Dengue is a mosquito-borne viral infection that is common in tropical and subtropical regions, including India. It is caused by dengue viruses and is mainly spread through the bite of an infected Aedes mosquito.

For many people, dengue causes a high fever, headache, body pain, nausea and weakness and improves with proper supportive care. However, some patients can develop severe dengue, which may cause serious bleeding, fluid leakage, shock or organ problems. Early medical assessment and careful monitoring are therefore important.

What Is Dengue?

Dengue is an infection caused by one of four closely related dengue virus types: DENV-1, DENV-2, DENV-3 and DENV-4.

The virus is transmitted mainly through the bite of an infected Aedes mosquito. These mosquitoes can live around homes and commonly breed in containers or other places where water collects.

Dengue can affect people of all ages. A person can also get dengue more than once because infection with one dengue virus type does not provide complete protection against the other types. Some evidence indicates that a later infection with a different dengue virus type can carry a higher risk of severe dengue.

How Does Dengue Spread?

Dengue spreads through a cycle involving mosquitoes and humans.

1. An Aedes mosquito bites a person who has dengue virus in their blood.
2. The mosquito becomes infected.
3. The infected mosquito bites another person.
4. The virus enters the new person’s bloodstream.
5. That person may then develop dengue infection.

Dengue does not normally spread directly from one person to another through ordinary contact, such as touching, sitting together or sharing food.

An important point is that a person with dengue can infect mosquitoes that bite them during the period when virus is present in their blood. Therefore, preventing mosquito bites while sick is important for protecting other members of the household and community.

Dengue Symptoms

Not everyone infected with dengue develops noticeable symptoms. When symptoms occur, they commonly begin several days after infection.

Typical symptoms include:

• High fever
• Severe headache
• Pain behind the eyes
• Muscle pain
• Joint and body pain
• Weakness and tiredness
• Nausea or vomiting
• Skin rash
• Sometimes swollen glands

Symptoms commonly last around 2–7 days, although tiredness may continue for several weeks after the infection has improved.

Dengue can sometimes look like other illnesses

Fever, body aches, headache and weakness can occur in many infections. Dengue symptoms may overlap with illnesses such as chikungunya, malaria, influenza and other viral infections.

Therefore, symptoms alone cannot always confirm dengue. A healthcare professional may recommend appropriate blood tests based on the patient’s symptoms, illness duration and local disease patterns.

Warning Signs of Severe Dengue

One of the most important things to understand about dengue is that a fall in fever does not always mean the patient is recovering.

Warning signs of severe dengue can appear around the time the fever begins to settle, often during the next 24–48 hours. Severe dengue can progress rapidly and requires urgent medical attention.

Seek immediate medical care if there is:

• Severe abdominal pain or tenderness
• Persistent or repeated vomiting
• Bleeding from the nose or gums
• Vomiting blood
• Blood in the stool or black stools
• Rapid or difficult breathing
• Extreme weakness
• Unusual restlessness, irritability or drowsiness
• Very pale or cold skin
• Excessive thirst
• Reduced urine output or other signs of dehydration
• Altered consciousness or confusion

Severe dengue may involve plasma leakage, severe bleeding or organ impairment and can become life-threatening within a short period.

If any warning sign is present, do not wait for the symptoms to improve on their own. Seek emergency medical care immediately.

Why Can Dengue Become Severe?

Dengue is a dynamic illness, meaning that the patient’s condition can change during the course of the disease.

In severe dengue, one important problem is leakage of fluid from blood vessels into surrounding tissues. This can reduce the amount of fluid circulating in the bloodstream and, in serious cases, lead to shock.

Severe dengue may also cause:

• Significant bleeding
• Fluid accumulation
• Breathing difficulties
• Liver involvement
• Kidney problems
• Problems affecting other organs

Early recognition and appropriate supportive treatment are important because severe dengue can progress quickly.

The Three Phases of Dengue

Clinically, dengue is often described in three phases.

