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Dengue Hemorrhagic Fever - Primary And Secondary Infections

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Dengue Hemorrhagic Fever - Primary And Secondary Infections

Internal Medicine | Posted on 05/11/2020 by Dr. Sushil Kalra

Dengue fever is a mosquito-borne viral disease caused by four closely related viruses related, which spread through the Aedes mosquitoes. The fever is spread through the bite of an Aedes mosquito that is carrying the dengue virus. This species of mosquito can breed inside or outside the house in containers holding water and do not have the capacity to fly more than 200 meters away from its place of birth. The Aedes Mosquito is most active during the early hours of the morning and before sunset. Dengue fever is extremely painful, and debilitating and often causes high fever, along with headache and extreme muscle or joint pain. The fever rarely causes death; however, it can progress into a serious form known as Dengue Hemorrhagic Fever.

Dengue hemorrhagic fever is linked to secondary dengue infection, which implies that the person is infected with another serotype of dengue virus than before resulting in a more severe form of dengue virus. Essentially, dengue is an arthropod-borne disease that is caused when one of the four serotypes of dengue virus infects the person; infection by one of the dengue viruses immunes a person from the serotype for the whole life and this infection is known as primary infection which is not very severe and easily manageable with directed cure. However, if a person, who has had a primary infection before, is later infected by any of the other three serotypes of the dengue virus, a severe complicated version of dengue will emerge known as dengue hemorrhagic fever. Repeated exposure to the dengue virus makes one more prone to developing dengue hemorrhagic fever.

Symptoms of dengue hemorrhagic fever 

A person infected with the dengue virus can experience symptoms such as:

  • Unexplained, sudden high fever
  • Severe headache
  • Nausea
  • Vomiting
  • Rash on the skin
  • Rashes on the eyes
  • Severe weakness
  • Fatigue
  • Acute bone, joint and muscle pain
  • Easy bruising or bleeding
  • Mild bleeding
  • Pain behind the eyes
  • Swollen glands

A person may be recovering from these dengue symptoms and might develop severe new symptoms, which could indicate dengue hemorrhagic fever. These symptoms include:

  • Restlessness
  • Sudden rise in body temperature
  • Bleeding or bruising under the skin
  • Vomiting and nausea
  • Severe abdominal pain
  • Nose bleeding
  • Cold Skin
  • Lower blood pressure

People at high risk of developing dengue hemorrhagic fever

  • Infants
  • Small children
  • Pregnant women
  • Elder people
  • People with a weakened immune system

Diagnosis of dengue hemorrhagic fever

The doctor will check for symptoms and analyze the type of virus that has infected. The first primary infection will be diagnosed and then studied further to detect dengue hemorrhagic fever. The doctor might also conduct a few tests to diagnose the infection, these tests or checks include:

Moreover, you would need to specify your medical history, family history, lifestyle, recent travels, etc.

Treatment of dengue hemorrhagic fever

There is no specified treatment or vaccination for dengue or dengue hemorrhagic fever. However, the treatment objective is to manage symptoms and prevent the infection from worsening further. These treatments include:

  • Intravenous fluids
  • Over-the-counter pain medications
  • Electrolyte therapy
  • Transfusion of blood
  • Blood pressure monitoring
  • Oxygen therapy
  • Attentive nursing care

Moreover, the doctor will suggest rest and frequent hydration to keep the symptoms from getting worse. Symptoms of dengue hemorrhagic fever are the most difficult to manage since they are more intense and appear at a faster rate.

Prevention of dengue hemorrhagic fever

The best way to prevent dengue hemorrhagic fever is to stay away from mosquito bites and stop the birth and breeding of Aedes mosquitoes. The following preventive methods can help stop the breeding of dengue carriers:

  • Get rid of any containers placed under the air conditioners or coolers
  • Do not store water in containers – inside or outside – and leave them open
  • Maintain distance from anything that has stored clear stagnant water
  • Change the feeding bowls for pets
  • Pour fresh water into flower vases every day
  • Remove any excess water in flower pots or plates
  • Check your water tanks for proper seal
  • Use mosquito repellents and mosquito nets all the time
  • Wear fully-covered clothes
  • Use air conditioners to keep mosquitoes away
  • Keep all windows and doors closed
  • Do not apply strong perfumes or soaps, since smell attracts mosquitoes
  • Do not walk outside at dawn or dusk
  • Do not take shelter under the trees at dawn or dusk

Further, protect the patient (from any further mosquito bite) that has been infected by the virus, since that could cause the spreading of the virus if the infected mosquito, in turn, bit another person. 

Complications of dengue hemorrhagic fever

Dengue hemorrhagic fever can cause:

  • Seizures
  • Damage to brain
  • Blood clots
  • Liver and lung damage
  • Heart problems
  • Shock
  • Death

However, dengue hemorrhagic fever can be treated effectively provided it is detected early.

That said dengue hemorrhagic fever is a very severe condition and must be diagnosed and treated early to prevent complications.