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Dengue Information

(information from the American Embassy School communication to parents fall 2012)

Dengue fever is a viral infection transmitted by mosquito bites.  The mosquitoes which carry dengue are most active during the day, especially around dawn and dusk, and are usually found in or around human habitations in urban areas.   The illness is less often found in rural areas and rarely above 4000 feet elevation.  In New Delhi the greatest risk for Dengue follows the monsoon, September through November.

Symptoms:  Dengue fever, also known as “break-bone fever”, should be suspected when a sudden onset of high fever (40°C/ 104°F) is accompanied by two of the following symptoms: severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. The rash generally appears 3-5 days after the onset of the fever.  Symptoms usually last for 2-7 days, after an incubation of 4-10 days after the bite form an infected mosquito.  Convalescence may be prolonged if symptoms were severe.  Patients should be seen by a doctor soon after developing symptoms, to ensure they do not develop Hemorrhagic Fever (a rare but serious complication), or other disease with similar symptoms.   Dengue is commonly confused with flu, malaria, typhoid, and scarlet fever.

Treatment:  Treatment is symptomatic only, with rest, hydration, and Acetaminophen (Tylenol or Paracetamol) to reduce fever and discomfort.  Avoid Aspirin or Ibuprofen products (Motrin, Advil), which may increase the risk of bleeding and worsen the course of the disease.  Blood work is often required to monitor platelet levels. Recommended fluids are ORS (oral rehydration solution), Gatorade, water, and clear fruit juices. 

Prevention is key:  As there is no vaccine to prevent dengue fever, those who live or travel in susceptible areas should avoid mosquito bites by remaining in well-screened areas, using mosquito nets, plug-ins or coils where mosquitoes are present in sleeping and living areas, wearing clothes that cover most of the body, and using insect repellent on any exposed areas of the skin.  Repellent can also be used on clothing.  The most effective repellent is DEET, an ingredient found in most insect repellents.  These repellents should always be used according to the label and should contain no more than 35% DEET.  Repellants containing DEET in concentrations between 15%-30% are approved by American Academy of Pediatrics for use in children older than 2 months of age. 

To further prevent transmission of dengue fever, it is necessary to remove standing water in plant containers, evaporative coolers, low areas in yards, etc.  There are several WHO-approved chemicals available that can be applied to areas of pooling water such as plant containers to reduce mosquito breeding.  Remove trash or containers where water could pool.

Special warning:  Dengue Hemorrhagic fever is highest in individuals who were previously infected with dengue.

What YOU can do to prevent Dengue: 

  • Prevent mosquito breeding in the home by ridding the home of ponded or stagnant water. 
  • Wear long sleeves and pants as often as possible, especially during sports and outdoor activities or activities around dawn or dusk.
  • Apply mosquito repellent before leaving the home.
  • Install plug-ins or coils in the home.
  • Use mosquito netting in the home as required.
  • Alternative options include ingestion of Garlic or Vitamin B1
  • Alternative options include applying oils of citronella, lavender, geranium, lemongrass, mint, rosemary and thyme to skin.
Products available in the markets:
  • Odomos creams and sprays (contain DEET)
  • Good Knight (contains natural ingredients such as Lavender oil and DEBA, which is a chemical with a similar molecular structure to DEET.  I have not been able to find substantial research to support safety in children).
  • Good Knight and All-Out plug-ins.
  • Mortein products (variety of products ranging from natural to chemical)
  • Patches to be worn on clothing (usually containing natural products). 
Additional information regarding insect repellents:

http://epi.publichealth.nc.gov/cd/diseases/deet.html
http://www.healthychildren.org/english/safety-prevention/at-play/pages/Insect-Repellents.aspx

Additional information regarding Dengue:

http://www.cdc.gov/dengue/ 
http://www.who.int/topics/dengue/en/