The dengue is a viral infection (caused by the virus Dengue) which is transmitted by mosquitoes of the genus Aedes infected. The dengue is a disease that affects any age group with different evolution, depending on the individual characteristics of the victim. It represents a serious public health problem as more than half of the world's population is at risk of contracting the disease.
How is it transmitted?
The Aedes aegypti mosquito (the main transmitting agent) lives in urban, semi-urban or cosmopolitan habitats and reproduces mainly in wastewater, especially in tropical and subtropical climates in different regions of the planet. Unlike other mosquitoes, this one feeds during the day, so the bites increase in periods between dawn and dusk.
The World Health Organization classifies it as dengue and severe dengue (formerly known as classic and hemorrhagic), which other authors and researchers describe as dengue with or without signs of severity, depending on the associated symptoms and the involvement of one or more white organs (for example, kidney, neurological, liver involvement, etc.).
Dengue shock (the most severe degree) is a life-threatening complication that can occur with the passage of fluid from the vascular space to a third space, generating edema (accumulation of fluids) in different spaces such as the pleura, pericardium, abdomen and pelvis, in addition to producing heart, kidney, liver and / or respiratory failure, severe bleeding, disseminated intravascular coagulation and multi-organ failure.
What are the symptoms of dengue?
There are four known serotypes of dengue virus, so it is possible to contract a new infection if it is of a different serotype that will generally have a more severe clinical presentation. Symptoms usually appear 3 to 14 days (average 4 to 7 days) after the bite of the infected female mosquito.
The symptoms of dengue usually occur are high fever accompanied by one or more of the following symptoms: headache, retro - orbital pain, myalgia and polyarthralgia (muscle and joint pain), nausea, vomiting, swollen lymph nodes or pinpoint rashes on the skin called petechiae, thrombocytopenia (decreased blood platelet count), bleeding gums or blood loss through urine, vagina, etc. However, up to 70 to 80% of patients may be asymptomatic.
Warning signs in a dengue patient that may indicate impending shock (circulatory collapse) include: increased heartbeat, abnormally increased respiratory rate, low blood pressure, increased sweating, cold and pale skin, signs of massive bleeding (bleeding from the nose, gums, bloody stools, blood in urine and vagina), shortness of breath (which may indicate pulmonary edema), abdominal pain and altered consciousness or seizures.
What are the symptoms of dengue?
Once the virus has entered the body of the affected person, it binds and enters a type of white blood cell known as macrophage, which is responsible for the immune response by engulfing (phagocyting) and eliminating pathogens (such as viruses, bacteria, parasites, etc.), multiplying and spreading throughout the body.
Macrophages respond once infected by producing pro-inflammatory mediators to activate the immune system. One of these mediators are cytokines, which are responsible for causing dengue symptoms, so the virus is not directly the damaging agent, but rather the symptoms are a consequence of the organism's exacerbated immune response.
Normally, severe forms appear when there is a second exposure to a serotype different from the first exposure. In this way, the immune system is sensitized and responds in a more aggressive way to a new infection, generating worse symptoms.
How should you act?
So far there is no specific treatment or vaccine for dengue. Treatment is only symptomatic, with acetaminophen being indicated to relieve fever and pain, since non-steroidal anti-inflammatory drugs are contraindicated (which can have a reduction in platelets as a side effect and, therefore, aggravate the signs of bleeding).
Another therapy is hydration, either with oral rehydration salts or intravenous solutions, to replace the fluid lost within the blood vessels. When there is the possibility of bleeding, absolute rest is recommended.
Early detection and access to proper medical care can lower death rates by a large percentage. Dengue prevention and control depend exclusively on effective anti-mosquito measures.
In recent years, the incidence and severity of the disease have increased dramatically in Spanish-speaking countries, which is why education on the subject is relevant for taking measures such as fumigation, use of repellants and nets, disposal of water ponds that serve as breeding sites for the mosquito, and finally, avoid self-medication and immediately consult a doctor.
Getting less than six hours of quality sleep every night can disrupt the balance of insulin and blood sugar. If you are not getting good, restful sleep, try avoiding alcohol, caffeine and spicy foods at night. You could also try lowering the temperature of your bedroom at night. Make your bedroom as dark and quiet as possible. Lastly, establish a sleep routine by going to bed and rising at the same time every day.