What is dengue hemorrhagic fever?

As any Internal Medicine Specialist would tell you, there is difference between dengue fever and dengue hemorrhagic fever (DHF). The latter is rapidly fatal and needs prompt management. Read on to know more about the complications of dengue hemorrhagic fever and how to deal with them:

What is dengue fever?

Dengue fever is a consequence of aedes mosquito bite, that transmits an of the four dengue viruses—DENV1, 2, 3 or 4—especially in the tropical and subtropical regions. The mosquito bite and subsequent infection it causes, presents with high fever, flu-like symptoms, and may progress to dengue hemorrhagic fever.

Every year, millions of people are infected by the dengue fever, especially in the highly prevalent regions, including: Caribbean, Northern Australia, Latin America, Africa, Southeast Asia, western Pacific islands, with outbreaks in Europe and southern United States.

Who is at risk of dengue hemorrhagic fever?

Not everyone who is infected with dengue fever gets to develop dengue hemorrhagic fever. This severe form of disease only occurs in some people, around 3 to 7 days after fever. Unlike malaria, dengue fever is more common in rural areas. Individuals at higher risk of developing dengue hemorrhagic fever include:

  • pregnant women
  • people at the extremes of ages like the infants and the elderly
  • individuals with lowered immunity such as cancer patients receiving chemotherapy and people with organ transplants receiving immunosuppressants.

What are the symptoms of dengue hemorrhagic fever?

Dengue hemorrhagic fever is characterized by damage to: the blood vessels, lowered platelet count, circulatory system collapse, damage to the lymphatic system, internal bleeding, and liver enlargement.

On its own, dengue fever is rarely fatal and easily managed. However, when it progresses to dengue hemorrhagic fever, the disease becomes difficult to managed with rapid patient deterioration.

The symptoms of dengue hemorrhagic fever include:

  • mild to moderate fever
  • intense headaches
  • nausea and vomiting
  • severe pain in the joints and muscles
  • retro-orbital pain with intense pain in the eyes
  • rashes on the skin which may appear on the fifth day of fever onset
  • restlessness
  • nosebleeds
  • rapid decrease in blood pressure

The criterion for dengue hemorrhagic fever according to WHO includes: fever, positive tourniquet test, low platelet count (less than 100,000 per microliter), minor or major hemorrhage, low albumin count and fluid in the abdomen or lungs.

What are the complications of dengue hemorrhagic fever?

Dengue hemorrhagic fever can damage the blood vessels and the organs. The complications therefore, include:

  • seizures
  • heart damage
  • brain damage
  • damage to the liver and lungs
  • organ damage
  • shock and eventually death

How to deal with dengue hemorrhagic fever?

The goal of the treatment is to manage the symptoms and to keep the infection from worsening. In case of diagnosis of dengue hemorrhagic fever, emergency treatment is needed, such as:

  • electrolyte therapy due to electrolyte imbalance as third spacing occurs
  • blood transfusion may be needed as the platelet count drops and the patient bleeds
  • oxygen therapy as fluid leaks into the lungs
  • careful monitoring of the blood pressure as the patient goes into shock
  • management of pain through over-the-counter pain medication
  • intravenous fluid therapy to control and alleviate the symptoms

Despite these measures, the patient can worsen as dengue hemorrhagic fever is difficult to treat. The patient deteriorates rapidly in dengue hemorrhagic fever and needs constant monitoring by the healthcare provider. Only with early recognition of patient symptoms, and timely intervention is there a positive outlook for dengue hemorrhagic fever.

How to prevent dengue hemorrhagic fever?

Even though the FDA has approved a three-dose vaccine for dengue fever, its effectiveness remains to be seen. The best way to prevent dengue hemorrhagic fever is stopping mosquito bites and targeting their breeding grounds. This is especially true for people living or traveling to the endemic regions. Such people should seek prior help from Internal Medicine specialist in Lahore.

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