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    Monsoon woes: The rise of dengue and its prevention

    By Emily Hagan | Published on Oct 17, 2023

    The monsoon season brings relief from the scorching summer sun, transforming the barren hills surrounding the city into a lush green canopy. However, it also brings with it a darker side – an increase in the incidence of diseases. One such disease is dengue, which is not only dreaded but also endemic in many parts of the world.

    Did you know that approximately one third of the global population, around 2.5 billion people, live in areas where dengue is endemic? This means that these individuals are constantly at risk of acquiring the infection. Shockingly, about 50 million people contract the virus annually, leading to an estimated 25,000 deaths per year.

    India, in particular, has witnessed a steady rise in dengue infections since 2001. States like Maharashtra, Karnataka, Tamil Nadu, Pondicherry, Delhi, Haryana, Rajasthan, and Chandigarh bear the major disease burden. With the spread of urbanization, even states like Mizoram, Odisha, and Arunachal Pradesh, where the disease was previously non-existent, have reported dengue infections.

    The Devil’s Disease

    The origin of the name “dengue” remains unclear, but one theory suggests that it comes from the Swahili word “ka-dinga pepo,” which means “cramp-like seizure caused by an evil spirit.” Severe muscle and joint pain, one of the typical symptoms of dengue, reflect the cramp-like nature of the disease. Other symptoms can range from mild flu-like illness to bleeding and multi-organ failure.

    How does dengue spread?

    Dengue is spread through a mosquito vector, specifically the Aedes aegypti and Aedes albopictus species. These mosquitoes not only transmit dengue but also chikungunya and zika virus. They are most active during the early morning and late evening hours. When an infected mosquito bites a person, it transfers the virus, causing the infection. Aedes mosquitoes lay their eggs in water, and even a small amount is sufficient for their development into larvae, pupae, and eventually adults.

    It is important to note that an infected mosquito can carry the virus throughout its life and pass it on to its progeny.

    Why does the severity of the infection vary?

    The severity of a dengue infection depends on the serotype of the virus. Dengue has four different serotypes: DEN-1, DEN-2, DEN-3, and DEN-4. If a person acquires the infection for the first time with one serotype, the body develops immunity against that particular serotype. The patient usually experiences mild symptoms and recovers fully. However, if the patient later acquires the infection from a different serotype, the body only partially recognizes the virus. As a result, the immune response attacks the patient’s own tissues and organs, leading to a more severe infection.

    Diagnosing Dengue

    Several tests are available to diagnose a dengue infection. During the initial phase of dengue, which lasts about 4-5 days, a viral antigen called NS1 can be detected in blood samples. While rapid tests are available for NS1 detection, they are less accurate than the ELISA method, which takes slightly more time but provides more reliable results.

    Dengue virus PCR, another diagnostic test, can detect the viral RNA in the blood within the first few days of symptom onset. The advantage of this test is its ability to detect the viral RNA from cerebrospinal fluid in suspected cases of dengue affecting the brain. After the initial phase, dengue virus-specific antibodies can be detected in the blood, with the IgM antibody appearing after around 7 days and remaining in the blood for up to 21 days. The IgG antibodies, on the other hand, are detectable in the third week of infection and are more useful for identifying past infections. ELISA is commonly used to detect IgM and IgG antibodies.

    It is important to consult a doctor if you test positive for dengue, as additional laboratory tests may be required. Other monsoon fevers such as malaria, chikungunya, and zika virus infections should also be considered in the differential diagnosis of dengue. Performing all necessary tests is crucial for identifying the cause of these fevers.

    Prevention is Key

    Preventing dengue infection involves simple measures that anyone can follow to reduce mosquito breeding and exposure:

    • Ensure water does not collect in empty containers by storing them upside down or tightly closing their mouths. Regularly drain any water that collects and change the water in flower pots frequently. Scrub out containers to destroy any eggs that may be present.
    • Use mosquito repellents to protect yourself from mosquito bites.
    • Wear full-sleeved, light-colored clothes that cover your arms and legs to minimize exposed skin.
    • Encourage the use of mosquito nets for added protection.
    • Municipal authorities often spray pesticides and insecticides to control mosquito populations by destroying mosquito larvae and adult mosquitoes.

    Although there are no specific drugs or vaccines available against dengue in India at present, prevention remains the best approach.

    Stay vigilant, follow these preventive measures, and enjoy a safe and healthy monsoon season!

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