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Dengue in Detail | The Break-Bone Fever
#1
Till my high school, I was quite a healthy guy. I would dance, I would race, I would trek (I would do everything which a young enthusiast could do). But the moment I entered my college, I don't know how and why, I became vulnerable to plethora of diseases! You name one, I would have that! It started with IBS, followed by tonsilitis, then Herpes and then Dengue!!!

Whereas other diseases weren't that shaking/life threatening, Dengue just shook the wits of mine! I was at 'Death Bed'! And worst so, I confronted Dengue TWICE in my Life!

So here's my story of facing DENGUE TWICE in LIFE! And just for your knowledge- I'm just 25.


DENGUE - The Disease that took me to Death Bed (Twice)


I will start with the (cute) picture of the tiny creature that did all the havoc in my life:
[Image: Aedes_aegypti_CDC-Gathany.jpg]
Aedes aegypti: The vector for transmitting several types of tropical fevers (Dengue being a common one). Image courtesy wikimedia
Now let's see the image of the 'core culprit' - The Virus that resides in this vector and causes the disease to the infected person.
[Image: Dengue.jpg]
 Dengue virus virions (the cluster of dark dots) in this TEM micrograph. Image courtesy: wikimedia.


About the Dengue Virus

Dengue virus is named by the disease itself, DENV: Dengue Fever Virus. It's an RNA virus belonging to the family Flaviviridae (with a broad range of arsenals in it's kitty - epaciviruses known for causing hepatitis. flaviviruses known for dengue hemorrhagic fever, encephalitis. pestiviruses the culprits behind hemorrhagic syndromes, fatal mucosal disease and even abortions)

DENV has 5 serotypes or strains (the major cause behind multiple infections of this disease). Whereas the 5th strain has recently been reported in 2013, the first four are recognized as DENV-1, DENV-2, DENV-3 and DENV-4.

An infection by one strain gives life long immunity to that particular serotype, but not for other serotypes.


About the Mosquito (Aedes aegypti)

If you confront a small dark mosquito having banded legs with white lyre shaped markings, stay alert, it's an Aedes aegypti!!

Quote:
Once this mosquito feeds on your blood, it would look for a container/stagnant waters and would lay it's eggs just above the water-line. It keeps doing so over a period of several days. The eggs are very tolerant to extreme conditions (dessication) and can survive for over 6 months, to hatch upon contact with (rain) water.

Some important points about this mosquito:
1. It is generally low flying and would bite you at your ankles and elbows.
2. It mostly bites During The Day.
3. It generally bites inside houses (than open spaces), and it has a preference for humans!
4. An egg can turn into an adult within 7-8 days (so keep changing/removing stagnant waters in/near your household.
5. Goes without saying that it's the female mosquito that needs blood to nurture and lay eggs.

How Dengue Occurs?

Let's answer this question by busting the popular myths:

1) Dengue is contagious?
No Dengue isn't contagious at all! It can't be transmitted from humans to humans directly. A mosquito as a vector (carrier) for the virus is a must!

2) If I'm bitten by an Aedes mosquito, I'll definitely contract Dengue?
No. An Aedes mosquito will cause you Dengue only if it had bitten a Dengue infected person before biting you. Dengue infection follows human-to-mosquito-to-human cycle. 
Also, an "uninfected-Mosquito" must feed on a 'viremic' person (i.e a dengue infected person within whom the virus is multiplying at a very fast rate, a stage called viremia. A person develops viremia within 4 days of getting bitten by a dengue vector).

3) A mosquito can cause Dengue only once?
No. Once a mosquito gets virus in its body, it can cause dengue throughout it's life time (which is 3-4 weeks)! Dengue virus enters a mosquito's system with the blood (meal), where it keeps spreading for a period of around 10 days. This makes the mosquito a potential vector for spreading the disease throughout it's lifetime.


