Several major cities in Pakistan are implementing ‘health emergency’ measures to combat the spread of the dengue virus, a viral infection often referred to as break-bone fever. This disease is transmitted to humans through the bite of Aedes mosquitoes, which thrive in the hot and humid summer conditions prevalent in Pakistan. These ideal conditions facilitate the proliferation of mosquitoes, making them key vectors for vari-ous viral and parasitic diseases.Children are particularly susceptible to dengue due to their comparatively weaker immune systems and higher metabolic rates, which lead to increased sweating that makes them more attractive to mosquitoes. While many individuals infected with dengue may be asymptomatic, the disease can also present as a febrile illness. In rare cases, it can escalate to severe illness requiring hospitalization and, in extreme situations, may even be fatal. Dengue is transmitted through the bite of an Aedes mosquito carrying the virus.
Aedes mosquitoes are mainly active during the day, especially within two hours after sunrise and just before sunset. These times pose the greatest risk for mosquito bites and potential infections. The likelihood of in-fection rises in areas where water collects, such as around homes, workplaces, and communities, since Aedes mosquitoes breed in stagnant water. Their breeding sites can be as minimal as buckets, old tires, puddles, or even bottle caps.
Dengue is not transmitted directly between individuals. However, in the first week of infection, the virus circulates in the bloodstream of the infected person. If a mosquito bites them during this time, it can become infected and later spread the virus to others. Furthermore, pregnant women infected with dengue can transmit the virus to their babies either during pregnancy or at the time of delivery. In most cases, dengue symptoms are mild or may not be even visible at all, with recovery generally taking one to two weeks. However, in certain instances, dengue can escalate to severe forms, resulting in potentially life-threatening complications. Symptoms typically manifest four to ten days after infection and can last from two to seven days.
The several key symptoms characterizing dengue feverinclude a high fever reaching 40°C (104°F). Patients often experience intense headaches and pain behind the eyes, as well as significant muscle and joint pain. Additional symptoms may include nausea, vomiting, swollen glands, and a rash. These manifestations can vary in intensity among individuals, but they collectively contribute to the overall discomfort associated with the disease.
Individuals who contract dengue for a second time are at a higher risk of developing severe dengue infection. This serious condition typically presents symptoms that arise after the initial fever has resolved, including intense ab-dominal pain, persistent vomiting, and rapid breathing. Other concerning signs may involve bleeding from the gums or nose, feelings of fatigue and restlessness, blood in vomit or stool, extreme thirst, pale and cold skin, and overall weakness. It is crucial for anyone exhibiting these severe symptoms to seek immediate medical attention. Additionally, even after recovery, some individuals may experience lingering fatigue for several weeks.
To diagnose acute dengue, healthcare providers should request NS1 ELISA and IgM tests, or alternatively, NAAT and IgM tests. If dengue is suspected, it is important to initiate appropriate management without delay for test re-sults. To minimize the risk of dengue infection, individuals should take measures against mosquito bites, such as wearing clothing that covers as much skin as possible and using mosquito nets treated with insect repellent while sleeping during the day. Installing window screens can further enhance protection, and applying mosquito repel-lents containing DEET, Picaridin, or IR3535, along with using mosquito coils and vaporizers, is also recom-mended.
Similarly, to prevent mosquito breeding, it is important to manage the environment by eliminating potential egg-laying sites. This includes properly disposing of solid waste and removing containers that collect water.
Regularly covering, emptying, and cleaning domestic water storage containers, along with applying appropriate insecticides to outdoor water storage areas, is also essential to control mosquito populations. If you contract dengue, it’s vital to take certain precautions. Ensure you get plenty of rest and stay well-hydrated. For pain relief, use acetaminophen (paracetamol) and avoid non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin. Monitor your condition closely for any severe symptoms and seek medical attention imme-diately if they arise. Currently, the QDenga vaccine has been approved in some countries for individuals aged 6 to 16 in areas with high dengue transmission, and several other vaccines are also under evaluation.
Dengue cases in Pakistan see a marked increase each year during the late summer months, underscoring the urgent need for more effective prevention and control policies. To enhance efficiency, public awareness campaigns utiliz-ing both print and social media should be strengthened. There should also be a strong focus on mass education, empowering individuals to recognize symptoms and know when to seek medical attention. Furthermore, training school staff to educate children about preventive measures is essential, reinforcing the timeless adage that preven-tion is always better than cure.
The writer is Paediatrician at Fatima Jinnah Medical University alumna, currently working at the Pakistan Insti-tute of Medical Sciences (PIMS), Islamabad.
