DENGUE

                                       A serious infectious disease caused by a virus carried by Aedes aegyptii mosquitoes and most often found in hot climates. Symptoms include rash, fever, headaches, and severe muscle and joint pain. The pain is so severe, its nickname is “breakbone fever.”

Causes

               Dengue fever is caused by several related viruses (four different arboviruses). It is transmitted by the bite of mosquitoes, most commonly Aedes aegypti, found in tropic and subtropic regions. This includes portions of Southeast Asia, the Indonesian archipelago into northeastern Australia, parts of sub-Saharan Africa, and parts of South and Central America.

              Dengue fever begins with sudden onset of a high fever, often to 104-105 degrees Fahrenheit, headache, and slightly later the appearance of severe joint and muscle pains.

             A flat, red rash may appear over most of the body early during the fever. A second rash, measles-like in appearance, appears later in the disease. Infected people may have increased skin sensitivity and are very uncomfortable.

Symptoms   

This infectious disease is manifested by a sudden onset of fever, with severe headache, muscle and joint pains (myalgias and arthralgias — severe pain gives it the name break-bone fever or bonecrusher disease) and rashes; the dengue rash is characteristically bright red petechia and usually appears first on the lower limbs and the chest - in some patients, it spreads to cover most of the body. There may also be gastritis with some combination of associated abdominal pain, nausea, vomiting or diarrhea.

Some cases develop much milder symptoms, which can, when no rash is present, be misdiagnosed as a flu or other viral infection. Thus, travelers from tropical areas may inadvertently pass on dengue in their home countries, having not being properly diagnosed at the height of their illness. Patients with dengue can only pass on the infection through mosquitoes or blood products while they are still febrile.

The classic dengue fever lasts about six to seven days, with a smaller peak of fever at the trailing end of the fever (the so-called "biphasic pattern"). Clinically, the platelet count will drop until the patient's temperature is normal.

 

Diagnosis

There exists a WHO definition of dengue haemorrhagic fever that has been in use since 1975; all four criteria must be fulfilled:

  1. Fever
  2. Haemorrhagic tendency (positive tourniquet test, spontaneous bruising, bleeding from mucosa, gingiva, injection sites, etc.; vomiting blood, or bloody diarrhea)
  3. Thrombocytopaenia (<100 platelets per mm³ or estimated as less than 3 platelets per high power field)
  4. Evidence of plasma leakage (hematocrit more than 20% higher than expected, or drop in haematocrit of 20% or more from baseline following IV fluid, pleural effusion, ascites, hypoproteinaemia).

positive tourniquet test

A tourniquet test determines capillary fragility.It is also known as a Rumpel-Leede Capillary-Fragility Test or simply a capillary fragility test. It is a clinical diagnostic method to determine bleeding tendencies in a person who might have a disease such as dengue fever. It assesses fragility of capillary walls, evaluates bleeding tendencies, and identifies thrombocytopenia (a reduced platelet count).

In dengue, the test is defined by the WHO. A blood pressure cuff is inflated to a point between the systolic and diastolic blood pressures for five minutes. The test is positive if there are more than 20 petechiae per square inch (a petechia is a small red or purple spot on the body, caused by a minor hemorrhage).

HOMOEOPATHIC MANAGEMENT

There have been large number of medicines . Homoeopathic mangement is based on genus epidemicus in case of epidemic.