One smooth operator, SHE has the eyes to see and track you with, an extra nose to better smell you with, the wings to fly, and six strong toned legs. Legs that allow her to stand on water, execute that perfect touchdown with you as her runway, and eventually, her preferred source for a full course meal. Prolific, evasive, unapologetic, she gets what she wants 99 percent of the time.
Among the mosquito-borne diseases, dengue remains to be a major public health concern. Globally, the World Health Organization has documented an “eight-fold increase in the number of cases over the last two decades.“ Annually, our country, which is hyperendemic for dengue, records around 200,000 to 250,000 cases. In 2019, the total number of cases rose to 400,000. In a recent report of the Department of Health, from the months of January to May, there was a notable 23-percent increase in cases as compared to the same period last year with the majority involving the pediatric age group. The total number of deaths was 180. These numbers are expected to increase into the rainy season.
The majority of dengue infections are mild and asymptomatic but may also lead to severe disease, shock, or death. Failure to recognize or seek early consult has resulted in less than favorable outcomes. It is a complex disease for multiple reasons, and here is an attempt to get you better acquainted.
First, as a virus, it has four serotypes, and immunity from one serotype does not afford protection for the others. This means that you can have dengue up to four times! Second, the only theory available on its pathogenicity is that the infection that follows after the first will be more severe. Third, only 20 percent of affected individuals exhibit symptoms, so one may be unaware of having been infected. Fourth, due to the nonspecificity of signs and symptoms, such as fever, headache, eye pain, rash, nausea, abdominal pain, vomiting, body malaise, and joint pains, diagnosis can be challenging as it can mimic other conditions, such as the flu, COVID, or other mosquito-borne diseases like chikungunya. Confirmatory tests are needed to establish the disease and rule out other possible infectious causes. Co-infection is possible, and we have seen patients with both dengue and COVID. Taken as a whole, the ambiguity of the disease has translated to lack of a known treatment, and management remains supportive.
Efforts to prevent and provide solutions to address dengue have included disease and vector surveillance, vector control, and in recent years, the promise of being a vaccine-preventable disease and possible antiviral medication. For now, left with no major answers, ensuring vector control through the elimination of breeding places, avoiding being bit, synergized with sustained community and educational efforts on dengue prevention can at least curb the spread.
As a female of the two-legged specie, I end this piece hoping to have been a vector in effective knowledge transmission. Prevention and initial management may hopefully be less complex if you constantly feed on these pieces of advice.
Do be vigilant about the signs of dengue.
Ensure adequate and proper hydration.
Never use ibuprofen for fever, acetaminophen is recommended.
Go for early consult.
Understand that dengue may have complications.
Ensure your environment is not conducive to breeding mosquitoes.
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