What is Severe Dengue and how is it different from Dengue?

Friday, 23/09/2016

Before we get to the details of the differences between Severe Dengue and Dengue, we need to understand the basics clearly. First, Dengue is a viral infection, which means the virus will enter your body, run its course and die. Unlike a bacterial infection, most viral infections won’t kill you unless a complication arises.

1. How viral infections occur?

Viruses are extremely small, smaller than that of bacteria and cannot infect the subject without a host or a carrier, i.e. people, animals, plants. They also need a host to survive and multiply and cannot manage on their own. When it enters your body it tries to attack your cells and takes hostage its working, reproducing those cells and producing the virus, they do eventually die and have a short-incubation period with mild discomfort to the affected area.

2. What is Dengue fever?
Dengue, as everyone must know, is caused by a mosquito bite (the chosen host for DEN-1, DEN-2, DEN-3 and DEN-4). You cannot get infected with Dengue directly by an infected person but there’s an off-chance that the mosquitoes present in the room might transfer it to you from the patient’s body.

3. What is Severe Dengue fever?
• Severe Dengue is the ‘complication’ that can prove to be deadly. Dengue itself isn’t going to harm you as much, but if your platelet count drops below 10,000 (normal range is from 150,000-400,000 platelets per micrometre mCL), that is when the issues might arise.
• It is to be noted that even though the danger starts below 150,000 platelet count, the danger can vary from person to person depending on their tolerance. Some individuals with 90,000 platelet count can also have a speedy and normal recovery depending upon their health and tolerance.

Dengue does not have a sub-section called Severe Dengue, but it is just a term given to the alarm or to communicate that a potentially deadly complication had emerged (could be due to various factors like plasma leaking, respiratory distress, fluid accumulation, organ impairment etc). Imagine it to be like a car accident, you can get a scratch (meaning, you can get just a fever. No need for Dengue medication), get a bad bump and indent (meaning you may need Dengue medication and medical assistance) or get rammed into a tree with the engine out and the fuel leaking (meaning you may need immediate attention and are extremely critical).

4. Symptoms of Dengue
• Dengue has symptoms like high fever (40°C/104°F) and has at least two other symptoms accompanying it — a severe headache, pain behind the eye, joint or muscle pain, rash and swollen glands, and vomiting.
• These symptoms last for 2-7 days and usually occur after an incubation period of 4-10 days after being bitten by the infected mosquitoes.
• Again, it is to be noted that the damage is not permanent and the Dengue fever will not turn into a severe case just like that. Taking proper precautions can help you and your family to avoid catching Dengue fever. In some cases, Dengue fever acts like a normal fever and the host does not even realise that he or she has been infected with the Dengue virus and gets cured by the body’s normal defence mechanism and over-the-counter medication or normal prescriptions. It should be known that the death rate is 1% for Dengue fever with proper medical care.

5. Symptoms of Severe Dengue
• Similar symptoms are found in Severe Dengue, but with the inclusion of severe ammoniacal pain, rapid breathing, bleeding gums, restlessness, vomiting blood, persistent vomiting and fatigue.
• When the bleeding is attached to Dengue fever, it is referred to as Dengue Hemorrhagic Fever. In such situations, the patient could be in grave danger and would require immediate medical attention.

6. Test used to check for Dengue fever
In India, the official test to check for dengue fever is NS1 Elisa (enzyme-linked immunosorbent assay) the sensitivity and count of the platelets. Its performance is extremely good and can tell 112/120 93.3% times (sensitivity) and 98.9% (178/180) specificity.