How To Know If You Have Dengue? What To Do Then?

 

As we head into the season where fever and common cold would be an everday part and parcel in homes, we also need to keep a watch on a few aspects just to be sure we are not affected by Dengue Fever. Here is a look at the symptoms and other related aspects of dengue fever.

Symptoms

The principal symptoms of dengue are:

  1. High fever and at least two of the following
  2. Severe headache
  3. Severe eye pain (behind eyes)
  4. Joint pain
  5. Muscle and/or bone pain
  6. Rash
  7. Mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising)
  8. Low white cell count
  9. Lack of appetite.

NOTE: The fever lasts for 5-7 days. In some patients, fever comes down on 3rd or 4th day but comes back. All the above symptoms and signs may not be present in the patient.

Emergency Medical Help

In case any of the following things are seen along with the symptoms, it is advisable to get immediate medical help

  1. Severe abdominal pain or persistent vomiting
  2. Red spots or patches on the skin
  3. Bleeding from nose or gums
  4. Vomiting blood
  5. Black, tarry stools (feces, excrement)
  6. Drowsiness or irritability
  7. Pale, cold, or clammy skin
  8. Difficulty breathing

NOTE: Occasionally the patient suffering from dengue may develop bleeding. Common sites for bleeding are nose, gums or skin. Sometimes, the patient may have coffee ground vomiting or black stools. This indicates bleeding in gastro intestinal tracts and it is serious. The patient with dengue who has bleeding has dengue haemorrhagic fever(DHF). Rarely the patient suffering from dengue may develop shock, then it is called dengue shock syndrome (DSS).

Steps To Prevent Dengue

Prevention is basically by:

  1. Avoiding mosquito bites (by using mosquito repellents)
  2. Eliminating pockets of stagnant water that serve as mosquito breeding sites at home, workplaces and their vicinity,
  3. Not storing water in open containers. Covering all water containers with lids.
  4. Preventing mosquito entry by keeping doors closed and windows screened.
  5. Wearing protective clothing like long-sleeved shirts, long pants, socks and shoes when outdoors.
  6. Using mosquito nets at home.
  7. Scrubbing and cleaning margins of containers used for water (to dislodge the eggs of Aedes aegypti)
  8. Covering overhead tank to prevent access to mosquitoes.
  9. Aedes mosquitoes usually bite during the day; therefore, special precautions should be taken during early morning hours before day break and in the late afternoon before dark.

Some facts about Dengue Fever:

What are the types of dengue?

There are four types of dengue viruses that cause dengue fever worldwide. These types are Dengue 1, 2, 3 and 4.

The two principal illnesses that dengue virus causes are: dengue fever – an acute illness with fever, headaches, joint pain, muscle pain and rash dengue haemorrhagic fever.

How can someone get dengue fever?

Dengue fever occurs following the bite of an infected mosquito Aedes aegypti.This type of mosquito has a peculiar white spotted body and legs and is easy to recognize even by laymen. It breeds in clean water (see Question 20) and has a flight range of only 100 – 200 metres.The mosquito gets the Dengue virus after biting a human being infected with dengue virus.

What is the difference between suspected and probable case of dengue?

If a patient suspected to be having dengue has reduced platelets or an increase in blood haematocrit, then the patient has probable dengue. These additional findings makes dengue more likely. Patients with dengue may not have a high haematocrit if the person was anaemic to start with.

Can dengue fever become dangerous?

The infection can become dangerous since it may cause damage to the blood vessels. The damage may range from increased permeability of the blood vessels, causing leakage of blood fluid/plasma into various organs to completely broken blood vessels that causes bleeding. The symptoms and signs of dengue haemorrhagic fever and dengue shock syndrome are related to damage to the blood vessels and derangement in functioning in components of blood that help it to clot.

Can people die from dengue fever?

People who suffer from dengue fever have no risk of death but some of them develop Dengue Haemorrhagic Fever or Dengue Shock Syndrome. In some of these cases death can occur. With proper treatment, the patients with Dengue haemorrhagic fever and dengue shock syndrome can recover fully. Good treatment provided in time can save most lives.

Can you get dengue again after suffering from it once?

It is possible to get dengue more than once. Dengue can occur because of 4 different but related strains of dengue virus. If a person has suffered from one virus, there can be a repeat occurrence of dengue if a different strain is involved subsequently. Being affected by one strain offers no protection against the others. A person could suffer from dengue more than once in her/his lifetime. The risk of dengue haemorrhagic fever increases if you contract dengue more than once.

What is dengue haemorrhagic fever?

Dengue haemorrhagic fever is a severe complication of the dengue virus. It is most commonly seen in children aged under 15 years but can occur in adults. It is more likely to occur if you have contracted dengue before.Symptoms for dengue haemorrhagic fever are the same as for dengue fever, but 2-5 days after the onset of fever, patients show a rapid deterioration in their condition. Cardiovascular disease, shock and sometimes death may follow.

Can I get dengue fever from another person?

Dengue does not spread directly from person to person. It is only spread through the bite of an infected mosquito.

When does dengue develop after getting the infection?

After the entry of the virus in the person, it multiplies in the lymph glands in the body. The symptoms develop when the virus has multiplied in sufficient numbers to cause the symptoms. This happens generally about 4-6 days ( average) after getting infected with the virus.

Can people suffer from dengue and not appear ill?

