Dengue Fever Risk Factors | Max Hospital

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Dengue Fever: Risk Factors, Variants, Vaccine & Latest Trends

By Dr. Rommel Tickoo in Internal Medicine

Aug 26 , 2024 | 2 min read

Dengue is triggered by a virus from the Flaviviridae family, with four distinct yet closely related serotypes responsible for the disease: DENV-1, DENV-2, DENV-3, and DENV-4. The recovery from infection is believed to provide lifelong immunity against that specific serotype. However, cross-immunity to other types (after recovery) is partial and temporary. Subsequent infections by the other serotypes increase the risk of developing severe dengue.

A patient normally enters a critical phase about 3-7 days after the onset of illness. At this time, when the fever drops (below 38°C/100°F) in the patient, warning signs associated with severe dengue may manifest. Severe dengue is potentially fatal due to complications like plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs include:

Severe abdominal pain
Fatigue
Persistent vomiting
Rapid breathing
Bleeding gums
Restlessness
Blood in vomit.

If patients develop these symptoms during the critical phase, close observation is necessary for the next 24–48 hours so appropriate medical care can be given to avoid complications and the risk of death. Elderly patients with multiple medical conditions may develop severe dengue.

There is no known cure for severe dengue. Patients with this type of dengue fever may need treatment in an ICU (intensive care unit). Treatment focuses on symptoms and includes the following:

Blood and platelet transfusion,
Intravenous fluids for rehydration,
Oxygen therapy is used if oxygen levels are low.

A patient could recover from severe dengue with immediate care and treatment. However, if the treatment is delayed and the patient develops multi-organ failure or goes into shock, the chances of fatality rate rise.

This year's dengue infection outbreak has been dreadful, and there have been several reports of infections taking a turn for severe and high hospitalizations, with a newer DENV-2 variant in circulation. Now, while dengue can present a lot of overlapping symptoms common with infections like the flu or COVID-19, it should not be treated lightly as it can manifest complications if the right treatment isn't followed. The DENV-2 strain is said to be harsher on those who have battled dengue before and/or have pre-existing illnesses, so it's necessary that one remains careful, and worsening symptoms must be recognized as soon as possible.

If you know you have dengue, avoid getting mosquito bites during the first week of illness. The virus may be circulating in the blood during this time, so you could transmit the virus to new uninfected mosquitoes, who, in turn, may infect other people.

The proximity of mosquito breeding grounds to human habitation poses a major risk factor for dengue and other diseases that the Aedes mosquito may transmit. Presently, the main method to control and prevent dengue transmissions is to combat the mosquito vectors.

The WHO position paper on the Dengvaxia vaccine (September 2018), the live attenuated dengue vaccine CYD-TDV, has shown in clinical trials to be efficacious and safe in individuals with previous dengue virus infection (positive individuals). However, it increases the risk of severe dengue for individuals who receive their first natural dengue infection after vaccination (those who were negative for dengue at the time of their vaccination).