The movement of tourists to these endemic areas has generated an increase in the incidence of infections caused by the Dengue virus in other regions of the globe, in March of this year, new cases of illness were reported in the United States of America – Puerto Rico, Florida and California. Other countries where an increase in the number of Dengue virus cases has been reported include: Afghanistan, Burkina Faso, Colombia, Dominican Republic, Ecuador, Ethiopia, Ghana, Grenada, India, Mali, Mexico and more.
Recent climate changes have created favorable conditions for the spread, including in Europe, of invasive species of mosquitoes that transmit various pathogens to humans, including Dengue viruses. In Romania, 7 cases of Dengue fever were confirmed this year, including a one-year-old child, the mosquito responsible for the transmission of this virus being identified in several counties in the country, including Giurgiu, Dambovita, Mehedinti, Sibiu and Bihor.
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How is dengue fever transmitted?
The mosquito species involved in the transmission of Dengue viruses are represented by Aedes albopictus or Ae. aegypti which usually resides in areas with high humidity and dense vegetation in the tropical and subtropical regions of the globe. These mosquito species are involved in the occurrence of several zoonoses (human infections transmitted from animals/insects), being able to transmit different types of pathogens both to humans and to other mammals (domestic or wild animals) during lunch hematophagus.
Dengue disease or hemorrhagic fever is caused by infection with Dengue viruses 1, 2, 3 and 4, mosquitoes carrying one of these serotypes, becoming infected during blood feeding from an infected person that associates a febrile syndrome (day 2-7 of the evolution of the disease ).
The studies carried out until now have demonstrated that the Dengue virus can also be transmitted vertically from mother to fetus during pregnancy, the main complications that can occur as a result of the infection being represented by premature birth, delayed growth and development of the fetus and fetal distress in varying degrees of severity.
Other ways of transmission of the Dengue virus that are less common in current medical practice include organ transplantation and transfusions of blood and its derived products from patients.
Simptome febra Dengue
After an incubation period that is usually between 4 and 10 days from the bite of the carrier mosquito, the viral infection can generate a wide spectrum of clinical manifestations, but in most cases the disease is asymptomatic or subclinical.
The main manifestations that make up the clinical picture of Dengue fever is similar to the flu syndrome and include:
- DISORDERS
- Fever
- Eye pain
- arthralgia
- myalgia
- Skin rashes
- Pain in the throat
- Altered general condition.
The disease usually evolves for a period of approximately 7 days and is remitted without the appearance of complications in young people with a strong immune system.
Forms of Dengue virus infection
Depending on the severity of the clinical manifestations presented by the patient, the Dengue virus infection can be classified as follows:
- Easy shapes which evolve asymptomatically or are similar to a flu syndrome and remit after an evolution period of approximately 7 days
- Severe form which associates:
- High febrile syndrome over 41°C
- seizures
- Hepatomegaly (increase in volume of the liver)
- Circulatory insufficiency
- Hemorrhages (epistaxis, hematemesis, melena, gingivorrhea, hematuria)
- Heart rhythm disorders
- Vomiting
- Abdominal pain
- Severe hydro-electrolytic imbalances
- MSOF multiple organ failure that can lead to the patient’s death.
After the remission of the infectious episode, the antibodies generated by the host’s immune system offer life-long protection for the viral serotype that generated the disease and partial and transient immunity that can last between 2-3 months against the other viral serotypes.
Febra Dengue diagnostic
The diagnosis of Dengue fever is established by the infection doctor based on the information obtained from the anamnesis and the detailed clinical examination of the patient, as well as the paraclinical investigations for the detection of circulating anti-viral IgM and IgG antibodies.
IgM antibodies appear first, approximately 3-5 days after the onset of symptoms and increase progressively until the 10th day of the disease’s evolution. Antibodies of the IgG type against Dengue virus are synthesized later, starting with the 7th day of the evolution of the disease, they gradually increase and remain detectable in the blood for the rest of life.
The rapid diagnosis of infections caused by the Dengue virus can be achieved by using the PCR technique polymerase chain reaction which identifies the RNA viral genetic material at the level of the patient’s biological products (blood or liver tissue).
Is there a treatment for Dengue fever?
Dengue fever benefits from supportive treatment aimed at the patient’s hydro-electrolytic balance by increasing fluid consumption, reducing the patient’s pain discomfort and febrile syndrome by administering non-steroidal anti-inflammatory drugs
Severe cases of the disease require hospitalization for permanent monitoring of the patient and the application of corrective measures that may include the administration of oxygen, blood transfusions and parenteral hydroelectrolytic rebalancing.
Children and the elderly represent the categories of people who associate an increased risk of the occurrence of unfortunate complications due to infection with the Dengue virus due to the limited mechanisms for compensating fluid losses in the body.
