Dengue Fever: Don’t Ignore the Symptoms

By Dr. Akshay Chugh in Internal Medicine

Aug 17, 2017

Dengue Fever Explained: Symptoms, Emergency Red Flags, Treatment & Prevention

Dengue is a mosquito-borne viral infection that is common in many tropical and subtropical regions, including India. It is transmitted primarily through the bite of infected Aedes mosquitoes, particularly Aedes aegypti.

Dengue can range from a mild illness to a severe infection requiring urgent medical care. Recognising the symptoms and warning signs early can help ensure timely evaluation and appropriate treatment.

What Is Dengue Fever?

Dengue infection can be caused by any of four recognised viral serotypes: DENV-1, DENV-2, DENV-3, and DENV-4.

A person can be infected with dengue more than once because infection with one serotype does not provide lifelong protection against all other serotypes. A subsequent infection with a different serotype may increase the risk of severe dengue in some individuals.

Dengue is not usually spread directly from one person to another through casual contact. The virus is predominantly transmitted to humans via the bite of an infected Aedes mosquito.

What Are the Symptoms of Dengue?

Symptoms generally develop several days after infection, although the timing can vary.

Common dengue symptoms include:

• Sudden high fever
• Severe headache
• Pain behind the eyes
• Muscle and joint pain
• Significant tiredness or weakness
• Nausea or vomiting
• Skin rash
• Reduced appetite

Some people may experience mild symptoms, while others can develop more significant illness.

Because dengue symptoms can resemble those of other viral infections, medical evaluation may be necessary when dengue is suspected, particularly during periods of increased mosquito-borne illness.

Dengue Warning Signs You Should Not Ignore

A person with dengue may initially appear to be improving as the fever comes down. However, warning signs of severe dengue can develop around the time the fever subsides.

Do not ignore these critical symptoms—get medical emergency support right away:

• Severe or persistent abdominal pain
• Repeated vomiting
• Bleeding from the nose or gums
• Blood in vomit or stool
• Unusual or excessive bleeding
• Extreme weakness, restlessness, or drowsiness
• Difficulty breathing
• Cold or clammy skin
• Reduced urine output
• Sudden deterioration after the fever decreases

These symptoms can indicate complications and require prompt medical assessment.

What Is Severe Dengue?

With timely symptomatic management and proper rest, the vast majority of patients achieve a full recovery from dengue.  However, a small proportion of patients can develop severe dengue, which may involve significant bleeding, plasma leakage, shock, or organ involvement.

Severe dengue can become life-threatening if not recognised and treated promptly.

People at higher risk of complications may include young children, older adults, pregnant individuals, and people with certain underlying health conditions.

How Is Dengue Diagnosed?

Dengue diagnosis is based on a combination of:

• Symptoms and clinical examination
• Recent travel or residence in an area where dengue is circulating
• Mosquito exposure
• Blood tests

Depending on the stage of illness, doctors may recommend tests that detect the dengue virus or its components, such as NS1 antigen or molecular testing, or tests that detect the body’s immune response, such as IgM antibodies.

A complete blood count (CBC) may also be monitored during illness. Platelet levels may decrease in dengue, but platelet count alone does not determine whether a patient has severe dengue. Doctors assess the overall clinical condition and other laboratory findings when deciding on management.

How Is Dengue Treated?

There is currently no specific antiviral medicine routinely used to eliminate dengue infection. Treatment is primarily supportive and focuses on maintaining hydration, monitoring symptoms, managing fever and pain safely, and identifying complications early.

Stay Hydrated

Adequate fluid intake is important, particularly when fever, vomiting, or reduced appetite is present.

Depending on the patient’s condition, doctors may recommend oral fluids or intravenous fluids.

Manage Fever and Pain Safely

Paracetamol (acetaminophen) may be recommended for fever and body pain when appropriate.

Medicines such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, are generally avoided when dengue is suspected because they can increase the risk of bleeding.

Do not self-medicate. Please consult a qualified physician to determine the correct medication and personalized dosage.

Monitor Your Condition

Patients with suspected or confirmed dengue may require follow-up examinations and blood tests depending on their symptoms, risk factors, and stage of illness.

