It is the time of cold fever. Due to the change in the weather, the fever continues in the house. Seasonal fever reduces appetite. The body becomes weak. Many are afraid that the fever will turn into an attack.
Monsoon fever and dengue outbreaks go hand in hand with the rains. This fever is more in the month of September-October. So be careful.
Medicine and diabetes expert professor Dr. Khwaja Nazim Uddin.
If someone has a short-term fever in our country from July, there is nothing wrong in thinking dengue. This fever usually lasts for 7-8 days. At first pain, headache is the real symptom. As with any fever there may be loss of appetite, nausea, runny nose, red eyes but the characteristic is body aches. The pain is so severe that many call it ‘break bone disease’. One of the symptoms is pain when moving the eyes. Phlegm cough, sore throat may be present but this is not characteristic of dengue fever. Weakness, swelling of the glands occurs in some but its severity is mild.
Fever: Similar to other fevers except that the fever occurs in two phases. After 3-4 days with a break of 2 days again fever for two days. Decreased pulse rate with fever is characteristic; Many are depressed for quite some time.
Rash: Confluent convulsant rash is the definitive way to understand dengue fever. It rises on the 6th day. First it spreads to the body and then to the arms and other places. Not in the palms of the hands and feet. Scarlet fever (2nd day) may also cause a rash similar to measles (4th day).
Haemorrhage: Fever, rash, haemorrhage are characteristic of dengue. Can be from any site (nose, eyes, skin, esophagus, urinary tract). It is more common in girls, even after menses, menses occur again. It should be remembered that haemorrhage is not dengue hemorrhagic fever.
Complications: Dengue hemorrhagic fever, dengue shock syndrome, DIC, severe organ failure (multi organ failure).
Possible place of dengue fever
It is a warning sign if you are in dengue area and fever is accompanied by any two of the following like vomiting or nausea, rash, pain, positive tourniquet test, leukopenia.
It is important to confirm them by laboratory test. Treatment is observation, being alert to warning signs. No other major illness or pregnancy requires admission.
Warning signs of dengue
Warning signs of dengue
Dengue should be suspected if any of the following are present, such as abdominal pain, abdominal stiffness, persistent vomiting, pleural effusion or ascites, hemorrhage, liver enlargement greater than one inch, rapid rise in hematocrit, or rapid decrease in platelets. It is grade-2 dengue hemorrhagic fever. If urgent treatment is required, OPD or indoor should be taken, saline should be given, admission should be advised.
Severe dengue: Shock due to severe plasma leakage (dengue shock syndrome), dyspnoea due to pleural effusion.
Severe bleeding: Bleeding in the esophagus (haematemesis, melena).
Malignant organ involvement (atypical features)
Liver: AST or ALT >˄ 1000
Nervous system: seizures, unconsciousness.
Heart and blood vessels: cardiomyopathy, heart block, arrhythmia.
Other: Kidney failure, pancreatitis, ARDS (lung failure), systemic hemorrhaging and coagulation (DIC), muscle breakdown (rhabdomyolysis).
Dengue viral fever is a simple illness similar to the classical cold. Otherwise it is fatal. Warning signs (symptoms of severity) should be observed i.e. monitored carefully.
Laboratory tests: As with all fevers, TC, DC, ESR, platelet count should be done on day 3 or 4. TC (total count) falling below five thousand is characteristic of dengue. Platelet count (normal 150000 to 450000) decreases in almost all fevers, if it is less than 100, it is dengue hemorrhagic fever, in which case precautions should be taken and follow up should be done. SGPT, SGOT indicate liver lesions, OT is elevated in dengue. The NS-1 antigen dengue test, however, is more reliable than the ELISA. Other tests should be done if there are warning signs or serious symptoms.
Treatment: Paracetamol and necessary water should be taken to bring down the fever. Both of these are basically dengue treatment. It is important to overcome the fear of dengue.
The difference from other fevers is that you have to be careful until 2 days after the fever goes away, these two days are the critical time because serious complications occur during this time. Drinking more water is beneficial at first, but be frugal at this time. If you drink more water will accumulate in the stomach (ascites), lungs (effusion). Only 2 liters of water in 24 hours. But it is better to determine the amount by looking at the amount of urine and blood pressure. Pulse pressure should be kept above 20.