Dengue fever prevention measures
The main measures to prevent the spread of the Dengue virus involve:
- Individual protection against mosquitoes by adopting appropriate clothing that covers as much of the body as possible, using repellent sprays, mosquito nets and household devices equipped with substances against mosquitoes and other insects (pills, impregnated strips, aerosols)
- Preventing the breeding of mosquitoes by covering water containers in the house, cleaning up lakes and puddles near residential areas and regularly dispersing insecticides in parks and areas with dense vegetation in cities
- Limiting travel in dengue virus endemic areas
- Limiting outdoor activities, especially during periods of increased mosquito activity at sunrise and sunset
- The administration of the tetravalent vaccine for Dengue disease to people over 4 years of age who come from the endemic areas of this pathogen and to those who intend to travel to these regions.
People who intend to move to endemic areas are advised to contact the epidemiologist for the prevention of various exotic pathological conditions. Travel medicine involves, in addition to international vaccination and chemoprophylaxis of various hemorrhagic fevers, a series of aspects that must be addressed according to the particularities of each individual traveler (pregnant woman, elderly with multiple comorbidities, child).
In this sense, the epidemiologist can issue a series of indications and recommendations based on evidence and studies recently carried out in the medical field, in order to effectively prevent various tropical pathologies that can be contracted when traveling to endemic areas of these exotic pathogens.
References:
- Aedes albopictus – Factsheet for expertsEuropean Centre for Disease Prevention and Control (ECDC)
- Current Dengue OutbreakCDC
- Dengue and severe dengueWorld Health Organization (WHO)
- Diagnosis of Dengue by Using Reverse Transcriptase-Polymerase Chain Reaction
- Dengue feverDSP Timis
- Global DengueCDC
- The Risk of Emerging of Dengue Fever in Romania, in the Context of Global WarmingLarisa Maria Ivanescu, Ilie Bodale, Smaranda Grigore-Hristodorescu, Gabriela Martinescu, Bianca Andronic, Simona Matiut, Doina Azoicai, Liviu Miron
(sitting in a mock news desk, with a cheeky grin) Ah, lovely, lovely, lovely, folks! Today we’re going to talk about something that’s just a real barrel of laughs – Dengue fever! (in a Rowan Atkinson-esque accent) Yes, because nothing says “holiday fun” like a mosquito-borne illness that can leave you feeling like utter rubbish.
(chuckling) Now, I know what you’re thinking, “Dengue fever, isn’t that just a tropical disease that only affects people who live in far-flung places with palm trees and exotic wildlife?” Well, not quite, my friends. (in a Ricky Gervais-esque tone) You see, with climate change and all that malarkey, these pesky mosquitoes are spreading their wings and flying to a town near you!
(in a Jimmy Carr-esque deadpan) I mean, can you imagine the travel brochure? “Come to Romania and experience the thrill of Dengue fever! Visit our lovely mosquito-infested countryside and enjoy the scenic views while having your lunch… of blood!” (smirking)
But seriously, folks, this is quite a serious issue. The World Health Organization (WHO) says that Dengue fever is a leading cause of illness and death in the tropics and subtropics, and with the rise of global travel, it’s becoming a bigger problem in other parts of the world. (in a Lee Evans-esque tone) I mean, you’ve got your athletes from the Olympics coming back with weird rashes, and your tourists returning with a funny tan… that’s actually just a fever rash. (chuckling)
Now, let’s get to the juicy stuff. (clears throat) Dengue fever is caused by four different types of viruses – 1, 2, 3, and 4. (shipping out rapid-fire facts) The incubation period is usually 4-10 days, and symptoms can range from mild to severe, including fever, headache, joint pain, and in severe cases, bleeding and organ failure. (grimacing) Not exactly the kind of souvenir you want to bring back from your holiday.
(mockerous tone) But don’t worry, there’s good news! There are ways to prevent it. (sarcasm) Oh, yes, it’s a real party trick – wearing insect repellent, covering your skin, and staying in air-conditioned rooms. (in a fake enthusiastic tone) Who doesn’t love a holiday where you can’t leave your hotel room without looking like you’ve been doused in DEET? (laughs)
(sighing) Seriously, though, folks, it’s essential to take precautions when traveling to areas where Dengue fever is common. (back to a serious tone) Check with your doctor, get vaccinated if necessary, and take those preventative measures seriously. It’s better to be safe than sorry, especially if you’re planning on, you know, not dying on your holiday.
(rapid-fire summary) So, to recap, Dengue fever is no joke, it’s spreading due to climate change, and you should take precautions when traveling to affected areas. (in a mock announcer voice) Don’t wait until it’s too late, folks! Book your appointment with your doctor today and get vaccinated! (winking) Trust me, your holiday (and your health) will thank you.
(chuckling) And that’s all for today, folks. (smirking) I hope you found that informative and entertaining. (fake serious tone) Now, if you’ll excuse me, I’m off to book my next holiday… to a mosquito-free zone, of course! (laughs)
