Understanding Dengue Fever, Symptoms and Prevention
Dengue fever is a viral infection transmitted primarily through the bite of infected Aedes aegypti mosquitoes. It is not transmitted directly from person to person.
In the UAE, dengue fever is monitored through national disease-surveillance and early-detection systems. Prevention focuses on reducing mosquito populations, eliminating breeding sites and identifying cases early to minimise transmission and the risk of complications.
Symptoms of Dengue Fever
Dengue fever commonly presents with:
- High fever, which may reach 40°C
- Severe headache
- Pain behind the eyes
- Muscle and joint pain
- Nausea and vomiting
- Skin rash
- Mild bleeding, such as nosebleeds or bleeding gums, in some patients
Anyone experiencing symptoms, particularly following travel to an area where dengue fever is prevalent, should seek medical advice.
The Critical Phase
Dengue fever typically progresses through different clinical phases. A critical phase may occur between the third and seventh day after the onset of fever, often around the time the fever begins to subside.
A reduction in fever does not necessarily indicate recovery. Patients should be monitored closely for warning signs, including:
- Severe abdominal pain
- Persistent vomiting
- Bleeding
- Difficulty breathing
- Marked weakness or fatigue
These symptoms require urgent medical assessment, as severe dengue can lead to complications such as significant bleeding, circulatory shock and organ impairment.
Who Is at Greater Risk of Complications?
Young children, older adults, pregnant women and people living with chronic medical conditions or weakened immune systems may be at increased risk of complications and may require closer clinical monitoring.
Diagnosis and Treatment
There is currently no specific antiviral treatment for dengue fever. Management is primarily supportive and may include:
- Maintaining adequate hydration
- Rest
- Fever and pain management
- Monitoring blood counts and other relevant clinical parameters
- Regular assessment for warning signs and complications
Paracetamol may be used to manage fever and pain when appropriate.
Patients with suspected or confirmed dengue should generally avoid aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and diclofenac, unless specifically advised by a healthcare professional, due to their potential to increase the risk of bleeding.
Preventing Dengue Fever
Preventing mosquito bites and reducing mosquito breeding sites are key measures to reduce the risk of dengue transmission.
Recommended precautions include:
- Using an approved insect repellent
- Wearing long-sleeved clothing and long trousers
- Using insect screens on windows and doors
- Eliminating stagnant water around homes and other premises
- Emptying and cleaning water containers regularly
- Keeping water tanks and other water-storage containers covered
- Removing stagnant water from flowerpots, buckets, tyres and other potential breeding sites
Community mosquito-control measures also play an important role in reducing mosquito populations.
Dengue Fever and Travel
International travel can contribute to the introduction of dengue virus into areas where competent mosquito vectors are present. Travellers visiting areas where dengue fever is prevalent should take precautions to prevent mosquito bites during their trip and after returning.
Anyone who develops fever or flu-like symptoms during travel or within two weeks of returning should seek medical advice and inform the healthcare professional about their recent travel history.
Dengue Virus Serotypes
Dengue fever is caused by four recognised virus serotypes: DENV-1, DENV-2, DENV-3 and DENV-4. Infection with one serotype does not provide complete protection against the others, and subsequent infections with a different serotype may increase the risk of severe dengue in some individuals.
The Role of Healthcare Providers
Early recognition and appropriate clinical assessment are important in dengue management. Healthcare providers may consider recent travel history, clinical symptoms, laboratory findings and the presence of warning signs when evaluating patients with suspected dengue fever.
Timely identification of cases, appropriate supportive management and notification to relevant health authorities, where required, support effective disease surveillance and help reduce further transmission.
Expert Advice
Dr George Ghaly, Specialist in Internal Medicine, emphasised the importance of preventive measures, particularly for travellers visiting areas where dengue fever is prevalent. Avoiding mosquito bites, using approved insect repellents and following local health recommendations can help reduce the risk of infection.
Dr Titi Mary Thomas highlighted the importance of close monitoring during the critical phase of dengue fever. Although fever may decrease between the third and seventh days, the risk of complications may remain significant. Patients should therefore continue to be monitored for warning signs even when their temperature improves.
Dr Deepak Gopal Dubey noted that dengue prevention relies heavily on reducing mosquito breeding sites and preventing mosquito bites. Removing stagnant water, using insect repellents, wearing protective clothing and maintaining effective window and door screens are important preventive measures.
When to Seek Medical Care
Seek urgent medical attention if you or someone in your care develops severe abdominal pain, persistent vomiting, bleeding, difficulty breathing, significant weakness or other concerning symptoms, particularly following recent travel to an area where dengue fever is prevalent.
Early assessment and appropriate monitoring can help identify patients at risk of complications and support timely medical intervention.
