KOCHI: Close to four million people the world over are at risk of contracting dengue, the number of cases has escalated 30 times in the last five decades. WHO data suggests that while only nine countries recorded a dengue epidemic before 1970, the disease has now become endemic in around 128 countries with people from southeast Asia and Latin American nations being most prone.
As a vector-borne disease, Dengue has overtaken the threat of Malaria in India. "This is especially true in the case of Kerala. We have registered a lot many cases of dengue in the last few years," says Dr Abin J Kulangara, consultant of general medicine at Lisie Hospital. In tropical regions, an outbreak of dengue is mostly seasonal. The monsoon provides a conducive environment for rampant breeding of the disease-carrying mosquito. With the rain lashing the state, the scare of the virus spread by Aedes aegypti and Aedes albopictus species of the female mosquito looms large.
The rise in the malefactor mosquito population has been attributed to environmental changes and rapid urbanisation leading to degrading sanitation infrastructure in the cities. The Aedes mosquito also causes chikungunya which in some cases proves difficult to distinguish. "Chikungunya is also a viral fever but in the context of Kerala, the immediate suspicion goes to dengue as it's more prevalent. Also, if one looks at diagnostic reports, the platelet count in patients with dengue starts dropping while in chikungunya this is not so common. The main symptoms of chikungunya are myalgia and joint pains," adds Dr Abin.
Dengue is most commonly characterised by flu-like symptoms which include a sudden spike in body temperature, severe headache accompanied by pain behind the eye, joint and muscle pains, nausea or vomiting and skin rashes which appear few days after the first sign of fever. "A recurrent spell of dengue with a different stereotype might result in a serious drop in platelets," says Abin.
A combination of blood tests are conducted to determine the presence of the dengue virus. "An NS1 antigen test is done in the initial stage. Following that, after 6-7 days an IgM (immunoglobin M) is conducted as the antibody response starts getting positive, this helps to confirm the presence of the virus at the later stage. These are the two general tests done at the hospitals at present," informs Dr Abin.
Though a specific anti-viral medication is yet to be developed, treatment methodology mostly involves addressing symptomatic factors. "A dengue patient is advised to consume lot of fluids because a person suffering tends to vomit a lot and has really poor oral intake. Strict bed rest is also prescribed.
IV liquid is administered to patients who are frail or elderly, they are admitted to the hospital and monitored. However, in most cases, a patient can get better at home. Trial for a recently developed vaccine is underway but is yet to be approved," adds Dr Abin.