Dengue Fever

In October 1982, there was an outbreak of Dengue Fever in Delhi.  Both Shri Nathji and HH Priya Nathji where down with Dengue Fever for few days. By the time the fever had left, both Shri Nathji and HH Priya Nath had lost 4 kilograms of weight each. They can barely get up and walk.

Shri Nathji suddenly begins to laugh very loudly as he says:

“Ye dengue itne logon ko tang kar gayaa–usse milaa kyaa? Khaak! Jaise Americans chandralok tak ho aaye magar laaye kyaa? Khaak!”

“The dengue virus has harassed so many persons and gone, but what did it gain from doing this? Nothing! The Americans sent their spaceship to the moon–but what did they gain from it? Nothing!”

Both, HH Priya Nath and Shri Nathji, laugh for a long time at Shri Nathji's joke on the virus.

Shri Nathji continues:

“Sab thheek to chal rahaa thaa–illness kaa to naam nishaan bhi naheen thaa. Ye to pataa naheen kahaan se Dengue Fever aa gayaa. Dengue! Dangar kaheen ka!”

“Everything was going on smoothly, there was no sign of illness. Where did this Dengue Fever come from? Dengue! What a beast!”

HH Priya Nath found Shri Nathji's humour to be incredibly delightful. Shri Nathji was looking very comical indeed in his loose shirt-kurtaaa, as he jokes about the Dengue Virus.

For a while it appears as if Shri Nathji might fall ill again as he almost vomits again, but the situation is well under control and Priya Nath and Shri Nathji begin making a good recovery.  There are reports in the newspapers that the raging Dengue Fever had claimed many lives. Both, Shri Nathji and Priya Nath, have had a very narrow escape.

Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.

Dengue is transmitted by several species of mosquito within the genus Aedes, principally A. aegypti. The virus has four different types; infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications. As there is no commercially available vaccine, prevention is sought by reducing the habitat and the number of mosquitoes and limiting exposure to bites.

Treatment of acute dengue is supportive, using either oral or intravenous rehydration for mild or moderate disease, and intravenous fluids and blood transfusion for more severe cases. The incidence of dengue fever has increased dramatically since the 1960s, with around 50–100 million people infected yearly. Early descriptions of the condition date from 1779, and its viral cause and the transmission were elucidated in the early 20th century. Dengue has become a global problem since the Second World War and is endemic in more than 110 countries. Apart from eliminating the mosquitoes, work is ongoing on a vaccine, as well as medication targeted directly at the virus.

The characteristic symptoms of dengue are sudden-onset fever, headache (typically located behind the eyes), muscle and joint pains, and a rash. The alternative name for dengue, "breakbone fever", comes from the associated muscle and joint pains. The course of infection is divided into three phases: febrile, critical, and recovery.

When a mosquito carrying dengue virus bites a person, the virus enters the skin together with the mosquito's saliva. It binds to and enters white blood cells, and reproduces inside the cells while they move throughout the body. The white blood cells respond by producing a number of signaling proteins, such as interferon, which are responsible for many of the symptoms, such as the fever, the flu-like symptoms and the severe pains. In severe infection, the virus production inside the body is greatly increased, and many more organs (such as the liver and the bone marrow) can be affected, and fluid from the bloodstream leaks through the wall of small blood vessels into body cavities. As a result, less blood circulates in the blood vessels, and the blood pressure becomes so low that it cannot supply sufficient blood to vital organs. Furthermore, dysfunction of the bone marrow leads to reduced numbers of platelets, which are necessary for effective blood clotting; this increases the risk of bleeding, the other major complication of dengue fever.

There are no approved vaccines for the dengue virus. Prevention thus depends on control of and protection from the bites of the mosquito that transmits it. There are no specific treatments for dengue fever. Treatment depends on the symptoms, varying from oral rehydration therapy at home with close follow-up, to hospital admission with administration of intravenous fluids and/or blood transfusion.