IMA has released dengue guidelines and has asked citizens not to panic. The present serotype is less fatal than the one in 2013 and the more reliable test is haematocrit rather than test for platelet count. Here are a few important things about dengue that you should know:- Dengue normally are of Den1, Den2, Den 3 and Den4 serotypes. Serotypes 1 and 3 are less dangerous as compared to 2 and 4. This year serotypes 2 and 4 are prevalent. 2)) Serotype-specific symptoms..... Every strain carries the risks of hemorrhagic fever, but type 4 is less virulent than type 2. Risk of severe dengue is highest with dengue-2 viruses. 3)) General symptoms..... Symptoms typically develop between four and seven days after the bite of an infected mosquito. The incubation period may range from three to 14 days. Fever typically lasts for five to seven days. The febrile period may also be followed by a period of marked fatigue that can last for days to weeks, especially in adults. 2 days after the last episode of the fever are crucial and during this period, a patient should be encouraged to take plenty of oral fluids mixed with salt and sugar. Giving fluids orally or by intravenous routes, if given at a proper time, can save fatal complications. 4)) Do not panic..... A platelet transfusion is not needed unless patient has active bleeding (other than petechiae) and platelet counts are less than 10,000. Unnecessary platelet transfusion can cause more harm than good. Only these need admission Persistent vomiting, lethargy or restlessness. Bleeding, pallor, Cold /clammy extremities. Abnormal mental status. Dramatic plasma leakage often develops suddenly; therefore, substantial attention has been placed on early identification of patients at higher risk for shock and other complications. An elevation of the hematocrit is an indication that plasma leakage has already occurred and that fluid repletion is urgently required. Mild elevations in serum SGOT and SGPT levels are common. Bit in severe dengue the levels are very high with SGOT > SGPT levels. NS 1 of >600 mg/ml suggests severe dengue. Additionally, hospitalization should be considered for patients who may have difficulties with outpatient follow-up (eg, patients who live alone or who live far from a healthcare facility without a reliable means of transport). 7)) Fluid requirement..... 10 ml/kg over the next first hour 5 ml/kg/hour for next four hours 8)) Assessment..... Duration of extra fluids. Intravenous fluid supplementation should be discontinued once patients have passed the period of plasma leakage. Excessive fluid administration after this point can precipitate hypervolemia and pulmonary edema. In the absence of complications from prolonged hypotension or from medical interventions, most patients with severe dengue recover within a few days of admission. Two days have passed after an episode of shock. Normal normal appetite, urine output, and hematocrit. Patients with dengue should be cautioned to maintain their fluid intake to avoid dehydration and to take paracetamol as needed for fevers and myalgias. 11)) Some more facts..... When the dominant strain remains the same for a long period, a significant population develops immunity to it, and fewer patients are diagnosed with the virus. However, immunity to the other dengue serotypes is transient, and individuals can subsequently be infected with another dengue serotype (secondary infection). The risk for severe dengue appears to decline with n age, especially after age 11 years. www.keralites.net
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