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23. What should the doctors treating dengue do?
Patients suspected to be suffering from dengue haemorrhagic fever
or dengue shock syndrome should be admitted to a hospital without
delay. The progress of these patients should be monitored regularly
at 1-2 hours interval. Platelet counts and haematocrits should be
monitored repeatedly to review the progress of patients. If the
haematocrit levels fall dangerously then a blood transfusion should
be considered. A fall of more than 20 % as compared to previous
levels may be an indication for transfusion. If the haematocrit values
rise, the patient should be given fluids intravenously and the fluids
carefully monitored to ensure that the patient does not get excess
fluids. A rise of more than 20 % as compared to previous levels may
be an indication for IV fluids. The doctor should decide based on best
24. What should the doctors treating dengue avoid?
Do not prescribe Aspirin and Brufen or any other medicine that reduces
the platelets or increases the tendency to bleed. Avoid giving IV (Intra
Venous) fluids unless the patient is bleeding or the haematocrit level
is rising progressively. Avoid rushing into giving blood transfusion
unless the haematocrit is falling dangerously. Do not give platelet
transfusion unless the platelet count is very low or unless there is
25. What is your advice regarding reporting of dengue?
All suspected or probable dengue cases should be reported to the
health authorities. The health authorities do further confirmation of
the cases. Seek their guidance on blood collection and transportation
of samples from suspected/probable cases of dengue.
26. What can the community do to prevent dengue?
In fact, the community participation is the key factor in dengue
prevention. As elaborated above, prevention of dengue relies heavily
on preventing the mosquito (Aedes aegypti and Aedes albopictus)
that transmits dengue from breeding inside and in the vicinity of
homes. Every household can undertake the very simple measures to
prevent existing water collections from becoming places for breeding
of Ae. aegypti by draining out water from various containers, by regular
changing of water plus cleaning flower vases and other items or, in
the case of unused items, by discarding/destroying them. Since the
mosquito does not travel far, house cleaning by all members of a
community will ensure that no breeding places exist, preventing
dengue from occurring. The main strategy in the prevention and control
of dengue is source reduction, or prevention of breeding places,
Dr.U.S.N. MURTY, Center Co-ordinator, Head Biology Division, IICT,
in blood haematocrit. Patients with dengue may not have a high
haematocrit if the person was anaemic to start with.
6. Can you get dengue again after suffering from it once?
Dengue infection is caused by a virus, often manifests as dengue
It is possible to get dengue more than once. Dengue can occur because
fever. Occasionally the patient suffering from dengue may develop
of 4 different but related strains of dengue virus. If a person has
bleeding from sites like nose, gums or skin. Sometimes, the patient
suffered from one virus, there can be a repeat occurrence of dengue
may have coffee ground vomiting or black stools which indicates
if a different strain is involved subsequently. Being affected by one
bleeding in gastro intestinal tracts. Rarely the patient suffering from
strain offers no protection against the others. A person can suffer
dengue may develop shock, then it is called dengue shock syndrome
from dengue more than once in her/his lifetime.
2. Is dengue an emerging infectious disease?
Dengue fever occurs following the bite of an infected mosquito Aedes
Yes. All types of Dengue viruses are re-emerging worldwide and
aegypti ((Tiger mosquito) )and Ae.albopictus which is characterized
causing larger and more frequent epidemics, especially in cities in
by a peculiar white spotted body and legs and is easy to recognize
the tropics. Several factors are contributing to the resurgence of
even by layman. It breeds in clean water and has a flight range of
only 100 200 metres. The mosquito gets the Dengue virus after
· No effective mosquito control efforts are underway in most
biting a human being infected with dengue virus.
8. Can I get dengue fever from another person?
Public health systems to detect and control epidemics are
Dengue does not spread directly from person to person. It is only
spread through the bite of an infected mosquito.
Rapid growth of cities in tropical countries has led to overcrowding,
urban decay, and substandard sanitation, allowing more
9. When does dengue develop after getting the infection?
mosquitoes to live closer to more people.
After the entry of the virus in the person, it multiplies in the lymph
· The increase in non-biodegradable plastic packaging and
glands in the body. The symptoms develop when the virus has
discarded tyres is creating new breeding sites for mosquitoes.
multiplied in sufficient numbers to cause the symptoms. This happens
· Increased air travel is helping people infected with dengue viruses
generally about 4-6 days after getting infected with the virus.
10. Can people suffer from dengue and not appear ill?
Yes. There are many people who are infected with the virus and do
Dengue viruses occur in most tropical areas of the world. Dengue is
not suffer from any signs or symptoms of the disease. For every
common in Africa, Asia, the Pacific, Australia, and the Americas. It is
patient with symptoms and signs there may be 4-5 persons with no
widespread in the Caribbean basin. Dengue is most common in cities
symptoms or with very mild symptoms.
but can also be found in rural areas. It is rarely found in mountainous
11. Is it possible to treat dengue at home?
Most patients with dengue fever can be treated at home. They should
take rest, drink plenty of fluids that are available at home and eat
Dengue should be suspected when you have sudden onset of fever.
nutritious diet. Whenever available, Oral Rehydration Salt/ORS
The fever is high 103-105 degrees F or 39-40 degrees C. It is
(commonly used in treating diarrhoea) is preferable. Sufficient fluid
accompanied with severe headache (mostly in the forehead), pain
intake is very important and becomes more important in case DF
behind the eyes, body aches and pains, rash on the skin and nausea
progresses into DHF or DSS where loss of body fluid / blood is the
or vomiting. The fever lasts for 5-7 days. In some patients, fever
most salient feature.It is important to look for danger signs and contact
comes down on 3rd or 4th day but comes back. All the above symptoms
the doctor as soon as any one or more of these are found.
and signs may not be present in the patient. The patient feels much
discomfort after the illness. The severity of the joint pain has given
12. What is the possible treatment for Dengue?
dengue the name breakbone fever.
