What is Dengue Hemorrhagic Fever?
Dengue Hemorrhagic Fever (DHF) is a disease caused by viruses mainly transmitted by Aedes aegypti (a type of mosquito), though other species of mosquito can also transmit this disease. DHF is popularly known as the "break-bone disease" because most of its victims suffer from muscle and joint pain. Diagnosis of dengue should be done promptly because the disease may progress so fast that saving the life of the patient may be impossible. This is harder than most would have thought because the first signs and symptoms of DHF are not symptom-specific.
Dengue is commonly occurring in tropical and sub-tropical areas. It is endemic in countries around the equator and potentially affects over 2.5 billion people. There are many efforts made by government and non-government organizations to at least curb down or eliminate the risk of developing DHF. Some of these efforts were successful but there is still so much work to do.
Pathophysiology of DHF
Dengue virus needs a host to thrive. When it is contracted by a mosquito, the dengue virus will stay in the saliva and when the mosquito bites a person, the saliva carrying the virus will enter the skin. The virus will then look for a cell, in this case white blood cell, where it will replicate itself as it moves throughout the body. The white blood cell will then try to suppress the proliferation of this virus. This will trigger most of the non-specific symptoms of DHF such as fever, body pains, and flu. When the body cannot stop the virus from spreading throughout the body, the virus will affect bones and liver. The virus will also feed on the small capillaries in the body which will cause its collapse. This explains the petechial hemorrhage and bleeding in different parts of the body. As the disease progresses, hypovolemic shock may happen which may lead to death.
Treatment and Management
There is no single course of treatment for dengue fever. Management greatly depends upon the symptoms experienced by the patient. One of the most common therapies performed is the oral rehydration therapy because of the great danger for dehydration. Dengue patient suffers from hemorrhage and fluid loss, thus it is important to look closely for signs of fluid deficit. In addition to this, aspirin should not be given as this might decrease blood clotting.
When the patient is already in the recovery phase, the reverse occurs. The body starts to regain and reabsorb lost fluids. There is a danger for hypervolemia. Loop diuretics may be prescribed to decrease body fluid. When the body is stable and vital signs are within normal range, stopping further intake of fluid is enough as a means of management.