What is dengue and how is it treated?

Online Q&A
December 2017
Q: What is dengue and how is it treated?
A: Dengue is a viral infection transmitted by the bite of an infected female Aedes
mosquito. There are four distinct serotypes of the dengue virus (DEN 1, DEN 2,
DEN 3 and DEN 4). Symptoms appear in 3–14 days (average 4–7 days) after
the infective bite. Dengue fever is a flu-like illness that affects infants, young
children and adults.
There is no specific treatment for dengue fever. Severe dengue is a potentially
lethal complication but early clinical diagnosis and careful clinical management
by experienced physicians and nurses often save lives.
More than 70% of the disease burden is in South-East Asia and the Western
Pacific. In Latin America and the Caribbean, the incidence and severity of
disease have increased rapidly in recent years. The African and Eastern
Mediterranean regions have also recorded more outbreaks of the disease in the
last ten years. Since 2010 indigenous transmission of dengue has also been
reported in Europe. Urbanization, rapid movement of people and goods,
favorable climatic conditions and lack of trained staff have all contributed to the
global increase of dengue.

Malaria is an infectious disease of tropical countries. It is spread by mosquitoes. It

is manifested by fever along with chills and rigors. Unless it is diagnosed and
treated promptly, it can be fatal. A single mosquito bite may be enough to cause
the infection.
Symptoms of malaria

Features of malaria include high fever over 38C (100.4F) along with chills and
sweating. There is intense muscle pain, headache, blurring of vision and dizziness.
Some patients may develop diarrhea and vomiting as well. Symptoms develop
within seven days after being bitten or may take between 10 to 15 days to appear.

High risk areas for malaria

Malaria is found mainly in the tropical countries all around the world. It is seen in
large parts of Africa and Asia, Central and South America, Haiti and the Dominican
Republic, some Pacific islands, such as Papua New Guinea and some parts of
Middle East.
Malaria is not seen commonly in the United Kingdom. In the United States around
1,500 cases of malaria are reported every year. Worldwide around 3.3 billion
people live in areas at risk of malaria transmission in 106 countries and territories.

In 2010, according to the World Health Organization, there were 216 million
episodes of malaria and 655,000 deaths worldwide. Of these deaths around 91%
were seen in the African Region, followed by the South-East Asian Region (6%),
and the Eastern Mediterranean Region (3%). About 86% of deaths globally were in
children.

Causes of malaria

Malaria is caused by a type of parasite known as Plasmodium. This is a

microscopic parasite that is transmitted by certain species of mosquitoes. Although
there are numerous types of Plasmodia parasites, only four cause malaria in
humans. These include:

 Plasmodium falciparum
 Plasmodium vivax
 Plasmodium ovale
 Plasmodium malariae

There is a fifth species causing malaria in humans. It is called Plasmodium

knowlesi. It is distributed across South East Asia and is often misdiagnosed as P.
Malariae. The infection has a potentially more serious and even life-threatening
course.

The Plasmodium parasite is mainly spread by female Anopheles

mosquitoes, which are night-biting mosquitos.

Diagnosis and treatment of malaria

Malaria is diagnosed by looking at blood samples. The parasites are visible under
the microscope. Once the diagnosis is made, treatment should be begun promptly.
Almost all individuals make complete recovery.
Anti-malarial medication is used both to treat and prevent malaria. The type and
duration of drugs depends on the type of malaria, its severity and if the patient is
pregnant.

Malaria can sometimes become complicated. Some of the complications include:

 severe anaemia
 cerebral malaria
 malaria during pregnancy
 spleen rupture
 acidosis
 kidney damage
 multi-organ failure etc.
 These are more common with malaria caused by P. Falciparum

 Prevention of malaria

 Malaria can be prevented by taking several simple precautions. Awareness

of the risk of malaria in high risk zones is the first step to preventing malaria.
Mosquito bites can be prevented by using covered clothes and mosquito
repellents.

 While travelling to a malaria endemic zone, antimalarial tablets may be

prescribed to prevent contracting malaria. Immediate diagnosis and
treatment can help prevent complications and death.

 These are more common with malaria caused by P. Falciparum

 Prevention of malaria

 Malaria can be prevented by taking several simple precautions. Awareness

of the risk of malaria in high risk zones is the first step to preventing malaria.
Mosquito bites can be prevented by using covered clothes and mosquito
repellents.
  While travelling to a malaria endemic zone, antimalarial tablets may be
prescribed to prevent contracting malaria. Immediate diagnosis and
treatment can help prevent complications and death.