1. Febrile Phase

This is the period when fever is prominent.

The patient may experience:

• High fever
• Headache
• Body and joint pain
• Pain behind the eyes
• Nausea or vomiting
• Rash
• Weakness

The febrile phase commonly lasts several days.

2. Critical Phase

This phase can occur around the time the fever decreases.

This is particularly important because some patients may develop warning signs or severe dengue even though their temperature is coming down.

During this period, medical monitoring is especially important for patients at increased risk or those showing warning signs.

3. Recovery Phase

If the patient passes safely through the critical phase, the body gradually recovers.

Appetite, urine output and general wellbeing usually improve. Some patients may continue to experience weakness or tiredness for several weeks.

How Is Dengue Diagnosed?

A healthcare professional may suspect dengue based on:

• Fever and symptoms
• Physical examination
• Duration of illness
• Local dengue activity
• Travel or exposure history
• Blood test results

A blood test can confirm dengue infection, although the exact test used depends on the stage of illness and the clinical situation. Other blood tests may also be performed to monitor the patient’s condition.

Why monitoring blood counts matters

Doctors may monitor parameters such as:

• Platelet count
• White blood cell count
• Haematocrit
• Kidney function
• Liver function
• Electrolytes
• Other indicators depending on the patient’s condition

A platelet count should not be interpreted by itself. The patient’s symptoms, vital signs, hydration, bleeding, blood pressure, urine output and other laboratory findings are also important when assessing dengue.

Dengue Platelet Count: What Patients Should Know

Platelets often decrease during dengue infection, which is why many patients become concerned when they see a low platelet count.

However, the platelet number alone does not tell the complete story.

Doctors assess the patient as a whole, including:

• Whether there is active bleeding
• Blood pressure and circulation
• Hydration status
• Haematocrit
• Urine output
• Warning signs
• Other laboratory results
• Overall clinical condition

Routine platelet transfusion is not recommended simply because the platelet count is low; decisions about blood products should be made by the treating medical team according to the patient’s clinical condition.

Treatment of Dengue

There is currently no specific antiviral medicine that cures dengue infection. Treatment is mainly supportive and focuses on maintaining hydration, controlling fever and pain safely, monitoring for complications and providing hospital care when necessary.

For uncomplicated dengue, treatment may include:

Adequate fluids

Maintaining hydration is important. Patients may be advised to drink appropriate amounts of water and other fluids, depending on their condition.

If a patient cannot drink adequately or develops complications, intravenous fluids may be required under medical supervision.

Importantly, IV fluids are not automatically required for every dengue patient. Fluid treatment needs to be carefully adjusted because both dehydration and excessive fluid administration can be harmful.

Rest

Adequate rest helps the body recover and can reduce physical stress during the illness.

Fever and pain management

Paracetamol (acetaminophen) is generally used for fever and pain when appropriate.

Patients with suspected or confirmed dengue should avoid aspirin and NSAID painkillers such as ibuprofen unless specifically advised otherwise by their treating doctor, because these medicines can increase bleeding risk.

Medical monitoring

Patients with warning signs or severe dengue may need hospitalisation and close monitoring of vital signs, fluid balance, blood tests and organ function.

When Does Dengue Require Hospitalisation?

Not every person with dengue needs to stay in a hospital.

Hospital care may be necessary when a patient:

• Has warning signs
• Has severe dengue
• Has significant bleeding
• Develops shock or circulatory problems
• Cannot maintain adequate fluid intake
• Has breathing difficulties
• Develops organ involvement
• Has other medical conditions that increase risk
• Requires close monitoring or supportive treatment

The decision should be made by a healthcare professional after assessing the individual patient.

What Should a Dengue Patient Eat and Drink?

There is no special food that can cure dengue.

The main goal is to maintain adequate nutrition and hydration according to the patient’s condition.

