan
    Posted Jul 2013 at 6:38 am | Permalink

    Dengue like illness.how to differentiate from dengue

  2. Raghavendra Kulkarni
    Posted Jul 2013 at 5:25 am | Permalink

    Dengue and most other infections causing fever cannot be diagnosed accurately with clinical examination only. Laboratory diagnosis is the only way to identify the causative agent in these cases. For dengue detection of circulating dengue specific antigen – NS1, is an excellent tool. You can use ELISA or ICTs for this test. This test is positive even on the day 1 of the fever. It is, therefore, certainly an excellent and dependable serological parameter. I would always prefer ELISA over ICT, though ICT is not a bad option at all in the peripheral areas where ELISA facilities are not available.

  3. VALLURI RAMARAO
    Posted Jul 2013 at 1:55 pm | Permalink

    True. It is clinical exam and NS1ANTIGEN
    in first 3 days of infection. We need clinical interpretation and lab diagnosis at earliest opportunity to avoid complication in these days of epidemic..Thank you for your timely article.

  4. Jagdish Chinnappa
    Posted Aug 2013 at 4:40 pm | Permalink

    Most dengue infections in children are easily manageable,however a subset can surprise and challenge every clinician.Beware of the child with rapid progress,tender hepatomegaly ,a prolonged INR and history of severe illness in the family.This subset does not give you time and high mortality despite efficient management is the outcome .Would invite comments

  5. Agni Saha
    Posted Aug 2013 at 9:45 am | Permalink

    Most kids with Dengue does not even need hospital admission. Problems start in a small subset of patients only. Complications happen once fever remits. Capillary leak is a distinct phenomena – heralded by feeling unwell, cold extremities, sweating, abdominal pain followed by hypotension. If detected early and treated aggressively – mortality even in this group should be negligible. Haemorrhage secondary to low platelets is a separate issue which may or may not be associated with capillary leak. Death in Dengue due to bleeding alone almost never happens. Problems occur when leak is identified late or not treated aggressively and patient remains hypotensive for a considerable period of time. Regards.

  6. raman balasubramanian
    Posted Aug 2013 at 1:25 pm | Permalink

    Theoretically talking about management of Dengue fever is easy. But, imagine the plight of solo practitioner like me. How many benign URIs and Viral infections we are seeing which present almost like Dengue fever. Is it possible
    to do the suggested tests on all those patients. Many caregivers are not going to feel good when they encounter negative tests AND STILL HAVE TO PAY FOR THOSE TESTS. Is there any way we can identify the typical case of Dengue that need definitive intervention. That is the need of the day.

  7. Sanjay Kumar
    Posted Aug 2013 at 3:14 am | Permalink

    As mentioned by our friends, dengue can be diagnosed on the basis of clinical suspicion and lab test.It is better to ask for NS1 test in first 5 days. If NS1 test is +ve,we can follow patients closely for development of complications and can treat them at earliest.

  8. j.p. kapoor kapoor
    Posted Aug 2013 at 9:26 am | Permalink

    Twice daily recording of Blood pressure and timely detecting, referring the patients with low mean blood pressure will save many lives. it will prevent serious bleeding diathesis too. do it in all patients suspected to be suffering from Viral fevers in dengue season.please don’t create panic for thrombocytopenia.

  9. D k Chauhan
    Posted Apr 2014 at 3:23 am | Permalink

    Remember to give only that much fluid which is required especially in cardiac renal or elderly patients fluid overload can be a killer

  10. Dr. Anil Kumar Sagar
    Posted Sep 2016 at 9:56 am | Permalink

    Thank you for your timely article

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