Zika virus (ZIKV) is a member of the virus family Flaviviridae.[3] It is spread by

daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus.[3] Its name
comes from the Ziika Forest of Uganda, where the virus was first isolated in
1947.[4] Zika virus is related to the dengue, yellow fever, Japanese encephalitis,
and West Nile viruses.[4] Since the 1950s, it has been known to occur within a
narrow equatorial belt from Africa to Asia. From 2007 to 2016, the virus spread
eastward, across the Pacific Ocean to the Americas, leading to the 2015–16 Zika
virus epidemic.[5]
The infection, known as Zika fever or Zika virus disease, often causes no or only
mild symptoms, similar to a very mild form of dengue fever.[3] While there is no
specific treatment, paracetamol (acetaminophen) and rest may help with the
symptoms.[6] As of 2016, the illness cannot be prevented by medications
or vaccines.[6] Zika can spread from a pregnant woman to her baby. This can result
in microcephaly, severe brain malformations, and other birth defects.[7][8] Zika
infections in adults may result rarely in Guillain–Barré syndrome.[9]
In January 2016, the United States Centers for Disease Control and
Prevention (CDC) issued travel guidance on affected countries, including the use
of enhanced precautions, and guidelines for pregnant women including considering
postponing travel.[10][11] Other governments or health agencies also issued similar
travel warnings,[12][13][14] while Colombia, the Dominican Republic, Puerto
Rico, Ecuador, El Salvador, and Jamaica advised women to postpone getting
pregnant until more is known about the risks.[13][15] Zika is
pronounced /ˈziːkə/ or /ˈzɪkə/.[16][17]

Flu Treatment

WHO and NREVSS collaborating laboratories, which include both public

health and clinical laboratories located in all 50 states, Puerto Rico, Guam,
and the District of Columbia, report to CDC the total number of respiratory
specimens tested for influenza and the number positive for influenza by virus
type. In addition, public health laboratories also report the influenza A
subtype (H1 or H3) and influenza B lineage information of the viruses they
test and the age or age group of the persons from whom the specimens were
collected.

If you get sick with flu, antiviral drugs may be a treatment option.
Check with your doctor promptly if you are at high risk of serious flu complications
and you get flu symptoms. People at high risk of flu complications include young
children, adults 65 years of age and older, pregnant women, and people with
certain medical conditions such as asthma, diabetes and heart disease.

Key facts

 Chikungunya is a viral disease transmitted to humans by infected

mosquitoes. It causes fever and severe joint pain. Other symptoms
include muscle pain, headache, nausea, fatigue and rash.
 Joint pain is often debilitating and can vary in duration.
 The disease shares some clinical signs with dengue and zika, and can
be misdiagnosed in areas where they are common.
 There is no cure for the disease. Treatment is focused on relieving the
symptoms.
 The proximity of mosquito breeding sites to human habitation is a
significant risk factor for chikungunya.
 The disease mostly occurs in Africa, Asia and the Indian subcontinent.
However a major outbreak in 2015 affected several countries of the
Region of the Americas.
Chikungunya is a mosquito-borne viral disease first described during an outbreak
in southern Tanzania in 1952. It is an RNA virus that belongs to the alphavirus
genus of the family Togaviridae. The name “chikungunya” derives from a word in
the Kimakonde language, meaning “to become contorted”, and describes the
stooped appearance of sufferers with joint pain (arthralgia).

Key facts

 Chikungunya is a viral disease transmitted to humans by infected

mosquitoes. It causes fever and severe joint pain. Other symptoms
include muscle pain, headache, nausea, fatigue and rash.
 Joint pain is often debilitating and can vary in duration.
 The disease shares some clinical signs with dengue and zika, and can
be misdiagnosed in areas where they are common.
 There is no cure for the disease. Treatment is focused on relieving the
symptoms.
 The proximity of mosquito breeding sites to human habitation is a
significant risk factor for chikungunya.
 The disease mostly occurs in Africa, Asia and the Indian subcontinent.
However a major outbreak in 2015 affected several countries of the
Region of the Americas.
Chikungunya is a mosquito-borne viral disease first described during an outbreak
in southern Tanzania in 1952. It is an RNA virus that belongs to the alphavirus
genus of the family Togaviridae. The name “chikungunya” derives from a word in
the Kimakonde language, meaning “to become contorted”, and describes the
stooped appearance of sufferers with joint pain (arthralgia).

Signs and symptoms

Chikungunya is characterized by an abrupt onset of fever frequently accompanied

by joint pain. Other common signs and symptoms include muscle pain, headache,
nausea, fatigue and rash. The joint pain is often very debilitating, but usually lasts
for a few days or may be prolonged to weeks. Hence the virus can cause acute,
subacute or chronic disease.

Most patients recover fully, but in some cases joint pain may persist for several
months, or even years. Occasional cases of eye, neurological and heart
complications have been reported, as well as gastrointestinal complaints. Serious
complications are not common, but in older people, the disease can contribute to
the cause of death. Often symptoms in infected individuals are mild and the
infection may go unrecognized, or be misdiagnosed in areas where dengue occurs.

Transmission

Chikungunya has been identified in over 60 countries in Asia, Africa, Europe and
the Americas.

The virus is transmitted from human to human by the bites of infected female
mosquitoes. Most commonly, the mosquitoes involved are Aedes
aegypti and Aedes albopictus, two species which can also transmit other mosquito-
borne viruses, including dengue. These mosquitoes can be found biting throughout
daylight hours, though there may be peaks of activity in the early morning and late
afternoon. Both species are found biting outdoors, but Ae. aegypti will also readily
feed indoors.