How does one treat dengue fever?
Dengue fever (also known as demam denggi in Malay) is a mosquito born with a serious viral infection. The number of dengue cases reported to the World Health Organization (WHO) has increased over 8 fold over the last two decades, with the largest number ever reported globally in 2019, of which Malaysia had 131,000 cases. It usually presents as a self-limiting flu-like illness that can affect people of all ages, but it seldom causes death. There is no specific antiviral treatment against dengue fever, and the mainstay is supportive treatment. Recovery from a dengue infection provides lifelong immunity against that one particular virus serotype, but there is no cross-immunity against the 3 other serotypes, meaning that it is possible to be infected four times. Subsequent infection with other serotypes also raises the risk of developing critical dengue, which is a possibly lethal complication.
Since there is no specific treatment for dengue fever, supportive treatment aims to control symptoms and prevent complications. In cases of a milder form of dengue fever, the use of fever reducers and pain killers are indicated to control aches and pains, also to bring down the fever. The best option to treat these symptoms is acetaminophen or paracetamol. The use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin should be avoided as they act by thinning the blood, which increases the risk of bleeding in a case of dengue infection. Your doctor may also recommend that you rest more and drink plenty of fluids to avoid dehydration from vomiting and a high fever, signs and symptoms of dehydration to watch out for are such as decreased urination, dry mouth or lips, cold or clammy extremities, lethargy or confusion. Go to your doctor immediately if you develop any of the signs and symptoms of dehydration. Rehydration salts can also help to replace fluids and minerals. In a few clinical studies, researches have also found that Carica papaya leaf extract (papaya leaf) is effective in treating dengue fever.
In cases of severe dengue, hospitalization is required as medical care by experienced physicians and nurses can help decrease the mortality rates of severe dengue from more than 20% to less than 1%. Close monitoring on the presence of any warning signs such as severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums or nose bleeding, fatigue or restlessness is crucial as severe dengue is a medical emergency, immediate medical attention or hospitalization is needed as it may result in death. The maintenance of a patient’s body fluid volume is most important in the care of severe dengue. Intravenous fluid and electrolyte replacement is given if the patient cannot take fluids by mouth, and blood transfusion is given to replace blood loss or in patients with severe dehydration. Hospitalization of patients with severe dengue will allow proper monitoring in case symptoms get worse.
The first dengue vaccine, Dengvaxia, has been approved by the World Health Organization (WHO) and the U.S. FDA (Food and Drug Administration) has been appointed for the prevention of dengue generated by the four dengue virus serotypes. It is used targeting people living in areas with a high incidence of dengue fever, with age ranging from 9-45 years old, who have had at least 1 documented dengue virus infection previously. The vaccine is given in three doses, over a 12 months period. This criterion for vaccination is developed after it is found that there is an increased risk of severe dengue in those who experience their first natural dengue infection after vaccination. Although vaccination should be considered as part of an integrated dengue prevention and control strategy, the best way to prevent an infection is to avoid being bitten by mosquitoes by practicing preventive measures that involve protecting yourself and keeping the mosquito population down.