In case of bleeding, if blood pressure decreases (systolic below 100), pulse increases (rate more than 100), hemoglobin decreases (less than 10, hematocrit is low), blood should be given (blood for blood).
Low blood pressure but high hematocrit (even with bleeding) should be given normal saline or hypertonic saline or plasma expander (never blood). Typical dengue can be treated by keeping them in the general ward. Atypical cases appear to be the cause of death, previously they were not called dengue symptoms, dengue deaths were attributed to secondary diseases such as kidney, heart, lung disease. Now it is seen that dengue causes disease of brain (encephalitis) and other organs. Many cases (especially multi-organ failure) require treatment in intensive care. Dengue treatment does not require platelets. Complications like shock syndrome do not occur for drinking water from the beginning. Everyone should be aware of the warning signs, have an understanding of atypical dengue.
Prevention: Mosquito prevention is the key, domesticated Aedes must be killed at all costs. Water should not be allowed to accumulate in any container for more than 5 days so that mosquito larvae do not grow in the container.
Vaccine: After the dengue vaccine was discovered, it is available in 10 countries including Indonesia. Not only because of cost, but also because of the practical complexity of the four-strain vaccine, it cannot be made universal.
What to do if you have a fever
* First four days: Reduce fever with paracetamol. One tablet of 500 mg should be given every 6 hours. If the temperature does not fall below 102, another should be given. If you drink water, the fever will go away. If the fever is 100, it will continue. No need to do 99.
* Drink plenty of water (3+ liters). Must rest. You have to try to eat and drink properly, you will get calories in juices etc.
* If it is more than 4 days, if you have other symptoms, you should see a doctor.
* Viral fever does not last more than 7 days.
* Rest reduces suffering during and after fever.
* If there is fever for more than 7 days, typhoid, paratyphoid, rickettsia should be considered in our country. Typhoid does not last more than three weeks. If more than three weeks, black fever, malaria should be considered. Typical symptoms of malaria will be found at this time. Black fever has reduced in our country.
* Fever lasting more than three weeks is called pyrexia of unknown origin (PUO for short). In their case, the cause of fever needs to be discovered by conducting 2-3 outdoor tests and even keeping them in the hospital.
Chikungunya is a viral infection carried by the Aedes mosquito like dengue
Joint pain with fever is the main symptom. There is no rash, no bleeding, no shock and no death. Rainfall starts from May and is highest in July-August.
Pain: Pain can occur in all joints, but is more common in the hands and feet. The groin may not swell but the pain (arthalgia) is severe. Chikungunya means stooped. There is a lot of pain in the neck, back and lumbar spine. To pray, to break the stairs, it will seem like the gira is breaking. Extreme pain to lie down in bed, to turn to the side, to go to the toilet. Pain resolves within three weeks, with many taking more than three months. All pains are completely cured. Dengue can cause massaging pain, muscle pain, bone pain but not so serious pain in the groin.
Rash : Maculopapular, not confluent petechial (bleeding) as in dengue. Out after 5 days. Symptoms can be severe in children, elderly patients and those with other medical conditions.
Blood platelets do not decrease. The diagnosis can be confirmed by an IgM antibody test after seven days. It is not needed for treatment. Dengue and chikungunya can occur simultaneously, one does not confer protection for the other. BSMMU contains IgM antibodies. It should be done in government big medical. There was no out break like last year. Dengue is more this time. The same outbreaks do not occur every year (cyclic outbreaks). We have national guidelines for both chikungunya and dengue.
Treatment: Treatment of fever in the first week is the same as for dengue – rest, 3 liters of water, 3 grams of paracetamol (no other medicine).
After Fever (Afebrile Phase): Care should be taken in hemorrhagic dengue as the patient may go into shock during this critical period. Chikungunya does not have this danger. Many people suffer from pain after fever, NS aids are needed. Corticosteroids, hydroxy chloroquinoline have no special effect. The patient should be reassured that whatever the pain may be, the joint will not be damaged.
Remedy: Avoid mosquitoes. Do not store water in the container for more than 5 days. Pots will not breed mosquitoes. No matter how many measures are taken to kill mosquitoes in the house, domestic mosquitoes should not be deterred.
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