Symptoms of Dengue Infection

After getting bitten by an infected mosquito, it might take 3-15 days for the first symptoms to appear. The usual time period for symptoms to appear is upto 8 days. I'm writing the symptoms below in the order they usually appear:
1) Chills and Headache
2)Pain in the back of the eyes and lower back ( accompanied by body (joints and muscles) ache with cracking bone (sound) and feeling as if getting hammered: hence break bone disease)
3) Very high fever, which keeps recurring despite doses of paracetamol | Rashes also appear on the body
4) Nausea and Vomits leading to dehydration
5) Bleeding in nose, gums with easy tendency to get bruises

Different symptoms thus appear in different phases of Dengue infection. Following image summarizes it really nicely:
[Image: 360px-Dengue_fever_symptoms.svg.png]
Image Source: wikimedia

Quote:
A pleural effusion is a condition in which abnormal amounts of fluids accumulate around the lungs (in pleural cavity).
 
Ascites on the other hand is the accumulation of body fluids in the peritoneal cavity (space between the two membranes that separate the organs in the abdominal cavity from the abdominal wall), causing abdominal swelling.


More Content to come | Will Update on next visit to this forum (and that will be very soon!)

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#2
Coming from a tropical island where mosquito borne diseases are fast becoming epidemic, one need to be wary of dengue fever, especially secondary infection as you have experienced Sunil. Persons who have suffered with dengue fever more than once should be more concerned about Dengue Haemorrhagic Fever (DHF). As already mentioned, this type is more severe and life threatening as it can lead to dengue shock syndrome, with a fatality rate of as high as 44% especially amongst children. So if you are having signs of fever, bleeding gums or nose, red rash and vomiting blood or blood in stool, please check your doctor.

Maureen
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#3
Rainy season has just passed and more than 400 people dies in my country this year of dengue. Prevention is the best cure. All standing water bodies, closed or open, are potential mosquito breeding grounds. what might look clear may not always be clean. While the general method of preventing mosquito breeding has been adding certain larvae killing chemicals to water, this method also has its side effects. The chemical has been shown to be harmful to both humans and ecosystem if brought to regular use over large water bodies. Instead, introducing certain breeds of fishes that feed on the larvae and eggs can be used. this not only is greener but also more efficient and better in the aspect that mosquitoes over a time will develop immunity to the chemical, but they will never get past the fish. hope this helps. Big Grin
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#4
Hello f2014843

I am sorry to hear of the amount of people who have died in your country from dengue fever. Can I ask which country is this? I agree with you in that prevention is better than cure especially for vector borne diseases. As composed to other types of diseases such as hereditary or autoimmune diseases, lifestyle and vector borne disease have a solution. So why the global resurgence of vector borne infectious diseases?

Vector borne infectious diseases are a result of a number of combined factors such as global climate change, lack of public education, developing resistance to insecticides and medications, shifting of emphasis on treatment options rather than prevention techniques and measures and genetic modification and changes of pathogens. But the one common thread of all vector borne diseases is effective prevention measures such as the use environmentally safe chemicals, proper training and education of persons in the communities, vaccines development and alternatives approaches to vector control.

To date the most effective method of controlling the spread of dengue is larviciding. Larviciding is killing mosquito larvae before they emerge into adult mosquitoes, however different countries use different chemicals for larviciding. The reason for this is that some chemicals are actually banned from use in developed countries and it all depends on what is available. In addition different strains of mosquitoes are indigenous to different locations. Regardless of what chemicals are being used for example organophospates, their repeated use can lead to disruption of the natural ecosystem and can even cause resistance. Thus there is the need for the development of eco-friendly products.

This has prompted research into plant origins that have natural larvicidal properties. Extracted oils from certain seeds such as Z. Armatum DC also known as Rutaceae has proven efficient against three mosquito strains however more research needs to be performed for wide scale use.1

1. Tiwary M et al. (2007) Chemical composition and larvicidal activities of the essential oil of Zanthoxylum armatum DC (Rutaceae) against three mosquito vectors. JVect Borne Dis 44 pp 198-204.
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Dengue in Detail | The Break-Bone Fever51