What is breakbone fever?

By Y.L.M
  • Health
  • Wednesday, 14 Aug 2013

This 2006 photograph depicts a female Aedes aegypti mosquito while she was in the process of acquiring a blood meal from her human host, who in this instance, was actually the biomedical photographer, James Gathany, at the Centers for Disease Control. Researchers on May 17, 2007 published the genome -- a map of the genetic composition -- of the mosquito species Aedes aegypti, a connoisseur of human blood that spreads disease in tropical and sub-tropical locales worldwide. REUTERS/James Gathany/Centers for Disease Control/Handout (UNITED STATES). EDITORIAL USE ONLY. NOT FOR SALE FOR MARKETING OR ADVERTISING CAMPAIGNS. NO SALES. NO ARCHIVES.

Some may call it breakbone fever, but we all know it as dengue fever.

MY daughter was recently diagnosed with dengue fever. She had a fever and a rash, and when we took her to the doctor, he sent us to the hospital because he said she had to be hospitalised. She is warded now and has been put on a drip. Is dengue fever dangerous?

Yes, dengue fever can be dangerous because of the possibility of bleeding. That is why your daughter is being warded in the hospital. There is no cure, and the only care is supportive. There is no vaccine for it either.

Dengue fever is actually caused by a family of viruses that are transmitted by the mosquito called Aedes, primarily Aedes aegypti.

Generally, the virus is called the dengue virus. There are four serotypes of the dengue virus, so it’s possible to get dengue fever four times in your lifetime.

The good thing is that once you suffer a particular subtype of dengue, you are immune to that subtype for the rest of your life. (With only three more subtypes to go.)

Dengue is also called “breakbone fever” or “dandy fever”, because the aches in the bones of the patients can be very severe. The word “dandy” came about because in the past, slaves in Honduras were in such pain that their posture and gait were altered. In fact, Honduras is in a state of emergency right now over a dengue outbreak which killed several people.

Dengue fever can affect anyone, but it tends to be more severe in people whose immune systems are compromised in any way, such as those with AIDS, or who are on chemotherapy.

How would I know if I have dengue fever?

The usual form of dengue fever (without bleeding) happens around five to eight days (but can be up to two weeks) after you get bitten by a mosquito carrying the dengue virus.

Then you get headache and chills. The pain is classically concentrated behind your eyes, but this is not necessarily always so. You can also experience backache.

Your joints and legs ache all over during the first few hours. After that, the fever spikes. It can be very high (around 40 degrees Celsius), and you will feel very ill. For some reason, your heart rate is low for the fever, and you can experience low blood pressure.

Your eyes become very red, and a pink rash starts to appear on your face (can also manifest as flushing). This soon disappears. Your lymph nodes in your neck and groin are often swollen.

After two to four days, your body temperature drops, and you experience a lot of sweating. You feel relatively well for a day or so, and you think it’s over. But it isn’t.

You can have another spike of fever, followed by a red (rosy) rash that covers your entire body (except for your face).

How can dengue fever make me bleed?

The more severe type of dengue (haemorrhagic fever) may manifest with petechiae, which are small red blotches of bleeding under your skin. You can have bleeding in your nose and gums, and also easy bruising. Your stools may even be black because of bleeding, and you can cough or spit out blood. There may be inflammation of your heart and lungs, as well as abdominal pain.

This is the type of dengue that can be very dangerous and can progress to an even more severe form of dengue fever: dengue shock syndrome.

The death rate in dengue hemorrhagic fever is around 2.5%.

What happens to me once I’m hospitalised with dengue fever?

Your blood work will be taken. In particular, the doctor will be monitoring (and in some occasions twice a day if it’s very serious) your platelet count daily.

Platelets are the blood factors that stop bleeding.

You feel extremely dehydrated when you have dengue fever, and you may feel thirsty all the time. So the doctor may connect you to an intravenous drip to ensure you are well-hydrated.

There are no antivirals to be given for dengue, and you can’t take medicines like Tamiflu either. So the hospital staff will just observe you, and the moment your platelet counts climb up and you are better, you may be discharged to go home to recuperate.

How long will I really take to recover?

Most patients stay in hospital for a few days, and then they are discharged home to recuperate.

The acute phase of the disease (with fever and body as well as joint aches) usually lasts for one or two weeks. You may actually take several weeks to recover because there is usually residual weakness. In general, you can go back to school or work in three weeks.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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