Yes. There are many people who are infected with the virus and do not suffer from any signs or symptoms of the disease. For every patient with symptoms and signs there may be 4-5 persons with no symptoms or with very mild symptoms.

Can dengue fever be treated at home?

Most patients with dengue fever can be treated at home. They should take rest, drink plenty of fluids that are available at home and eat nutritious diet. Whenever available, Oral Rehydration Salt/ORS (commonly used in treating diarrhoea) is preferable. Sufficient fluid intake is very important and becomes more important in case DF progresses into DHF or DSS where loss of body fluid / blood is the most salient feature. It is important to look for danger signs and contact the doctor as soon as any one or more of these are found.

Blood Requirement During Dengue

If the doctor tells you that one of your acquaintances is suffering from Dengue then it is very important for you to understand some things related to the need and availability of blood.

Need for Platelets

When a person is suffering from dengue, his/her platelet count can come down drastically. A normal platelet count in a healthy individual is between 150,000 and 450,000 per µl (microlitre) of blood. If the patient’s platelet count falls below 50,000 per µl then one must prepare to arrange for platelets. Normally the doctor advices platelet transfusion only when platelets count falls below 30,000 per µl. Not all patients suffering from dengue require platelets.

During Dengue Outbreak

Massive Shortage

There is terrible shortage of platelets in all blood banks across the state.

Why is there a shortage of blood platelets?

  1. One must understand that platelets may not be available off the shelf from most blood banks even if they are collecting hundreds of units per week because of the sheer size of demand.
  2. The shelf life of platelets is only 5 days
  3. Several blood banks do not have the facility to separate platelets from whole blood.
  4. Fewer voluntary donors donate blood in summer months adding to the shortage?

Random Donor Platelets

1 unit of platelets refers to the platelets separated from blood collected from a single donor. This is also referred to as Random Donor Platelets(RDP).

Understanding Blood Grouping For Platelets

There is no blood group for platelets. A person can be given RDP of any group unless the person is a lady in the child bearing age or younger than that.

Arrange For Blood In Advance

If you have friends or family members who are eligible blood donors and who are willing to donate for your patient, it is best not to wait for the last minute for the donation. You could get the blood donated in advance at the blood bank and reserve them for your patient.

It takes 4-6 hours for the good blood banks to process blood into platelets. However, in an emergency the need will be immediate. Therefore organsing donations well in advance is better.

Single Donor Platelets

If the doctor advises you to arrange for more than 4 units of platelets at once, then you could opt for a process of collecting only platelets from the donor. This is called Single Donor Platelet(SDP) or apheresis platelet. with this process a person can donate as much as 6 times the number of platelets which a patient gets from one blood unit from a single donation. A healthy male weighing more than 65 kgs and who fulfils other criteria for blood donation is an eligilble platelets donor. Platelets donation is absolutely safe for the donor and it ensures that the patient receives good quantity of platelets with minimum risk of transfusion transmitted infection.

Searching For Platelets In Blood Banks

There are several blood centres who organise SDP. If you wish to know the blood centres in your vicinity, please call 9480044444.

You could call 9480044444 to know which blood banks in your vicinity have platelet stock. However, since the stock of platelets changes rapidly, the helpline may suggest you to call some blood banks where the platelets are more likely to be available.

Emergency Help

If platelets are not available in the blood banks, a volunteer of Sankalp will try to help you find them. It is strongly suggested that you maintain clear communication and follow the suggestions that the volunteer makes in order to ensure that you get platelets in the fastest possible manner. The volunteer is trained to guide you to make the best use if all available resources to find the unit of platelets successfully.

Financial Preperation

Coming to the financial aspect, each unit of platelet(RDP) costs between Rs.300-Rs.800/- in most blood banks. One may require upto 8-10 units of platelets for each patient. The cost of SDP is anywhere between Rs.8,000-Rs.12,000/-. It is wise to adequately provision for this and in many cases this cost may not be covered by insurance.

Summary

  1. Try to organise for blood donation as early as possible to ensure supply.
  2. Search for blood in blood banks if you can’t arrange by yourself. Take help of blood helpline: 9480044444.
  3. In case you still do not find platelets, take help of Sankalp’s Emergency Team.

Donate Blood Save Lives

Ideally you would want blood platelets to be available off the shelf at the time of need. This can’t happen if voluntary blood donors do not come by themselves and donate blood in the blood banks. Please help the blood banking services by encouraging people to donate blood voluntarily and thereby enable saving of precious human lives.

SDP vs RDP

SDP(Single Donor Platelets) RDP(Random Donor Platelets)
  1. Each unit of SDP is equivalent to 5-6 units of RDP
  2. SDP is safer to transfuse and minimises chances of Transfusion Transmitted Infection(TTI).
  3. SDP requires just 1 male donor above 65 kgs of weight.
  4. SDP is much more expensive when compared to equal volume of RDP.
  5. SDP is available only in very few blood banks
  6. SDP is available only on demand. You will have to take a donor to the blood bank to get SDP.
  7. It is preferable to have a donor of the same blood group as the patient in case of SDP.
  1. Is useful for children and people who require fewer units of platelets.
  2. Any donor weighing more than 55 kgs can donate blood which can be used to separate RDP.
  3. RDP is available in most well known and well established blood banks.
  4. Is available off the shelf in blood banks who seperate components.
  5. Blood group is of lesser significance while using RDP and platelets of any group can be given.

Sources for further reading:

Sankalp Unit
Blood Donation Organization
Blood Knowledge Base