Diseases caused by water (continued)


Dengue is one of the biggest concerns regarding infectious diseases in Brazil today. It is a virus transmitted by a type of mosquito (Aedes aegypti) that bites only during the day, unlike the common mosquito (Culex), which bites at night. The infection can be caused by any of four types (1, 2, 3 and 4) of dengue virus, which produce the same manifestations.

In general, the onset is sudden with high fever, headache and a lot of body pain. It is common to feel intense tiredness, lack of appetite and sometimes nausea and vomiting. Red spots may appear on the skin, similar to those of measles or rubella, and itching (itching) on ​​the body. Sometimes bleeding may occur (usually on the nose or gums). Dengue is not transmitted directly from one person to another.

What should a person do if they think they have dengue?

- See a Health Service early in the onset of symptoms. Several diseases are very similar to dengue, and have another treatment.

- Drink plenty of fluids, avoiding caffeinated drinks (coffee, black tea). Do not take medicines on your own, even those usually indicated for pain or fever. All medications may have side effects and some that may even make the disease worse. Dengue has no specific treatment. Medicines are used to attenuate the manifestations (pain, fever).

- Tell the doctor if you are using any medicine. Some medicines used to treat other conditions may increase the risk of bleeding.

- Do not take any pain or fever medicine containing acetyl salicylic acid (AAS®, Aspirin®, Melhoral® etc.) - which may increase the risk of bleeding.
Anti-inflammatories should also not be used as antipyretics because of the risk of side effects such as digestive bleeding and allergic reactions.

Dipyrone remedies (Novalgina®, Dorflex®, Anador®, etc.) should be avoided as they may decrease pressure or sometimes cause dengue-like skin blemishes.

Acetaminophen (Doric®, Tylenol® etc), which is most commonly used to treat dengue pain and fever, should be taken strictly at the doses and intervals prescribed by the doctor as very high doses may cause liver damage.

How is dengue diagnosis made?

The initial diagnosis of dengue is clinical (history + and physical examination of the person), made essentially by exclusion of other diseases. Once a clinical diagnosis of dengue has been made, some tests (hematocrit, platelet count) may provide useful information when analyzed by a physician, but do not support the diagnosis, as they may also be altered in various other infections.

Confirmation of the diagnosis, if desired for any reason, can be done by serology (examination that detects the presence of antibodies against dengue virus), which begins to become reactive ("positive") from the fourth day of illness. .

Do I have to wait for test results to start treatment?

No. Because other diseases are clinically excluded, dengue becomes the most likely diagnosis, test results (which may take a long time) cannot delay the initiation of treatment. Dengue treatment is most often done with an oral rehydration solution (available at Health Units), which should be started as soon as possible.

Is proof of dengue diagnosis useful for treating the sick person?

No. Serological evidence of dengue diagnosis may be useful for other purposes (epidemiological surveillance, statistics) and is a right of the patient, but the result of the test will usually be available only after the person has improved, making it useless for the patient. conduct of treatment. The serological examination also does not allow to say which type of virus caused the infection (which is irrelevant) and whether dengue is "hemorrhagic".

What is dengue hemorrhagic fever?

Dengue "hemorrhagic" is the most severe dengue. Despite its inaccurate name, the main danger of "haemorrhagic" dengue fever is not bleeding, but very low blood pressure (shock).

It is important to know that other illnesses, such as meningococcal meningitis, may be very similar to dengue, although the person gets serious much faster (on the first or second day of illness). Dengue can become more severe only when fever begins to subside. The most dangerous period is in the first three days after the fever begins to disappear. Any of these changes may appear:

- liver pain (ribs, right side)
- dizziness, fainting
- cold, sticky skin, cold sweat
- bleeds
- dark stools, like coffee grounds

What to do if any of these symptoms appear?

Immediately seek the nearest Municipal Health Center or Hospital.

THE "hemorrhagic" dengue only occurs in those who have dengue a second time?

No. The severe form of dengue can also occur in those who have the disease for the first time.

THE Is "hemorrhagic" dengue obligatory in having the disease a second time?

No. The risk is higher than in the first infection, but the vast majority of people who have the disease for the second or third time do not have the severe form of dengue.

How often can a person have dengue fever?

Up to four times as there are four different types of dengue virus (1, 2, 3 and 4). In Rio de Janeiro, so far, there are types 1, 2 and 3. Each time a person has dengue by a type, he is permanently protected against new infections by that type. That's why you can only have dengue fever four times.

Who has dengue gets any complications?

No. The recovery is usually total. It is common for a few days for a feeling of tiredness to disappear completely over time.

Everyone who is stung by Aedes aegypti get sick?

No. First, Aëdes must be infected with the dengue virus. Also, about half of those who are bitten by the mosquito that has the virus show no symptoms.

What to do to reduce the risk of getting dengue?

O Aedes aegypti It is a domestic mosquito that lives in or near the dwellings. The only possible way to prevent or reduce the duration of an epidemic and prevent the introduction of a new type of dengue virus is by eliminating the transmitters. This is very important because, in addition to dengue, the Aedes aegypti It can also transmit yellow fever.

Smoke is useful for killing adult mosquitoes, but it does not kill eggs. Therefore, it should only be used during epidemic periods with the aim of rapidly stopping transmission. The most important thing is to end the mosquito breeding grounds. Any collection of clean and still water, including water-accumulating plants (bromeliads), can serve as breeding grounds for Aedes aegypti.