Ref: CHB/News Bulletin/003/2014

Last year there was a small outbreak of Dengue in Tanzania, confirmed by the Ministry of Health. Once again, there have been reports of suspected Dengue cases at certain centres in Dar es Salaam. Dengue fever is a viral illness spread by mosquito bites. The severity of illness varies from mild to life threatening. The best cure is prevention. Read on to learn more about this disease.

How is Dengue fever Spread:

d1Dengue fever is spread by the bite of infected mosquitoes. The mosquito becomes infected when it bites a person with dengue virus in their blood. It can’t be spread directly from one person to another person. The mosquito that spreads dengue is different from the one that spreads malaria. It is called Aedes aegypti. This mosquito is also responsible for transmitting other diseases as well, such as yellow fever. These mosquitoes bite most frequently at dawn and dusk but can bite throughout the day especially in shaded areas. They breed in collections of stagnant water such as buckets and flower vases and even in toilet tanks and wet bathroom floors.

Symptoms:

d2Dengue infection can vary from a flu-like illness, to a potentially life threatening disease.

Dengue fever:

Dengue often just presents as an illness with fever and is difficult to distinguish from other causes of fever.

In an outbreak, dengue should be suspected when a high fever (40°C/ 104°F) is accompanied by two of the following symptoms:

  • severe headache,
  • pain behind the eyes,
  • muscle and joint pains,
  • rash.

Classically, the temperature of a patient affected by dengue follows a biphasic pattern. This means that after a few days of high fever there is a drop in temperature and it then again rises. The rash of dengue fever appears after a drop in temperature after a few days into the illness. 

Symptoms usually last for 2–7 days, after an incubation period of 4–10 days after the bite from an infected mosquito.

Dengue hemorrhagic fever is a severe form of dengue. Warning signs occur 3–7 days after the first symptoms in conjunction with a decrease in temperature (below 38°C/ 100°F) and include: 

  • severe abdominal pain,
  • persistent vomiting,
  • rapid breathing,
  • bleeding gums,
  • blood in vomit.
  • bruises without bumping into anything
  • tiny purple spots on the skin.

Dengue shock syndrome (DSS). The symptoms may progress to massive bleeding, very low blood pressure and death. The next 24–48 hours of the critical stage can be lethal; proper medical care is needed to avoid complications and risk of death.

Diagnosis in areas where there is an outbreak of dengue fever diagnosis is based on suspicion and the finding of a low white cell count as well as low platelet count on a full blood picture. However many other viral fevers and malaria can mimic dengue. It is important to rule out other causes of fever as well. A test to detect antibodies to dengue can confirm the diagnosis of dengue but only becomes positive after about a week of illness. Thus in the meantime it is important for your doctor to consider all the possible diagnosis and give appropriate care.

Treatment

There is no specific medicine to treat dengue infection. If you think you may have dengue fever, you should use pain relievers with acetaminophen and avoid medicines with aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids, as fluid balance and maintenance is critical to severe dengue care.

A patient with severe forms of dengue usually needs to be hospitalized. He or she will need to be given fluid through drips and sometimes may need a drip of platelets.

Prevention and control

At present, there are no approved vaccines for the dengue virus. The only method to control or prevent the transmission of dengue virus is to combat vector mosquitoes through:

  • d3Eliminating A. aegyptis habitats - This is done by emptying containers of water or by adding insecticides or biological control agents to these areas
  • covering, emptying and cleaning of domestic water storage containers on a weekly basis;
  • applying appropriate insecticides to water storage outdoor containers;
  • Using of personal household protection such as window screens, long-sleeved clothes, using mosquito netting, and using of insect repellent.

 

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