Understanding the Stages of Dengue Infection for Timely Detection and Treatment

Hyderabad: Amid an ongoing surge in viral fevers and influenza cases in the city, doctors called for the timely detection of dengue by understanding the various stages of the infection for the right treatment.

Dengue infection has an incubation period of around seven days after being bitten by the infected Aedes aegypti mosquito, which is active only during the daytime.

Doctors said that dengue progresses in two stages, first the fever phase — with symptoms of high-grade fever, body pain, joint pain and vomiting — and the advanced stage of the infection, also referred to as the critical stage, which could lead to dengue shock syndrome and subsequent fatality.

Dr Hari Kishan Boorugu, a consultant physician at a leading private hospital, said, “The fever phase is for 2-7 days where a patient experiences fever, body pain, weakness, vomiting, headache. This phase requires symptomatic treatment and more than 80 per cent of patients go into recovery phase after treatment in this phase. The critical stage begins when although the fever comes down, the patient experiences warning signs and symptoms. This phase usually comes after three to five days of the fever phase.”

The critical phase warning symptoms, doctors said, were severe abdominal pain, bleeding in nose and gums, extreme weakness, haemoconcentration, petechiae rash, excess vomiting and severe headache.

“Dengue recovery needs rest and lot of fluids in addition to prescribed medication. However, in certain cases in the critical phase, when the patient experiences rapid decline in the platelets, dengue shock syndrome with multiple organ failures, sudden drop in the blood pressure, jaundice, brain and kidney function failure can need admission and monitoring,” said Dr Hari Kishan.

Doctors further said that dengue deaths were a result of disseminated intravascular coagulation (DIC), known as dengue haemorrhagic fever (DHF), multiple organ failure, liver or kidney failure and dengue encephalitis.
Another important aspect of dengue is the platelet count, which would fall due to the infection. However, a critical stage would only be considered when the count ranged between 10,000 and 15,000, and only a rapid decline in the count would be a determining factor of the severity of dengue.

Dr Anish Ananad, consultant (internal medicine), emphasised the need for proper testing.

“A suspected case needs to take NS1 and IGM tests in the first seven days of the infection. Once the dengue is confirmed, we then ask the patient for a blood picture for haemoglobin and platelets, Liver Function Test (LFT) and creatinine test. If the platelet count is above one lakh, the blood picture is repeated after one week. However, if the platelets near a critical stage of 10,000, tests are conducted every alternate day,” said Dr Anish.

“I would advise that if the high-grade fever persists for more than 3-5 days, then it is advisable to visit a physician for the right and timely diagnosis of dengue. Delayed diagnosis could put patients in a critical stage,” he said.

He stressed that there was no need to panic and rush for multiple tests as the recovery rate for dengue was more than 98 per cent, saying strong immunity was the most important factor in combating dengue.

Doctors, however, advised more precautions for schoolchildren, pregnant women, elderly and patients with comorbidities.