Get tested for dengue at first sign of fever

Amidst the ongoing dengue outbreak, medical professionals have recommended individuals to promptly get tested upon the earliest onset of fever.

Patients with fever should get tested immediately irrespective of whether there are symptoms associated with dengue, including body ache.

While bed rest and nourishment through the consumption of liquids is urgent, doctors suggest refraining from taking painkillers or antibiotics. However, they recommend only paracetamol as primary medication.

"Currently, it is crucial for everyone to get tested for dengue as soon as the fever sets in," Dr Forhad Uddin Hasan Chowdhury Maruf, Medicine and Infectious Disease Specialist at Dhaka Medical College Hospital, told The Daily Star.

The dengue test is now cheaper, he said. On Wednesday, the health directorate announced that patients can get dengue tests at Tk 50 instead of Tk 100 in all public hospitals across the country.

If tested positive for dengue, the patient should only take paracetamol but not other painkillers or any antibiotic, he advised, adding that painkillers may be fatal for dengue patients at times.

In Bangladesh, dengue cases start rising from June and peak in November each year. However, the cases started rising a month earlier this year.

Since January this year, a total of 19,454 patients have been hospitalised with dengue infection, including 1,623 yesterday. Of them, 100 have died, including seven yesterday.

Different studies show that most people who are infected with dengue will have mild or no symptoms.

"But for those who do, the most common symptoms are high fever, headache, body ache, nausea and rash. Most will also get better in one-two weeks," Dr Masum said.

According to the WHO, if symptoms occur, they usually begin 4–10 days after infection and last for two–seven days.

Individuals who are infected for the second time are at greater risk of severe dengue.

"There are seven signs of severe dengue infection which often exhibit after the fever has gone away. These can arise between the third and the seventh day from the onset of fever. In such cases, patients must be admitted to the hospital immediately," Dr Masum said.

According to Dr Masum, the seven symptoms of severe dengue are: intolerable abdominal pain, persistent vomiting, breathing difficulty, bleeding gums or nose, slurred speech, declining blood pressure and severe fatigue which leaves a patient unable to even walk or stand up.

Additionally, blood in vomit or stool, extreme thirst, and pale and cold skin constitute some other symptoms of severe dengue infection, according to the WHO.

"Often, most importance is given to platelet levels in the blood. But this is not that vital. Rather, declining blood pressure is the most critical symptom of severe dengue," Dr Masum said.

He said, "If there is no fever for two days (48 hours) after the fever dissipates, the danger is gone."

According to Dr Saif Ullah Munshi, a professor of virology at Bangabandhu Sheikh Mujib Medical University (BSMMU), the four-five days following the patient's report of "no fever" are crucial.

"This is because patients may go into shock (or may develop severe symptoms) at any time during this period. So taking caution is crucial at this time," Prof Saif Ullah Munshi told The Daily Star.

According to different studies, the mortality rate among the patients with severe symptoms is one percent if treated. If not treated, the mortality rate is five percent.