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Dengue, a malady of our own making!

Year after year, we read in the papers about the deadly Dengue virus causing death and despair in our city. Every year we go through the same cycle of panic – fear - knee jerk blood tests - admission to hospital and medication - public hue and cry and very soon back to our usual indifference and complacence. Very few of us bother to find out details about the cause, and more importantly, the prevention of this disease. So here I am trying to explain this disease in as simple terms as possible. (Dr. Naveen Kini)


The Cause



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Dengue is caused by a Flavivirus, and has at least 4 types. The virus is transmitted by the bite of mosquitoes, mainly the species Aedes aegypti. This mosquito breeds in fresh water, and bites during the day.


The Disease


Contrary to popular knowledge, primary Dengue Fever is a relatively harmless disease, caused due to the child being infected by the virus for the 1st time. The child may have any, or a combination, of symptoms like high fever for 3 to 5 days, severe headache, eye pain, back pain, muscle pain, vomiting and rashes.


The immune system of the child reacts to this infection by producing antibodies. Most children produce neutralising antibodies, which help the child to limit the severity of the disease, and also help to fight it if the virus attacks again.


VA few children react to the initial infection by producing antibodies of a different kind, which have disease enhancing effects instead of protective effects. If this child is again infected with the Dengue virus, these antibodies help the virus to multiply faster, which can result in Dengue Hemorrhagic Fever (DHF), wherein the child develops bleeding, low platelets and breathing difficulty and if it progresses, Dengue Shock Syndrome (DSS), a potentially fatal condition if not treated early and aggressively.


Treatment



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Dengue fever is usually a self limiting disease, and treatment is directed towards reducing fever, relieving pain and ensuring that the child takes adequate fluids. Please note that antibiotics play no role in the treatment of this disease.


Early recognition and prompt treatment of bleeding and low blood pressure remains the mainstay of treatment of Dengue Hemorrhagic Fever, and Dengue Shock Syndrome, and with aggressive treatment most children recover from these two deadly conditions.


A few pointers for parents:


> The commonest fever that children get at this time of the year is still nonspecific Viral Fever, and there is no need to panic the moment the child develops fever.

> See that your child takes frequent small sips of liquids during fever, to ensure adequate hydration (the child should be passing urine at least 4 to 5 times in 24 hrs).

> Watch out for danger signs like breathing difficulty, bleeding, poor feeding, reduced urination, continuous vomiting, drowsiness etc. If you see any of these symptoms, rush the child to the nearest major hospital Pediatric ICU. You can contact your paediatrician on the way, or later, and not waste precious time if he is unavailable or busy.

>However, don't rush your child for admission to hospital at the first sign of fever, as you may end up occupying a hospital bed that may be required for another child whose need is more urgent.


Prevention



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This is where I come to the heading of my article. Dengue fever is flourishing in India because of the apathy of our people, and the indifference of our authorities. Why is it that we treat this beautiful city of ours and in fact this whole country, with such callous disregard? We do not hesitate to throw garbage into our drains and gutters, giving no thought to the consequences. Each one of us bothers only about our house and our front and backyards, and are oblivious to the fact that keeping the neighbourhood and city clean is our responsibility too. Why is it that it takes a major catastrophe (like the plague in Surat) before citizens start becoming aware of the importance of preventive measures, and that we need a reason, like a monetary fine, to start obeying rules which are there for our own benefit! We all seem to suffer from this 'hurry epidemic' and take unnecessary shortcuts to achieve meaningless goals, and in the process, compromise on our own safety and that of our children. Spare a moment to think about why the same virus has been unable to make inroads into countries like Singapore, Japan etc. which share more or less the same type of tropical climate as ours. It finally boils down to us, the people! We needed to change our attitude, our sensitivity and our response to situations at times of need, to ensure that we do not go through the same torture year after year.


Here are a few things that each one if us can do to control this deadly disease:

> Look around your house and immediate neighbourhood for potential breeding places for mosquitoes. Aedes mosquitoes breed in clear stagnant water, so look for discarded tyres, coconut shells, discarded buckets, storage bins etc. and see that they are promptly emptied.

> Educate your friends, family and employees about anti mosquito measures. Dress the child up with thick clothing, shoes and mittens while going to areas where the child is likely to be bitten by mosquitoes. Apply mosquito repellent creams to the exposed parts not covered by clothing. At home, use mosquito repellents, nets, window meshes etc.

> Aedes mosquitoes bite mainly during the day, so see that you take adequate anti mosquito measures during the daytime too.

> If you have to inevitably store water in containers, add a few drops of any vegetable oil to the water, so that it forms a thin film on top of the water.

> Form local associations to collectively encourage, direct and assist the civil authorities, instead if condemning them and demotivating them further.

> Assist the authorities in proper disposal of waste. Resist the temptation to discard garbage into drains, which causes stagnation of water, thus inviting mosquitoes to breed and multiply.

> Make a resolution to educate at least one person in your circle about the importance of preventive health care like proper disposal and segregation of garbage, proper purification and storage of water, personal hygiene, care of toilets etc.

> Teach your child by setting an example, not by preaching! Your child will then spread the message to his peers.

> Deal with someone who does not follow the rules with patience and repeated insistence. Old habits die hard, but they too can be made to come around with your perseverance.


We citizens owe this much to our city and country. Let us not just sit back and curse the various authorities, while this deadly virus is happily breeding in our own backyard. So wake up, shake away the cobwebs from your mind, and do something about the problem. We may not be able to get instant results, but each small effort put in by individuals can make a BIG difference to society. The lives of our little ones are at stake here!


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