Dr Harleen Kaur
Dengue Fever as we know it today, also called “Break Bone Fever” has centuries old relationship with human civilization. Our ancestors were very much aware about the mosquitoes as there are numerous descriptions in Indian writings from Vedic era! Acharya Susruta in his writings in ‘Lalpasthana’ has mentioned about 67 different forms of Keet whereas ‘Atharvaveda’ makes detailed reference of shape, habitat, and types of mosquitoes. In Charak Samhita, Acharaya Charak has mentioned about ‘Mashak’ in Chapter Visha Chikitsa. In Sanskrit the word ‘Mas’aka’ has been used as synonym of mosquitoes. Manusmriti has classified the organisms into four types, Jarayuja, Andaza, Svedeja and Udvija and according to this classification the mosquitoes were kept in Svedeja category (born from moisture and heat). In “Keet Visha” five different Mashak were identified and out of these ‘Parvatiya Mashak’ was most hazardous to humans. Acharya Susruta has told that after bitten by Parvatiya Mashak, there will be itching and swelling at places of bite and can lead to death! This shows that Indians of antiquity were very well versed about mosquitoes and their nuisance behavior and diseases caused to humans by these blood sucking insects! This is exactly what the modern science with the use of microscopes and electron microscopes have rediscovered about Malaria and Dengue!
In modern civilization the first documented epidemic of Dengue like illness was reported in 1780 but the virus was isolated for the first time simultaneously from Japan and Calcutta in 1943 -1944. North India bore the brunt of full blown epidemic of severe form of Dengue in 1996. Now as the rainy season has started thus providing moist and humid environment, it is the ideal time for the mosquitoes to proliferate. This is the undeclared war against the humanity let loose by these blood sucking insects all over the globe, leading to emergence and reemergence of many mosquitoes born diseases. To protect yourself from this potentially deadly disease it is imperative to know everything about these mischievous enemies and their strategies to cause harm to human race.
The re-emergence of this centuries old disease is because of a group of viruses called Flavivirus , designated as Type 1, 2, 3 and 4. These viruses spread in the society by the peridomestic mosquitoes, ‘Aedes aegypticus’ and its related version ‘Aedes albopictus’ also known as ‘Asian Tiger mosquito’. The mosquito can be recognized by Black & White markings on its legs and a marking in the form of a lyre on the upper surface of its thorax. Hence known as Tiger Mosquito. These dangerous insects have engulfed the entire tropical and subtropical belt covering more than 100 nations and has become a progressively worsening “Global Threat” to the very existence of a healthier society.
The bite of a mosquito (Aedes) carrying Dengue virus, can cause a variety of symptoms ranging from being asymptomatic to mild viral illness to severe fatal dengue hemorrhagic fever or Dengue Shock Syndrome. About 2. 5 billion people live in dengue risk regions with about 100 million new cases each every year. Dengue can be classified among those diseases where awareness is the only solution. Each and every individual should know when to consult your doctor in the event of appearance of any symptoms of viral illness especially in the rainy season and learn the Dos and Don’ts in the event of you being caught with fever!
Symptoms of Dengue fever
Day 1: The Dengue virus can cause sudden, persistent and continuous high fever of 39 -40 degrees, the face can become red like common cold. Frontal headache, eye socket pain, joint pains (arthalgia), pain in the muscles (myalgia), nausea, vomiting ,restlessness and lethargy are other symptoms.
Day 2: High fever continues and dengue fever spots may begin to appear on the body surface on skin, face, limbs, abdomen etc.
Day 3: Symptoms of Day 1 and 2 will continue. In addition patient may have bleeding from nose, bleeding gums, blood in urine, faeces or in vomiting.
Day 4 and 5: The high fever subsides but the symptoms of fever, nose bleeding, bleeding gums and bleeding from other sites may be there. There may be progressive fall in blood pressure during fever. Blood platelet count may fall drastically. This is the period when serious complications can occur.
Subsequently patient may develop pain and distension in abdomen, difficulty in breathing (because of accumulation of fluid in the lungs), and in complicated cases may lead to multi organ failure and irreversible damage.
There is no definite cure for Dengue and only symptomatic treatment is available but the good thing about Dengue is that it is 100 percent preventable disease and fits into the classical slogan, “Prevention is Better than Cure.” Ironically as the Dengue death is 99 percent avoidable, but inspite of this, a significant number of people die every year around the world because of it! Social factors play a very important role in spread and final outcome of this disease. The absence or delay in medical consultation can be very dangerous. It has been found in much research analysis that the danger of Dengue death is increased if the initial medical checkup is delayed for first three to four days! Dengue is a disease where you will yourself be responsible for the outcome of the disease. Ideally no one should get infected or die because of Dengue if proper preventive precautions are taken.
Dos and Don’ts for preventing Dengue
* As stagnant water is the breeding place for mosquitoes, so don’t allow any stagnation of water in and around your homes. Cover and clean all water containers like overhead water tanks, flower vases, pet water containers, coolers, as these mosquitoes will lay eggs in the standing water and will spread. Make it a habit to keep your house clean and junk free. There should be no old tyres and other storage containers with water inside, drain and clean your roof gutters and don’t allow water to accumulate. Clean your pools and fountains if you have them.
* Pay special attention to the clothes you and your children wear in this rainy season. Dengue virus carrying mosquitoes have black and white stripes and bites mostly on knees, legs, neck and ears, hence protect these areas. Wear clothes with long sleeves and pants. Use mosquito net and repellents. Apply mosquito repellent all over the exposed parts of your body.
* Prevent entry of mosquitoes in your homes by installing screens on your windows and doors. Remember dengue cannot spread from person to person by touch or through sneezing but mosquitoes can become infected once it bites a dengue patient and become capable of spreading among other family members also!
* Spread awareness about the Dengue in your mohallas and also educate children on Dengue symptoms.
* In case of occurrence of fever, observe the symptoms closely and always consult a doctor immediately and follow his advice strictly.
* Monitor Platelet count regularly.
* Take a nutritious diet to boost your immunity.
* Avoid self medication. Don’t give non steroidal anti inflammatory drugs like Aspirin, ibuprofen and steroids as these drugs can aggravate severe bleeding?
It is only you and your behavior which will decide this rainy seasonwhether you will get infected with Dengue or not and what will be the outcome! Each and everyone should actively spread the awareness about dengue and its prevention to all their nears and dears. The role of teachers, preachers, sarpanch, local leaders, mohalla committees is very important in this. So let us start a campaign that this rainy season no one should die because of this otherwise centuries old mosquito borne potentially fatal disease!
(The author is Professor of Microbiology Govt Medical College, Jammu)
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