Like most viral diseases, there is no specific cure for dengue fever.
Antibiotics do not help. Paracetamol (can be purchased without
5. What is the difference between suspected and probable
prescription) is the drug of choice to bring down fever and joint pain.
Other medicines such as Aspirin and Brufen should be avoided since
Dengue patients are characterized by reduced platelets or an increase
they can increase the risk of bleeding. Doctors should be very careful
when prescribing medicines. Any medicines that decrease platelets
female mosquito lays her eggs in water containers in and around the
homes, and other dwellings. These eggs will develop, become larvae,
and further develop into adults in about 10 days.
The infection can become dangerous since it may cause damage to
19. How can the multiplication of mosquitoes be reduced?
the blood vessels. The damage may range from increased permeability
Dengue mosquitoes breed in stored, exposed water collections.
of the blood vessels, causing leakage of blood fluid/plasma into various
Favoured places for breeding are barrels, drums, jars, pots, buckets,
organs to completely broken blood vessels that causes bleeding. The
flower vases, plant saucers, tanks, discarded bottles, tins, tyres, water
symptoms and signs of dengue haemorrhagic fever and dengue shock
coolers etc. To prevent the mosquitoes from multiplying, drain out
syndrome are related to damage to the blood vessels and derangement
the water from desert coolers/window air coolers (when not in use),
in functioning in components of blood that help it to clot.
tanks, barrels, drums, buckets etc. Remove all objects containing
water (e.g. plant saucers etc.) from the house. Collect and destroy
discarded containers in which water collects e.g. bottles, plastic bags,
People who suffer from dengue fever have no risk of death but some
tins, used tyres etc. In case it is not possible to drain out various
of them develop Dengue Haemorrhagic Fever or Dengue Shock
water collections or to fully cover them, use TEMEPHOS, an insecticide,
Syndrome. In some of these cases death can occur. With proper
(brand name Abate) 1 part per million according to the local guidelines
treatment, the patients with Dengue haemorrhagic fever and dengue
to prevent larvae from developing into adults.
shock syndrome can recover fully. Good treatment provided in time
20. How can I prevent mosquito bites to prevent dengue?
15. When should a patient suffering from Dengue go to the
There is no way to tell if a mosquito is carrying the dengue virus.
Therefore, people must protect themselves from all mosquito bites.
Generally the progress towards dengue haemorrhagic fever or dengue
Dengue mosquitoes bite during the daytime throughout the day.
shock syndrome occur after 3-5 days of fever. At this time, fever
Highest biting intensity is about 2 hours after sunrise and before
often comes down. This may mislead many of us to believe that the
sunset. Wear full sleeves clothes and long dresses to cover as much
patient is heading towards recovery. In fact, this is the most dangerous
of your body as possible. Use repellents- be careful in using them on
period that requires high vigilance from care-givers. The signs and
young children and old people. Use mosquito coils and electric vapour
symptoms that should be looked for are severe pain in the abdomen,
mats during the daytime also to prevent dengue. Use mosquito nets
persistent vomiting, bleeding from any site like, bleeding in the skin
to protect children, old people and others who may rest during the
appearing as small red or purplish spots, nose bleed, bleeding from
day. The effectiveness of these nets can be improved by treating
gums, passage of black stools like coal tar. Bring the patient to the
them with permethrin (pyrethroid insecticide). This bed-net is called
hospital whenever the first two signs, namely, severe pain in the
Insecticide Treated Nets and are widely used in the prevention of
abdomen and persistent vomiting are detected. Usually it is too late
if we wait until bleeding has occurred. The most dangerous type of
dengue is the dengue shock syndrome. It is recognized by signs like
21. Is there any advice for the patient with dengue fever to
excessive thirst, pale and cold skin (due to very low blood pressure),
prevent the spread of the disease to others?
restlessness and a feeling of weakness.
The spread of dengue from a patient to others is possible. The patient
should be protected from contact with the mosquito. This can be
16. Is there a vaccine to prevent dengue fever?
achieved by ensuring that the patient sleeps under a bed-net. Effective
A vaccine has been developed to prevent dengue fever but it is still
mosquito repellents are used where the patient is being provided
under trial. It is not yet available in the market. Scientific progress is
care. This will prevent the mosquito from biting the patient and from
likely to help in prevention of dengue fever by vaccination in the
getting infected and spreading it to others.
17. Are there any long- term ill effects of dengue fever?
22. What is your advice on travel if there is an outbreak of
Most people who suffer from dengue fever recover in 1-2 weeks time.
Some may feel tired for several weeks. However, if symptoms persist
There is no travel restriction. However, you should be aware of what
after this period, consult a doctor.
to do if you are travelling an area where dengue has been reported.
18. Where does the mosquito that spreads dengue live?
This includes observing prevention measures described in these
The highly domestic mosquito Aedes aegypti rests indoors, in closets
frequently asked questions and answers and reporting to the doctor
and other dark places. Outside it rests in cool and shaded places. The
if you have fever and are worried that it might be dengue fever.
MCQ – Respiration Answers are shown in Bold 1.Simple binary fission is found in a. Paramecium b. Sponge c. Euglena d. Amoeba a. Simple binary fission b. Transverse binary fission c. Longitudinal binary fission d. Oblique binary fission 3. Which of the following animal show Longitudinal binary fission a. Euglena and Vorticella b. Opalina and Monocystis c. Volvox and Chlamydomonas d.
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