Deadly Dengue (Detection, Prevention and Treatment)

Everyone hates mosquitos! Tiny as they are, yet they have been one of the deadliest enemies of man. Millions of people suffer from mosquito-borne diseases globally, and often die.

The incidence of dengue has increased significantly over the years, afflicting dramatic proportions seasons after season. Dengue is primarily a mosquito-borne viral disease of the tropics. Its deadly forms—dengue haemorrhagic fever and dengue shock syndrome—have become serious problems and are spreading across borders.

Deadly Dengue explains what dengue is and how it spreads; about Aedes aegypti, a day-biting mosquito and the dengue virus; preventive measure and about the clinical manifestations; complications and laboratory tests. The book particularly emphasizes early detection and treatment can get costly and may not be available in best hospitals. It aims to tide over the present crisis and create awareness, so that dengue outbreaks can be prevented and controlled in the future.

Dr. Ajit S. Puri is MD (Medicine) and has worked as visiting member of faculty, Newcostle General Hospital, UK. He has several awards, fellowships and DSc. (Honoris Causa) to his credit. A Crusader for disease/epidemic prevention he is working on his first-ever, continuing and the longest (over 40 years) global humanitarian compaign on common but fatal disease prevention, appreciated by the World Health Organisation (WHO). Dr. Puri has presented papers in several international medical conferences and writes frequently for leading newspapers and journals. His books include: How to Prevent Common Disease, All you Wanted To know About Sars and Bird Flu: Countering the Terror.

This publication is an extension of my book Speaking of How to Prevent Common Diseases, acclaimed worldwide in more than 40 countries with a foreword by the noted physician Lord Walton. This book was followed by a book on SARS (Severe Acute Respiratory Syndrome), the most lethal disease ever known in the history of humankind, and another book titled - Bird Flu: Countering the Terror, in view of the global threat of bird flu.

I have been ceaselessly working on my first-ever, ongoing and longest (over 40 years) global campaign on common but fatal disease prevention, appreciated by the WHO under the auspices of the United Nations. The previous publications and the present one are in continuation of this campaign.

At the outset, I would say that dengue is not a new disease. It is a mosquito-borne viral disease and its epidemics were not uncommon during the past, though these epidemics were limited to a particular locality or an area. Due to international travel, the disease spreads quickly from one country to another by infected persons.

The available literature, present and past, my own experience in dealing with the emergencies of dengue in the K'Us (intensive care units) of different hospitals have helped me in writing this book.

Website references, including those of the World Health Organization (WHO), provided essential and up- to-date information on this fatal disease. Data published in magazines, journals, especially in the Journal of the Association of Physicians of India were noted and referred to in this publication.

I have studied the mosquito Aedes aegypti, which is responsible for the spread of dengue and the dengue- virus, so as to provide a clearer insight into this disease.

My sincere thanks are due to all those scientists and organizations, national and international, who have over the years, made relevant contributions about this disease. I express my special gratitude to all the noted entomologists and virologists of the past/present, who did pioneering and thorough research on the mosquito Aedes aegypti and the dengue-virus and published results in medical texts. I am grateful to Jaswant Singh Puri, a journalist, for creating immediate awareness for the masses through media coverage about the disease in noted dailies like The Tribune, The India Post and the likes.

I hope this book will help the readers to tackle the threatening challenge of dengue the world over.

Dengue (also called Break-bone fever, Seven-day fever) is a serious disease of the tropical countries. Truly speaking it is now the most rapidly spreading mosquito- borne viral disease of the world and is, indeed, a global threat. In the last 50 years, the global incidence has become progressively larger

Dengue, in fact, is an old time disease. Its epidemics used to occur in the past too, but these were limited to a local area. The main reasons for its worldwide spread are largely due to increased international travel, population explosion, geographical expansion, urbanization and above all global warming. The invasion of mosquitoes occurs during warmer months.

The prevalence of the disease in any country depends on the mosquito-condition of the locality, the presence of infected persons, favourable conditions of temperature and humidity, and presence of susceptible persons.

As far as seasonal prevalence is concerned, an epidemic occurs generally after the rainy/monsoon season, but sporadic cases may occur at any time of the year when mosquitoes carrying the virus that cause dengue are present sufficiently. High atmospheric temperature seems to be a favourable condition for the occurrence of the disease, as it is prevalent during the moist hot part of the year.

In general, dengue occurs at all ages. It occurs equally in both sexes and all races are equally liable.

An estimated 50 million dengue infections occur annually and nearly 2.5 billion people live in dengue- endemic countries. The disease imposes a significant health, economic and social burden on the population of endemic areas. The number of cases varies substantially from year to year. Under-reporting and misdiagnoses are major obstacles to understanding the full burden of dengue. It may be said that a hospitalized case of dengue costs much more than an ambulatory patient. However, there is a substantial cost associated with dengue surveillance and vector control programme. Therefore dengue imposes substantial cost on both the health sector and the overall economy. If a vaccine was able to prevent much of this burden, the economic gains would be substantial.

Some of the other tropical diseases that may be mentioned are: (i) viral diseases, besides dengue, smallpox, chickenpox, rabies, (ii) diseases caused by bacteria, like typhoid, cholera, leprosy, plague, (iii) diseases caused by animal poisons, like snake-bite, scorpion-sting, (iv) diseases caused by parasites, like amoebiasis, giardiasis, malaria, (v) helminthic diseases, like hookworm disease, ascariasis (roundworm disease), enterobiasis (threadworm disease), filariasis. Likewise, diseases caused by spirochetes, diseases caused by rickettsiae, including tropical eosinophilia, tropical spleenomegaly, tropical sprue, etc. However, the list is never ending. Tropical counties are a hub of diseases and there is an urgent need to develop ways to curb them.