Dengue fever: What is the most dangerous stage?

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Nguyen Thi Nhat - Infectious Disease Specialist - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.
Dengue fever manifests through 3 stages of disease, the dangerous phase from the 3rd to 7th day of the disease, during this period there can be many life-threatening complications. Early recognition of signs of the disease go to reputable medical facilities for examination, diagnosis, treatment and monitoring of dangerous developments of the disease.

1. The risk of dengue infection

Dengue hemorrhagic fever is an acute infectious disease caused by the dengue virus. The disease is transmitted by blood, the transmission of which is the mosquito Aedes aegypti. This mosquito is usually active at dusk and dawn.

2. The dangerous stage of dengue fever

Dengue fever develops in three stages :
2.1 Incubation phase The initial phase of dengue fever can also be confused with common fever and viral fever. However, dengue fever often has characteristic manifestations such as: Congestive skin, subcutaneous dotted hemorrhagic rash, bleeding gums.
If severe, the patient often has abdominal pain in the liver, enlarged liver, less urine, more vomiting. At this time, the blood count test can show that hematocrit is elevated and platelets decrease rapidly.
2.2 Dangerous phase Patients with dengue fever usually move to the most dangerous stage about 3-7 days later. This is the stage that needs to be considered in order to take appropriate measures to limit the bad consequences.
If there is a lot of plasma leakage, it will lead to shock with clinical manifestations such as:
Convulsions, lethargy. Cold extremities, pale skin. Stagnant blood pressure, systolic and minimum blood pressure difference equal to or less than 20 mmHg, low or unmeasured blood pressure; urinating less... At the same time, there are signs of bleeding such as:
Subcutaneous hemorrhage is manifested as scattered hemorrhagic spots on the front of the legs and the inside of the arms, abdomen, thighs, ribs. Mucosal bleeding is manifested in the symptoms of nosebleeds, bleeding gums and teeth, bloody urine, prolonged menstruation or earlier menstruation. Visceral bleeding is manifested in the digestive organs, lungs, brain... and is considered a serious and dangerous sign. Some patients present with peritoneal and pleural effusion. Some severe cases may show organ failure such as: severe hepatitis, encephalitis, myocarditis; These severe manifestations may occur in some patients with no obvious signs of plasma leakage or without shock.
2.3 Recovery Phase This phase lasts 48-72 hours.
The patient's fever is gone, his general condition is better, his appetite, hemodynamic stability is stable, and he urinates a lot.

3. Note when treating dengue fever

For mild dengue fever, the patient can be treated at home as prescribed by the doctor. However, from day 3 to day 7, patients, especially children, should be closely monitored for symptoms of pre-shock due to blood loss. Especially from the 3rd day of illness (counting from the date of onset of fever), if you notice one or more symptoms such as fatigue, lethargy, lethargy, abdominal pain in the liver, vomiting a lot, urinating less, or internal bleeding organs, the patient must be rushed to the hospital. Dengue is transmitted by the mosquito Aedes aegypti, so mothers with dengue fever can still breastfeed normally.
If you have a high fever, only reduce fever with a single Paracetamon drug, use 10-15mg/kg/time for 4-6 hours. It is not recommended to use aspirin, ibuprofen because it can cause heavier bleeding.
Dengue fever in children is often more severe than in adults. Children with dengue fever are more susceptible to shock and re-shock than adults.
For children, by day 4, the fever has started to disappear and there are no other symptoms, meaning the disease is in remission but still need to continue to be monitored. If the baby shows warning signs such as lethargy or lethargy, liver pain, vomiting a lot, urinating less, mucosal bleeding... it must be taken to the hospital for re-examination.
Treatment of dengue fever is mainly symptomatic treatment and mostly outpatient treatment such as: antipyretic, oral rehydration. Should drink oresol, cooled boiled water, fruit juice, dilute salted porridge, coconut water, orange juice, milk......

4. Dengue fever prevention measures

Dengue fever is a mosquito-borne disease for which there is currently no vaccine or specific treatment. Effective measures to prevent disease today are to kill mosquitoes, kill larvae, larvae and prevent mosquito bites.
Clean house, especially and places prone to moisture. Spray mosquito repellent properly. Wear mosquito nets when sleeping, wear long clothes to prevent mosquito bites even during the day. Use mosquito repellent at home and out. When having dengue fever, it is necessary to rest, eat enough nutrients, easy to digest, supplement with many vitamins to improve physical condition, drink plenty of water and watch for warning signs and severe signs such as fatigue, weakness. dizziness, lethargy, abdominal pain in the liver, vomiting a lot, urinating less, or bleeding from the internal organs of the patient to take the patient to the hospital promptly.
Master. Doctor. Nguyen Thi Nhat has more than 10 years of experience in the field of artificial kidney, and in the field of infectious diseases, examination and management of patients with kidney disease and infectious diseases. Currently working as a Doctor of Infectious Diseases, Department of General Internal Medicine, Vinmec Hai Phong International General Hospital

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