The onset of monsoon every year brings with it significant range of ailments, including dengue, typhoid, malaria, and jaundice. Off late, the mosquito-borne disease, dengue, has been on the rise in various Indian cities. Many Indian states like Kerala, Odisha, Assam, Tamil Nadu, Maharashtra, West Bengal, and Karnataka continue to reel under the large numbers of dengue cases being reported everyday.
Along with heavy rains and severe floods, several regions of the country has been grappling with dengue. In Punjab, the dengue cases have spike to 288% in a span of 18 days. While the capital city of Delhi saw 105 cases in last week, Mumbai saw 317 cases till now, starting from August 1.
BOOM spoke to experts who explained that although the spike in cases during this time of the year isn't particularly unusual, precautions must be taken from our end nevertheless.
How does dengue spread?
Speaking to BOOM, general physician, Dr Ajay Mahajan, explained the science behind the spread of dengue which has the capability to reach epidemic proportions under inadequate control measures. He said, "Dengue is a viral infection spread by the infective bite of the Aedes Aegypti mosquito. Humans contract the disease five to six days after being bitten by an infected female mosquito that feeds both indoors and outdoors."
Unlike malaria which is caused by the carrier mosquito biting during night time, the carrier mosquito of dengue bites during the day, Mahajan added. These mosquitoes thrive in areas with standing water, including puddles, water tanks, containers, and air coolers.
Talking about the symptoms, Dr Arun Kumar, a Delhi-based physician, said that the symptoms of dengue begin to surface within 6 days after being infected. He added, "The infection manifests through symptoms such as high fever, severe headaches, joint and muscle pain and rashes."
According to Kumar, dengue is characterised by flu-like symptoms, such as a rapid, high-grade fever that comes in waves, pain behind the eyes, in the muscles, joints, and bones, a strong headache, an uncomfortable feeling of fullness in the abdomen, vomiting and a skin rash with red patches.
Kumar said, "Owing to the severity of muscle spasms and joint pain caused, dengue is also known as break-bone fever."
When does the symptoms become serious?
According to Kumar, dengue can cause health issues like hemorrhagic fever if it is not promptly and effectively treated. "The serious symptoms of this illness can cause bleeding from the nose and gums, liver enlargement, circulatory system failure, damage to lymph and blood arteries, and high fever."
It can induce massive bleeding and cause shock and death, this condition is known as Dengue Shock Syndrome. Individuals suffering from dengue can also experience a drastic fall in platelet count. "A normal human being has a platelet count between 1.5 lakhs and 4 lakhs, but dengue can reduce it to below 50,000. However, it also depends on the immunity of the person. Platelets below 40,000 can become life-threatening to some, while some are fine at a even lower count," said Kumar.
Platelets are small blood cells produced in the bone marrow, which helps the blood to clot enabling us to combat infections. Explaining the decline in platelet count, Kumar said, "During dengue, the bone marrow gets suppressed, resulting in a drop in platelet production. Antibodies that are produced during this time also cause huge destruction of platelets."
It is often said that when a person gets infected with dengue for the second time, the symptoms are serious. Mahajan told BOOM that this fact is not entirely wrong but there is a catch. He explained that dengue virus has four strains, namely, DENV1, DENV2, DENV3 and DENV4. Any of these strains can cause the infection.
According to Mahajan, "When an individual who has previously been infected by a particular strain contracts an infection from the same strain again, the resulting symptoms tend to be mild. This is attributed to the antibodies generated during the prior infection effectively combating the strain."
Conversely, if an individual is infected by a different strain, the symptoms become more severe, as the antibodies developed against the previous strain are not equipped to effectively counteract the new variant, he added.
What precautions should be taken?
According to Kumar, wearing full length clothes, eradicating mosquito breeding sites like stagnant water and using mosquito replant creams are effective preventive measures to keep the spread of dengue in check.
He advised, "Ensure that door and window screens work properly. One must follow basic precautions and take timely medical advice to avoid unnecessary hospitalisation and complications."
According to Mahajan, during this season one must get a dengue test done, on priority, if fever exceeds 2-3 days. "As the fever sets in, patients are recommended to opt for paracetamol over other medications such as combiflam or antibiotics. Administering antibiotics while dealing with dengue can lead to negative consequences, as it has the potential to lower the platelet count."
Apart from this, Mahajan strongly recommended increasing water intake during dengue. "In the course of a dengue infection, individuals experience symptoms such as gastrointestinal disturbances and intense diarrhea. Subsequently, these symptoms give rise to vomiting and a sense of fatigue. As a result of this, the body starts losing electrolytes at an accelerated rate," he said.
Therefore, it is strongly recommended to increase fluid intake to restore the body's electrolyte balance during this time.