The virus that causes dengue fever is carried by female mosquitoes "Aides Aegypti", it normally feeds during the daytime, and is transmit their virus to humans through their bite. It is more likely to occur during or after the rainy season. Dengue fever can occur to people of all ages but it mostly affects children under the age of 15 years, but can occur in all age groups. Avoiding mosquito bites during the day time is a critical precautionary measure. Infection with one dengue serotype provides lifelong immunity but each individual can eventually be infected by other 3 serotypes. Several serotypes can be in circulation during an epidemic. The virus of the mosquitoes is not contagious and cannot be spread directly from person to person. There must be a person-to-mosquito-to-another-person pathway.

Other Names of Dengue Fever are: Dandy fever, Three-day fever, Breakbone fever. It is called as Breakbone Fever because the Victims of dengue often have contortions due to the intense joint and muscle pain, hence it has named as breakbone fever.

Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and Central America. Cases have also been imported via tourists returning from areas with widespread dengue, including Tahiti, the South Pacific, Southeast Asia, the West Indies, India, and the Middle East.

Ayurvedic Name of Dengue Fever is "Dandak Jwara"

Causes of Dengue Fever :

• Increase in non-biodegradable plastic packaging and discarded tires
• Increased jet air travel is helping people infected with dengue viruses to move easily from city to city. 
• Lack of effective methods to control epidemics 
• Lack of effective mosquito control efforts 
• Poor Public health systems 
• Rapid growth or Overcrowding of cities in tropical countries 
• Urban decay, and substandard sanitation, allowing more mosquitoes to live closer to more people.

Signs & Symptoms of Dengue Fever

The time between the bite of a mosquito carrying dengue virus and the start of symptoms averages 5 to 7 days, with a range of 3 to 14 days. An infected person cannot spread the infection to other persons but can be a source of dengue virus for mosquitoes for about 6 days. When mosquitoes bite an infected person and then it bites another person then the virus is transmitted to one person to another. There are several signs and symptoms of dengue, some of them are as follows:

Signs & Symptoms of dengue include:

• Chills
• Flushed face
• Increase in temperature, a rash, and a headache. 
• The rash consists of small red bumps that begin on the arms and legs, but then spread to the back, abdomen, and chest.
• Lower back pain and general weakness.
• Red eyes and eye pain
• Severe joint and muscle pain
• Swollen lymph nodes
• Soles of the feet and palms of the hands also turn red and swell.

 These symptoms last for two to three days. Afterward, the fever drops and the patient experiences heavy sweat, but feel better for around one day.

In more severe cases, patients have fever and headache, and then develop a cough. The dengue virus causes the blood vessels to swell and leak, creating small purple colored spots on the skin, called petechiae. The skin may appear bruised in areas where the bleeding is worse. Bleeding into the stomach causes severe abdominal pains and vomiting of a black, grainy substance that looks like coffee grounds. The damaged blood vessels eventually become so large that they are unable to supply the needed blood flow and the oxygen it carries to the body's tissues. This causes the body to go into shock, and can damage major organs such as the heart and kidneys.

Dengue hemorrhagic fever (DHF) or Dengue shock syndrome (DSS)
Dengue hemorrhagic fever is a life threatening complication that is characterized by high fever, hemorrhagic (bleeding) phenomena - often with enlargement of the liver and in severe cases circulatory failure. The illness commonly begins with a sudden rise in temperature accompanied by facial flush and other symptoms of dengue fever. The fever usually continues for two to seven days and can be as high as 40-41°C, (104 to 106 degree Fahrenheit). Mostly the severe cases of dengue hemorrhagic fever occur in children.

Symptoms of Dengue Hemorrhagic Fever 

• Persistent red spot on the skin or in the nose, bleeding gums, 'coffee- ground '. vomit or dark stools
• The child remains ill despite fall in temperature, and develops cold and sweaty extremities such as hand and feet, clammy skin, restlessness or drowsiness

Diagnosis of Dengue Fever
Diagnosis is made on the basis of clinical symptoms and blood test. The earlier detection is the only cure for this illness.

Treatments of Dengue Fever

• Dengue fever is usually a self-limited illness, and only supportive care is required. Paracetamol may be used to treat patients with symptomatic fever.
• Keep up oral intake, especially of oral fluids and/or, oral rehydration salts to prevent dehydration.
• Aspirin and nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, diclofenac) and corticosteroids should be avoided. 
• During Dengue platelet count in the blood goes down. Since medicines like aspirin reduce platelet count, they should be avoided.

If symptoms of Dengue hemorrhagic fever are seen immediately report to your doctor or visit to the hospital for treatment.

Because dengue is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the treatment is purely concerned with relief of the symptoms. Rest and fluid intake for adequate hydration is important.

Preventions of Dengue Fever
At present, the only method of controlling or preventing dengue and DHF is to combat the mosquitoes. Aedes aegypti breeds primarily in man-made containers like earthenware jars, metal drums and concrete cisterns used for domestic water storage, as well as discarded plastic food containers, used automobile tyres and other items that collect rainwater. Discard or dry these items.

• Avoid heavily populated residential areas.
• Avoid mosquito bite even during day time. 
• Discard items that can collect rain or run-off water, especially old tires. 
• Eliminate mosquito breeding sites around homes. 
• Regularly change the water in outdoor bird baths and pet and animal water containers.  
• Sleeping area should have mosquito netting over the bed.
• Stay in well-screened areas. 
• Use long clothes to cover the body to avoid mosquito bite  
• Use mosquito repellents on skin and clothing. 
• When indoors, stay in air-conditioned or screened areas. Use bednets if sleeping areas are not screened or air-conditioned. 
• When outdoors during times that mosquitoes are biting, wear long-sleeved shirts and long pants tucked into socks.  

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