Dengue Fever: Symptoms, Platelet Tests, Care and Warning Signs

7 min read · Conditions · By the Asthra Health Care team

What is dengue?

Dengue is a viral infection spread by the bite of the Aedes mosquito, which breeds in clean, stagnant water such as water in coolers, flower pots, old tyres, coconut shells and uncovered tanks. Unlike many other mosquitoes, it bites mainly during the daytime, especially early morning and late afternoon.

Dengue cases rise sharply in Karnataka and Andhra Pradesh during and after the monsoon. There are four types of dengue virus. Having one type does not protect fully against the others, and a second infection with a different type can sometimes be more severe.

Symptoms of dengue fever

Symptoms usually start four to ten days after the mosquito bite. Many people have a mild illness, while some become seriously ill. Children may have milder or less typical symptoms, such as fever with vomiting and stomach pain. Some people have no symptoms at all but can still pass the virus to mosquitoes.

• Sudden high fever
• Severe headache and pain behind the eyes
• Strong muscle, joint and bone pain
• Nausea, vomiting and loss of appetite
• Skin rash, often a few days into the illness
• Extreme tiredness

The critical phase

Dengue often follows a pattern. After three to seven days of fever, the temperature comes down. Many people think they are getting better at this point, but this is when a small number develop severe dengue. Fluid can leak from blood vessels, blood pressure can drop, and bleeding may occur.

This is why it is important to keep drinking fluids and watch closely for warning signs for the next two days after the fever settles. Your doctor may ask for repeat blood tests during this time, even if you feel a little better.

Tests for dengue

In the first five days of fever, the dengue NS1 antigen test can detect the virus. After about five days, dengue IgM and IgG antibody tests are more useful. Your doctor will choose the right test depending on how many days you have had fever.

A complete blood count is repeated to track platelet count and haematocrit (the concentration of red cells in blood). A falling platelet count with a rising haematocrit is a sign the doctor watches carefully. A low platelet count alone does not always mean you need a platelet transfusion; doctors decide this based on the whole picture.

Treatment and home care

There is no specific antiviral medicine for dengue. Treatment focuses on rest, fluids and controlling fever. Drink plenty of water, oral rehydration solution, tender coconut water, buttermilk, fruit juices and soups. Eat light food. Aim to pass urine regularly, which shows you are drinking enough.

Use only paracetamol for fever and pain; follow the label or your pharmacist's advice and do not exceed the stated amount. Many people with dengue need only home care, but those with warning signs, pregnant women, infants, the elderly and people with diabetes, kidney or heart disease may need hospital care.

Medicines to avoid

Do not take aspirin, ibuprofen, diclofenac or other similar painkillers if dengue is possible, as they increase the risk of bleeding. Avoid injections into the muscle during dengue for the same reason. Steroids and antibiotics do not treat dengue and should be used only on a doctor's prescription for another clear reason.

There is no proven benefit from papaya leaf extract, goat milk or other popular remedies in preventing complications. Spending money and time on them can delay proper care. Rely on fluids, rest, regular blood count monitoring and your doctor's advice, and tell the doctor about everything you are taking.

Preventing dengue

Empty, clean and cover all water containers at least once a week. Check coolers, flower-pot trays, refrigerator trays, tyres and terraces for stagnant water. Use mosquito repellent, wear full-sleeved clothes in the daytime, and use window screens and bed nets, especially for babies and people who sleep during the day. A person with dengue should sleep under a net so mosquitoes do not spread it further.

Pregnant women with fever during the monsoon should be tested early, as dengue near delivery needs special care for mother and baby. If you have fever during the monsoon, see a doctor early rather than self-treating. Your doctor or pharmacist can advise on safe medicines and when to test.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.