Hemorrhagic Dengue
Unstoppable Health
Officials Say
According to the
Ministerio de Salud
(Health Ministry) the
hemorrhagic dengue
epidemic is unstoppable.
So far this year, 288
people have fallen ill
and eight deaths
confirmed, four of which
were under three years
of age.
The figures are 300%
higher that then number
of cases recorded in
2006, when only 72 fell
ill to hemorrhagic
dengue.
This infectious disease
is manifested by a
sudden onset of fever,
with severe headache,
muscle and joint pains (myalgias
and arthralgias - severe
pain gives it the name
break-bone fever or
bonecrusher disease) and
rashes. The dengue rash
is characteristically
bright red petechia and
usually appears first on
the lower limbs and the
chest - in some
patients, it spreads to
cover most of the body.
There may also be
gastritis with some
combination of
associated abdominal
pain, nausea, vomiting
or diarrhea.
Some cases develop much
milder symptoms which
can, when no rash is
present, be misdiagnosed
as influenza or other
viral infection. Thus
travelers from tropical
areas may inadvertently
pass on dengue in their
home countries, having
not been properly
diagnosed at the height
of their illness.
Patients with dengue can
only pass on the
infection through
mosquitoes or blood
products while they are
still febrile.
The classic dengue fever
lasts about six to seven
days, with a smaller
peak of fever at the
trailing end of the
disease (the so-called
"biphasic pattern").
Clinically, the platelet
count will drop until
the patient's
temperature is normal.
Cases of DHF also show
higher fever,
haemorrhagic phenomena,
thrombocytopenia, and
haemoconcentration. A
small proportion of
cases lead to dengue
shock syndrome (DSS)
which has a high
mortality rate.
The mainstay of
treatment is supportive
therapy. Increased oral
fluid intake is
recommended to prevent
dehydration.
Supplementation with
intravenous fluids may
be necessary to prevent
dehydration and
significant
concentration of the
blood if the patient is
unable to maintain oral
intake.
Dengue hemorrhagic fever
is a more severe form of
dengue and potentially
deadly.
Preventing dengue starts
at home, keeping the
house clean both inside
and outside reducing the
breeding grounds for the
Aedes aegypti mosquito,
a carrier of the dengue.
So, cleaning, more
cleaning and then some
more cleaning is the
best recommendation by
the Caja Costarricense
de Seguro Social. |
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