PANAJI
On August 20, 1897, Ronald Ross first discovered the connection between malaria and mosquitoes and therefore this day is remembered as ‘World Mosquito Day’. It is important to learn more about Dengue, a mosquito-borne disease spreading like wildfire in Goa.
According to the World Health Organisation, half of the world’s population is at risk of Dengue, with an estimated 100“400 million infections occurring each year.
Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas. It’s on the rise in our country, and Goa is noticing a significant number of cases.
CAUSES OF DENGUE
To fight dengue, we need first to understand what causes dengue. Dengue fever is caused by the dengue virus, which belongs to the flavivirus genus. There are four distinct serotypes of the dengue virus: DEN-1, DEN-2, DEN-3, and DEN-4.
The good news is that infection with one serotype provides lifelong immunity to that specific serotype but only short-term protection against the others. This means that though a person is protected against the strain that infected them, they can be infected with other types of dengue viruses later in life.
It is also important to note that a second infection with a different serotype of the dengue virus can be more dangerous. This is because of a phenomenon called antibody-dependent enhancement.
When a person is infected with a different serotype, the pre-existing antibodies from the first infection can bind to the new virus but are not able to neutralise it effectively. Instead, these antibodies facilitate the virus’s entry into host cells, leading to increased viral replication and a heightened immune response.
This can result in severe forms of the disease, such as dengue haemorrhagic fever or dengue shock syndrome. These complications can be life-threatening.
Dengue virus affects the bone marrow, where platelets are produced, leading to decreased production. The virus can further cause increased destruction of platelets in the bloodstream. The immune response triggered by dengue infection can also contribute to the drop in platelet levels. Lower platelets will impair the clotting mechanism and will lead to bleeding. They have to be monitored.
AEDES AEGYPTI MOSQUITO
The mosquito responsible for transmitting dengue virus is the Aedes aegypti mosquito. It is different from the one that transmits malaria and has distinct black and white stripes.
Aedes mosquitoes breed in clean stagnant water. Common breeding sites include discarded tires, coconut shells, tires, flower pots, water storage containers, and any other items that can collect and hold water.
Another noteworthy characteristic of this vector is that these mosquitoes are most active during the day, especially during early morning and late afternoon. If one has to take remedial measures don’t just think of the home surroundings, but also think of the possibility that you would have been bitten while at work or in school.
SIGNS AND SYMPTOMS
Dengue fever typically presents with a sudden high fever, temperature can rise to 102 or 103, and may not easily come down with the paracetamol tablet. There could be severe headaches, pain behind the eyes, joint and muscle pain, rash, and mild bleeding such as nose or gum bleeds.
Severe dengue, also known as dengue haemorrhagic fever, can cause severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, bleeding from other sites, severe fatigue, and restlessness.
While many dengue infections are asymptomatic or produce only mild illness, the virus can occasionally cause more severe cases, and even death by causing shock and bleeding.
There is no specific treatment for dengue “ hydration and symptomatic treatment is provided.
HOW TO FIGHT DENGUE
Remember the word DENGUE:
D: Diagnosis “ consider any fever as dengue and get tested at the nearest health centre. They will do a rapid NS1 antigen test and the IgM test. Tests are available free of cost at the PHCs across Goa.
E: Environment cleanliness “ Ensure the elimination of breeding sites, doors, and windows have screens. Aedes mosquitoes breed in clean stagnant water. The outbreaks occur in the monsoons as there are multiple water collection sites, ideal for breeding.
N: Never use any painkillers, and use Aspirin with caution as they can also enhance bleeding. Notify the nearest PHC regarding your diagnosis.
G: Get in touch with your doctor and ensure close monitoring of platelet count and get rest.
U: Use ORS to keep yourself hydrated “ speak to your physician about it. Drinking water is crucial.
E: Encourage community efforts to control mosquitoes and cooperate with health services.
COMMUNITY INVOLVEMENT
Community involvement is vital. Ensure that every case of fever is tested for dengue and malaria. Collective action is essential, and everyone must unite to fight this disease. Stay informed, stay protected, and support the Directorate of Health Services in their efforts to control the spread of dengue.
[The writer is Assistant Professor in the department of Preventive and Social Medicine at the Goa Medical College and In Charge of the Urban Health Centre, St Cruz. He has a diploma in Tropical Medicine from the London School of Hygiene and Tropical Medicine, UK, and has a keen interest in vector-borne diseases and has published several research papers in this area]
