Signs of dengue fever in adults

Prolonged hot weather with alternating heavy rains is a favorable time for infectious diseases to break out on a large scale. The most dangerous of which are dengue fever and hand, foot and mouth disease.

Dengue fever can be seen in adults or children. This is an infectious disease caused by the dengue virus. This virus is transmitted from an infected person to a healthy person by mosquito bites. In particular, Aedes aegypti (zebra mosquito) is the main mosquito that transmits the disease. The disease has diverse clinical manifestations.
Dengue fever often makes the patient's body fatigue, especially pain in the muscles and joints. Mild dengue can cause fever and a skin rash. Severe dengue can cause bleeding, a sudden drop in blood pressure, and death. The disease has a sudden onset and is likely to progress rapidly. Therefore, it is necessary to pay attention to watch for warning signs and to be hospitalized for timely inpatient treatment when the disease shows signs of worsening.
>> Details: Levels of dengue fever and accompanying signs - The article was expertly consulted by MSc Nguyen Thi Ngoc - General Doctor, General Health Examination Unit, International General Hospital Vinmec Central Park.

In Vietnam, dengue fever can be acquired in all 3 regions, including urban and rural areas. The disease usually occurs all year round but often breaks out into epidemics in the rainy season, from June to October every year. The virus causing the disease is Dengue, there are 4 serotypes: DEN-1, DEN-2, DEN-3 and DEN-4. To diagnose the cause of Dengue virus, patients need to have serological tests:
Rapid test: Dengue NS1 (finding NS1 antigen in the first 5 days of illness or finding IgM antibodies from day 5 onwards); ELISA test (for IgM, IgG antibodies). Slow test such as: PCR test, virus isolation. Dengue fever often has symptoms similar to common viral fever, so adults with dengue fever are often very subjective and self-medicate, only hospitalized when the signs of dengue in adults have changed. severe variable. Dengue fever is not detected, diagnosed and treated promptly, which can lead to hypovolemic shock, coagulation disorders, organ failure, etc., which can easily lead to death.
>> Details: If you have this level of dengue fever, pay attention to the hospital immediately - The article was professionally consulted with Master, Doctor Nguyen Thi Nhat - Infectious Disease Specialist - Department of Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

According to the World Health Organization (WHO) in 2009, adult dengue fever is divided into 3 levels and depending on each level, there will be different signs of disease:

Patient has a sudden high fever, continuous fever for 2-7 days and accompanied by at least 2 of the following signs:
Hemorrhagic manifestations: positive ligature test, subcutaneous hemorrhage, bleeding bleeding gums or nosebleeds. Headache, loss of appetite, nausea. Congestive skin, rash. Muscle pain, joint pain, eye pain.

Includes all symptoms of Dengue, with the following warning signs:
Struggling, lethargy, lethargic. Abdominal pain in the liver (right lower quadrant) or tenderness in the liver. Liver enlargement > 2 cm. Vomit a lot. Mucosal bleeding. Little urine.

Not only have the initial symptoms above, severe dengue can also cause rapid, life-threatening complications such as hemorrhage, multi-organ failure, shock, myocarditis... The disease has one of the following manifestations indicating severe dengue fever:
Severe plasma leakage leading to hypovolemic shock (Dengue hemorrhagic fever), fluid accumulation in the pleural cavity and abdominal cavity. Heavy bleeding. Organ failure.

Most dengue fever cases are treated as outpatients and monitored at medical facilities, mainly with symptomatic treatment and close monitoring. Especially, it is necessary to monitor to detect early manifestations of shock in dengue fever for timely treatment. Treatment of dengue fever is mainly symptomatic treatment:
If the patient has a high fever ≥ 39 degrees Celsius, take antipyretic drugs, loosen clothes and cool the whole body with warm water. The only antipyretic drug used is paracetamol, the dose is from 10 to 15 mg/kg body weight/time, every 4-6 hours. The total dose of paracetamol should not exceed 60 mg/kg body weight/24 hours. Do not use aspirin (Acetylsalicylic acid), Ibuprofen, Analgin to treat fever because it can cause bleeding and acidosis. Early rehydration for the patient by oral: oresol water or cooled boiled water, fruit juice (coconut water, orange juice, lemon juice...) or diluted porridge with salt. If the patient has signs of level 2 - Dengue hemorrhagic fever with warning signs and level 3 - severe Dengue hemorrhagic fever, they need to be hospitalized urgently for timely treatment. >> See also: Antipyretic drugs should and should not be used when having dengue fever - The article was professionally consulted by Pharmacist Ngo Thi Thu Thuy and pharmacist Nguyen Hoang Phuong Khanh - Faculty of Pharmacy - General Hospital Vinmec Central Park International Faculty.

Dengue hemorrhagic fever on special locations such as pregnant women, obese people, the elderly, people with comorbidities such as diabetes, pneumonia, bronchial asthma, heart disease, liver disease, disease kidney..., people who live alone or whose family is far away... then medical facilities should consider early hospitalization for monitoring and treatment. During treatment, pay special attention to the time of fever reduction (usually on the 4th day after the illness), this is the most dangerous time because serious complications can appear when the patient has a high fever, sudden change to no fever but cold limbs, lethargy, may be accompanied by vomiting or bloody stools.

Preventive measures are mainly to control insects that transmit diseases such as:
Kill larva (larvae), kill adult mosquitoes, clean the environment, remove reservoirs of standing water. Cover all water containers, change the water in flower vases regularly. Release fish to kill larvae. Avoid mosquito bites by: sleeping under nets, spraying mosquitoes, applying anti-mosquito cream, wearing long-sleeved clothes...