Do not delay—consult a doctor immediately if you notice any concerning symptoms.

Do Low Platelets Always Mean Severe Dengue?

Not necessarily.

A reduction in platelet count can occur during dengue infection, but platelet count should not be considered in isolation. Doctors also assess bleeding, blood pressure, hydration status, hematocrit, urine output, organ function, and other clinical findings.

Platelet transfusion is not routinely recommended simply because the platelet count is low. The decision depends on the patient’s clinical condition and bleeding risk.

How Can Dengue Be Prevented?

Since dengue is transmitted by infected mosquitoes, reducing mosquito exposure is an important part of prevention.

Prevent Mosquito Bites

• Use an appropriate mosquito repellent.
• Wear long-sleeved clothing and long trousers when possible.
• Ensure windows and doors are fitted with intact screens to keep mosquitoes out.
• Use mosquito nets, particularly for infants and people resting during the day.
• Follow local public-health recommendations regarding mosquito control.

Eliminate Mosquito Breeding Sites

Aedes mosquitoes can breed in small amounts of stagnant water.

Regularly inspect your surroundings and remove or cover water-holding containers such as:

• Flower pots and trays
• Buckets
• Discarded containers
• Water storage vessels
• Old tyres
• Coolers
• Other objects that collect stagnant water

Keeping surroundings clean and preventing water accumulation can help reduce mosquito breeding.

Can Dengue Spread From a Sick Person?

Dengue is primarily transmitted through infected mosquitoes. A mosquito can acquire the virus by biting an infected person and subsequently transmit it to another person.

Therefore, preventing mosquito bites around a person with dengue is also important to reduce the chance of further transmission.

Is There a Vaccine for Dengue?

Dengue vaccines are available in some countries and their use depends on local regulatory recommendations, age, previous dengue infection status, and other eligibility criteria.

Vaccination is not a substitute for mosquito-bite prevention. Speak with a qualified healthcare professional about whether dengue vaccination is appropriate in your specific circumstances.

When Should You See a Doctor?

Consult a healthcare professional if you develop:

• High or persistent fever
• Severe headache or body pain
• Rash accompanied by fever
• Persistent vomiting
• Significant weakness
• Abdominal pain
• Any unusual bleeding
• Symptoms that worsen as the fever starts to settle

Do not wait for symptoms to become severe before seeking medical care.

Frequently Asked Questions About Dengue

1. What is the main cause of dengue?

Dengue is caused by the dengue virus and is primarily transmitted through the bite of an infected Aedes mosquito.

2. What are the most common symptoms of dengue?

Common symptoms include sudden fever, headache, pain behind the eyes, muscle and joint pain, weakness, nausea, vomiting, and skin rash.

3. Is dengue contagious?

Dengue is not generally spread through casual person-to-person contact. It is mainly transmitted through infected mosquitoes.

4. What should I take for fever if dengue is suspected?

Paracetamol may be recommended for fever and pain when medically appropriate. Aspirin and NSAIDs such as ibuprofen are generally avoided because of the potential bleeding risk. Always consult a healthcare professional before taking medication.

5. Are low platelets always dangerous in dengue?

Not necessarily. Platelet levels can fall during dengue, but the overall clinical condition and other laboratory findings are more important when assessing severity.

6. Can dengue be treated at home?

Some people with uncomplicated dengue can recover with appropriate home-based supportive care and medical monitoring. However, patients with warning signs or risk factors may require hospital care.

7. Can a person get dengue more than once?

Yes. There are four dengue virus serotypes, and infection with one does not provide complete protection against the others.

8. How can dengue be prevented?

The key preventive measures are avoiding mosquito bites and eliminating stagnant water where Aedes mosquitoes can breed.

Key Takeaway

Dengue should not be ignored, particularly when fever is accompanied by severe weakness, abdominal pain, repeated vomiting, bleeding, breathing difficulty, or sudden worsening after the fever begins to subside.

Early medical evaluation, adequate hydration, appropriate fever management, monitoring, and timely recognition of warning signs can help reduce the risk of serious complications.

If you or a family member develops symptoms suggestive of dengue, consult a qualified Internal Medicine specialist for appropriate evaluation and guidance.