Dengue fever! You may have heard it, heard some people contact it, or might be a stranger on the news or your acquaintance, but what exactly is this dengue fever that people have been talking about? Should you worry about it? And how to avoid, or at least, mitigate the damage should you catch the disease?
Dengue fever is a tropical disease caused by the dengue virus spreading with the help of a certain mosquito species called Aedes Aegypti. It is typically manifested as sudden fever accompanied by headache often radiated to the area around the eyes, general muscle and joint ache, nausea, vomiting, and occasionally, stomach pain.
It is a tropical disease that might be rare in a non-tropical climate country, but an everyday occurrence in tropical countries especially during the rainy season.
In Indonesia itself, there are more than 110.000 cases in 2023, with almost 900 deaths. The number increased in 2024, with more than 200,000 confirmed cases with more than 1.200 deaths up to the 43rd week in 2024.
The dengue virus attacks your thrombocytes/platelets and white blood cells.
Your blood vessels constantly undergo small leaks and tears, however, the thrombocytes in your body form a clot and plug those leaks. However when the amount of your thrombocytes is below the required amount due to the dengue, your blood would start to become unable to fix the small tear and the plasma in your blood vessels would start to leak, which can lead to severe dehydration ending in multi-organ failure.
The plasma leakage that accumulates would also inhibit the space and push your organ, for example, if the accumulation of the leak happens inside your skull, it can push your brain leading to fatal consequences.
Meanwhile, the leakage of the plasma would cause your blood to thicken, which disturbs its flow, leading to an inability to supply oxygen to all of your organs.
The attack on the white blood cells also compromises your immune system, putting you more at risk of other pathogens, for example, salmonella co-infection.
Fortunately, some people who contracted the disease manifest rather mild symptoms, some even never realise they got dengue. However, when it manifests in such a way that it hinders your activity, such as when a fever starts to develop, we know we must not be negligent.
Some people have developed symptoms and severity that require proper medical treatment, even hospitalisation.
However, without adequate treatment, dengue does have a mortality rate as high as 20%, and even with treatment, the mortality rate can be as high as 2-5%. However, the mortality rate can be reduced to as low as less than 1% with early detection.
Dengue typically comes with an obvious sign of sudden fever. So if you experience a sudden fever, especially if it is accompanied by headaches and radiates to the area around your eyes, or muscle and joint aches, especially during the rainy season, It is better to get yourself checked by a medical professional for the possibility of dengue.
Unfortunately, dengue fever comes in a biphasic phase, which means the fever is not constant but has a “calm” period between the two phases of fever, which often become the pitfalls among those infected with dengue, as they often would consider themselves recovering during the “calm” phase, rendering their guard down, and did not seek medical examination, while in fact, the “calm” phase is the start of the critical phase where their thrombocytes started to be compromised.
The typical dengue's initial fever would last 2-3 days before entering the critical phase.
Therefore, should you find yourself or your loved one experiencing a sudden fever with a recent history of travelling to a tropical country, especially during the rainy season, it's a good idea to get yourself checked for dengue.
Fortunately, we have several “tools” at our disposal to detect dengue, although the sensitivity of the test would vary test-by-test and depend on which phase of the dengue fever you are in.
One of the most specific is the dengue antigen test (Ns1), which detects the presence of the dengue virus's nuclear. The test has approximately 70% sensitivity, although once reactive it is very specific. The test's sensitivity peaked on the first 2 days of fever, and would gradually diminish, albeit still detectable, up to 7 days.
The second test we have is the dengue IgM antibody test, although the test is relatively sensitive on the 5th day of fever forward, the sensitivity might not be too sensitive beforehand as the antibody would start to form and still at small amounts in the earlier phase of the infection.
The third test is the full blood count to assess the amount of thrombocytes, and to an extent, the white blood cells. Although hardly sensitive nor specific, the test can assess the severity of the dengue through the amount of thrombocytes.
The CDC (Central of Disease Control) recommended those with a fever on days 0-7 who had recently travelled to a dengue endemic country, should be tested for both antigen and antibody testing regardless of which phase of fever they are in.
Meanwhil, the full blood count test would be indispensable to assess the severity of both the thrombocytes and white blood cell deficiency.
Fortunately, all 3 tests are available in every branch of our Nusa Medica Clinic.
You definitely should seek medical advice. The doctor would either give you the option to treat the dengue as an outpatient or recommend you to be hospitalised depending on the severity of the symptoms and the result of the tests.
Fortunately, the dengue virus is a self-limiting disease, meaning the virus itself would kill itself after a while, which in dengue's case, typically in 7 days.
The goal of treatments is basically to prevent you from dying before the virus does.
The doctor would constantly monitor your condition by recommending a periodical evaluation and laboratory test, symptomatic medication, and specific treatment to prevent secondary infection or complications depending on how the disease develops, which may include aggressive treatment for secondary infection, and in the most severe case, platelets transfusion can also be recommended.
As dengue's transmission is exclusively through female Aedes Aegipty mosquitoes, you can prevent it by avoiding mosquitoes altogether, like applying mosquito repellent lotion, installing anti-mosquito screens, and wearing long-sleeved clothes.
Fortunately, vaccination for dengue exists and requires only 1 initial administration and 1 booster dose 3 months after the initial.
Once vaccinated, your body will develop protection against all 4 types of dengue virus, for life.
The vaccine has been proven to reduce the severity of the dengue symptoms as well as reduce the need for hospitalisation.
All Nusa Medica Clinic branches provide dengue vaccination for you and your loved one. (*)
Writer: dr. I Putu Gita Preasetya Adiguna, S.Ked - Medical Doctor Nusa Medica Clinic
@nusamedicaclinic Bali vibes, not dengue vibes! 🌞🦟 Protect yourself with the dengue vaccine at Nusa Medica Clinic. For more information, please visit Nusa Medica Clinic in Pecatu, Ubud, Canggu, Nusa Penida, or Gili, or contact our Call Center +62 81 808 811 911. #fypシ #denguefever #denguevaccine #nusamedicaclinic #bali #pecatubali #canggulife #ubudlife #nusapenidabali #gilitrawangan #giliair ♬ original sound - nusamedica
