Dengue Fever Danger That Can Kill Not Only Children But Also Adults

Article by – Dr. Moe Thit Nay (Ayeyarwaddy Times, July 26) In Myanmar, many lives are lost every year due to dengue fever during the monsoon season. Therefore, it is necessary for families to know in advance what conditions of dengue fever are life-threatening and to be able to save lives in time. Recently, a poet passed away from Dengue Hemorrhagic Fever (DHF). Although it is sad news, I want to clearly warn that dengue fever can be life-threatening not only to children but also to adults. Most people tend to think of dengue fever as a children's disease. However, the incidence of dengue fever in adults is now significantly increasing. Especially in the elderly over 60 years old, and in those with chronic diseases such as hypertension, diabetes, and heart disease, dengue fever can lead to more severe illness and a higher mortality rate than in children. Symptoms in adults are less obvious than in children and can be mistaken for other diseases, often leading to delayed hospital arrival and life-threatening situations. Pay Special Attention to the Period After Fever Subsides In dengue fever, the period after the fever subsides is the most life-threatening, medically termed the "Critical Phase." When the body temperature drops within 3 to 5 days of fever, patients may mistakenly believe they are recovering. In reality, at this time, the capillaries' function is impaired, and plasma leakage begins to occur outside the blood vessels. If not treated properly during this period, Dengue Shock Syndrome can develop, leading to organ damage and death. Therefore, if any of the following "Warning Signs" appear, not only during the fever but also after the fever has subsided, the patient must be immediately transported to the nearest hospital or clinic without delay. - Abdominal pain, severe pain when pressing on the abdomen. - Frequent vomiting (vomiting more than 3 times a day). - Bleeding from the gums, nosebleeds, blood in vomit, and bleeding from various sites. - Extreme lethargy, restlessness, or confusion. - Rapid breathing, difficulty breathing. - Cold extremities (fingers and toes) that extend up to the knees and elbows, and pale skin. These are "Warning Signs" that require immediate medical attention. The Three Phases of Dengue Fever (Day-by-Day Phases) Dengue fever typically lasts about a week from onset to recovery, passing through three phases according to the days. Febrile Phase (Day 1 to Day 3/4) Starting from the first day of fever, the body temperature can suddenly rise sharply to 40 degrees Celsius (104 degrees Fahrenheit). Symptoms include pain behind the eyes, severe headache, and muscle and bone aches. The pain can be so intense that it feels like bones are breaking, hence it was also called "Breakbone fever." Critical Phase (Day 4 to Day 6) This is the period that requires special attention and observation. The fever can suddenly drop, but this is not a sign of recovery but the most dangerous time. Plasma leakage from the blood vessels occurs, and platelets rapidly decrease. If warning signs appear, immediate hospitalization and treatment are necessary. Recovery Phase (Day 7/8 onwards) This is the period when the critical phase is overcome, and the patient recovers and heals. The body reabsorbs the leaked plasma into the blood vessels. The patient can eat and drink, and regain strength. Small itchy red rashes may appear all over the body, which is a sign that the disease is about to heal. Precautions During Home Care If dengue fever is suspected, improper home care can push the patient into further danger. Do not give any painkillers. For fever reduction, only Paracetamol should be given. Painkillers such as Ibuprofen, Aspirin, and Diclofenac should not be administered. These medications can worsen plasma leakage, cause gastrointestinal bleeding, and lead to death in a short period. Taking over-the-counter medications for fever without consulting a doctor can worsen dengue fever. Do not give injections. Injections to reduce fever can cause internal bleeding from the muscle at the injection site, as bleeding may not stop. This is a special caution for us Myanmar people who tend to want injections for fever. Treatment for Dengue Fever Currently, there is no medicine that can directly kill the dengue virus. Treatment is purely "Supportive Care" to alleviate symptoms. Hydration is the most crucial aspect. To prevent plasma leakage, oral rehydration solutions (ORS), fresh fruit juices, and broths should be consumed frequently. Drinking large amounts of plain water can cause electrolyte imbalance, so ORS should be prioritized. For fever reduction and pain relief, only Paracetamol should be given. In case of hospitalization, blood tests (CBC) will be performed regularly, and intravenous fluids (IV fluids) will be administered systematically and calculated as needed. It is not necessary to transfuse plasma every time platelets decrease in dengue fever. According to current WHO guidelines, transfusion of Fresh Frozen Plasma (FFP) is generally not recommended in the treatment of severe dengue fever patients. It is not necessary. Only in cases where massive bleeding is suspected, such as gastrointestinal bleeding with vomiting blood or bloody stools, severe shock, or a sudden drop in Hematocrit (Hct), are packed red blood cells transfused to save a life. How to Prevent the Disease (Prevention) The best way to prevent dengue fever is to eliminate the Aedes mosquito, which carries the virus, and to avoid mosquito bites. The Aedes mosquito lays eggs in clean water, so cover water jars and tanks around your home. Frequently change the water in flower pots and water bowls. Dispose of old tires and cans that can collect water. Strictly follow the methods of "Cover, Empty, Change, Check." Use a mosquito net when sleeping during the day. Wear long sleeves