Nagpur Today: This year, one should get alarmed at the first sign of fever – because it could be one of any these three serious ailments – Dengue, Malaria or typhoid. Typhoid is water borne, mostly caused by contaminated tap water where sewage water could be getting mixed with tap water due leaking pipes. Dengue is mosquito borne, just like Malaria, but a different breed of mosquitoe known an aedes aegypti. And dengue is definitely most virulent of the three since a patient can go into Dengue Shock syndrome which is mostly fatal.
“Even if one ensures that there is cleanliness and no stagnant rain water in your house and two houses on either side of yours, you can prevent being bitten by a Dengue mosquito since ‘aedes aegypti’ cannot fly very far unlike the malaria causing mosquito” said Dr. Meraj Shaikh, an Intensivist (critical care Doctor) at CARE Hospital, Nagpur.
In the past few months, CARE has seen a lot of Dengue patients, between 50 and 100 at a rough estimate. One case has been fatal.
Dengue can affect different patients differently, opined Dr. Shaikh, Those with better resistance and over all health can be mildly affected while patients in extreme age groups – i.e. either very young or very old – can be severely affected. “But this is not a hard and fast rule. Even a very healthy looking person in the prime of youth can go into Dengue Shock Syndrome, so any fever should be immediately reported to your Doctor who will advise you to go in for a blood test ” warned Dr. Meraj Shaikh.
Once a patient goes into DSS he can go into organ failure – any vital organ of the body like lungs, heart, kidney or liver could fail leading to fatality.
The case of a 3 year old girl dying in Mumbai after just a few days of fever is causing alarm everywhere in the state, coupled with the fact that a lot of Doctors themselves are catching the disease. This is because hospitals themselves are sometime not maintained properly and have accumulated water in some spots or even in AC ducts. This has been found to be the case in JJ Hospital, Mumbai where employees quarters and students’ hostels were found to be the mosquito breeding areas.
Also, knowledge about how to Differentiate Between Malaria, Dengue and Chikungunya Symptoms is necessary:
– Generally Dengue and Chikungunya are caused by infected Aedes Agypti (also Aedes Albopictus for chikungunya) which is active during the day and loves to breed as close to us as mosquitoly possible (open, clean water storage areas at home) whereas Malaria is caused by Anopheles which is prevalent during the night (even at dusk/dawn).
– Dengue takes 3 to 4 days for symptoms to set in and generally lasts for a week, whereas Chikungunya takes a week for symptoms to set in. In Malaria, the symptoms start after 2 weeks of mosquito bite.
– In all 3 cases body temperature is above 102⁰ F and common symptoms are sudden high fever, pain behind the eyes, severe headache, muscle, joint pain, vomiting, nausea, anemia, general weakness/dizziness.
– Dengue is differentiated by fever subside and reappear with skin rashes. Bleeding is also common in the cases of dengue hemorrhagic fever. It also shows relatively low WBC and platelet count.
– Chikungunya has intense joint pain (when compared to dengue). Unlike dengue there is no bleeding in chikungunya.
– Malaria includes fever which keeps reoccurring in shorter duration accompanied by chills, heat and sweating which follows one after the other.
Malaria is tested by microscopic examination of the sample and there are very effective anti malarial drugs available.
Testing for Dengue involves virus isolation in cell cultures, nucleic acid detection by PCR, viral antigen detection or specific antibodies (serology) like IgG and IgM ( this may not be evident at the early onset of the infection) . There are no vaccines or specific medicines available for Dengue or Chikungunya as yet. Only symptoms can be treated with the available general medicines.
Chikungunya is diagnosed by virus isolation test, antibody testing of IgM as well as by genetic identification of virus gene structures. Detection of either C or E1 genome indicates positive result.
It is always safe to keep the house and surrounding area clean, free from unwanted waste, stagnant or open water sources either clean or dirty. Ensure the house is well protected with detachable mesh and repellents. Once you are infected, make sure you are well hydrated, drink only boiled water and rest well.