Dengue spread causes panic... Cause of concern among Hooghly doctors; steps taken to initiate awareness programme

Hemant Jacob, SNS, Serampore, 26 October 2014: The recent spread of dengue in Hooghly district has become a cause of great concern among the doctors of the district. Steps are being taken to eliminate unnecessary panic among the masses and initiate awareness programmes.

In Hooghly, a number of dengue cases have cropped up and are creating great public health concern as one of the victim succumbed due to dengue hemorrhagic fever, according to physicians and general practitioners of Serampore, Baidyabati and Sheoraphuli locality. Dr Pradip Kumar Das, a physician and dermatologist in the area expressed concern as he has already diagnosed a number of cases of serologically-confirmed dengue fever within the last few days. He said that dengue has become one of the most important and widespread arthropod-borne viral diseases among humans, with 50 per cent of the world’s population living in dengue endemic regions, particularly in southeast Asia, the Pacific region.

Local living conditions, such as demographic density, population mobility, mosquito infestation, and sanitation are important risk factors. The recent spread of dengue has been attributed to a combination of urbanisation, poor living conditions, international global travel and trade, changes in mosquito distribution and abundance, climate via transmission.

He said that epidemic dengue transmission has a seasonal pattern, because of the influence of temperature and rainfall on mosquito abundance and capacity, with an increased intensity at the end of the summer, in rainy seasons, and during warm periods.

Dengue virus (DEN) is a small single-stranded RNA virus comprising four distinct serotypes (DEN-1 to -4). Transmission of all four dengue virus serotypes occurs via a mosquito-human cycle.

After an incubation period of 7-14 days, Aedes aegypti, the main vector becomes infectious and can transmit the virus by biting human hosts. The human incubation period is typically 4-7 days. For transmission, the mosquitoes must feed on an infected person during the five days when large amounts of virus are in the blood. Overall, three weeks are required for the virus to pass between two human hosts.

Epidemics depend on large numbers of mosquitoes, a susceptible human population, and high rate of contact between mosquitoes and humans widespread in both urban and rural areas, where multiple virus serotypes are circulating, and where dengue is a leading cause of hospitalisation and death in children.

The most prominent symptoms are fever, ranges from mild to very high, with severe headache, pain behind the eyes, muscle and joint pain, and rash with intractable itching all over the body causing disturbance of sleep. Severe dengue (also known as dengue hemorrhagic fever) is characterised by fever, abdominal pain, persistent vomiting, bleeding and breathing difficulty and is a potentially lethal complication, affecting mainly children but adults are not sparing. Early clinical diagnosis and careful clinical management by trained physicians and nurses increase survival of patients. regions.

Dr Das said that plasma leakage, haemo-concentration and abnormalities in homeostasis characterise severe dengue.

The mechanisms leading to severe illness are not well defined but the immune response, the genetic background of the individual and the virus characteristics may all contribute to severe dengue.

Thrombocytopenia may be associated with alterations in megakaryocytopoieses by the infection of human haematopoietic cells and impaired progenitor cell growth, resulting in platelet dysfunction, increased destruction or consumption. Haemorrhage may be a consequence of the thrombocytopenia and associated platelet dysfunction or disseminated intravascular coagulation.

In the absence of a vaccine, prevention depends on individual protection against mosquitoes and vector-control strategies. People who have dengue fever are advised to take rest, drink plenty of fluids and control fever by taking paracetamols or consulting a doctor . In the critical phase like shock or heamorrahage, patient should be admitted to a secondary health care facility.