Depending on tolerance, patients may take:

• Water
• Oral rehydration solutions
• Soups and other fluids
• Nutritious, easily tolerated foods
• Fruits and normal balanced meals as tolerated

If vomiting is persistent, the patient cannot drink adequately, or there are warning signs, medical attention is more important than trying to manage the illness through food or home remedies.

What about papaya leaf juice?

Papaya leaf products are widely discussed as a home remedy for dengue, particularly in relation to platelet counts. However, they should not be considered a treatment or substitute for medical assessment and monitoring. Patients should follow evidence-based medical advice rather than relying on remedies promoted as a cure.

Dengue and Antibiotics

Dengue is caused by a virus, so antibiotics do not treat the dengue virus itself.

Antibiotics may be prescribed only when a doctor identifies or strongly suspects a bacterial infection that requires antibiotic treatment.

Patients should not start antibiotics on their own simply because they have fever.

Dengue Prevention

The best protection against dengue is to avoid mosquito bites and reduce mosquito breeding around homes and workplaces.

Protect yourself from mosquito bites

• Use an appropriate mosquito repellent.
• Wear long-sleeved clothing and long trousers when possible.
• Use window and door screens.
• Use mosquito nets, especially when sleeping during the day.
• Keep doors and windows closed or screened where practical.
• Follow the instructions on mosquito-repellent products.

Dengue-transmitting Aedes mosquitoes can bite during the day as well as at night, so protection should not be limited to nighttime.

Eliminate Mosquito Breeding Places

Aedes mosquitoes can breed in relatively small collections of standing water.

Regularly check:

• Water coolers
• Flower pots and trays
• Buckets
• Open water tanks
• Discarded tyres
• Bottles and containers
• Roof gutters
• Construction materials
• Any object that can collect rainwater

Keep water-storage containers properly covered and remove standing water wherever possible.

Dengue prevention works best when individual households and the wider community both participate.

If Someone at Home Has Dengue

If a family member has dengue, preventing mosquito bites becomes particularly important.

During the period when the virus is present in the person’s blood, a mosquito can acquire the virus by biting the infected person and potentially transmit it to another person.

Therefore:

• Help the patient avoid mosquito bites.
• Use a mosquito net when appropriate.
• Use suitable mosquito repellent.
• Keep the patient’s surroundings free from mosquito breeding sites.
• Continue mosquito-control measures throughout the home.

Dengue in Children

Children can develop the same basic symptoms as adults, including fever, vomiting, headache, body aches and rash.

However, parents and caregivers should pay particular attention to:

• Poor drinking or feeding
• Repeated vomiting
• Increasing sleepiness or unusual irritability
• Severe abdominal pain
• Bleeding
• Difficulty breathing
• Reduced urination
• Cold or unusually pale skin
• Any sudden deterioration, particularly when fever comes down

A child with suspected dengue should be assessed by a healthcare professional, particularly if symptoms are significant or worsening.

Dengue During Pregnancy

Pregnancy requires additional medical attention when dengue is suspected.

Pregnant women with fever or symptoms suggestive of dengue should contact their healthcare provider promptly. The doctor can assess both the mother’s condition and any potential risks to the pregnancy.

Medication choices during pregnancy should be discussed with a healthcare professional rather than being decided through self-medication.

Common Myths About Dengue

Myth 1: “Once the fever goes down, dengue is over.”

Not always. Warning signs can appear when the fever is falling. This is one of the most important periods to monitor.

Myth 2: “A low platelet count automatically means severe dengue.”

Not necessarily. Platelets are only one part of the overall clinical assessment.

Myth 3: “Dengue can be cured with antibiotics.”

No. Dengue is caused by a virus, and antibiotics do not treat the dengue virus.

Myth 4: “Dengue mosquitoes bite only at night.”

No. Aedes mosquitoes can bite during the day as well as at night.

Myth 5: “There is one medicine that cures dengue.”

Currently, there is no specific antiviral treatment that cures dengue. Supportive care and timely medical management are the mainstay of treatment.

Myth 6: “Every dengue patient needs a platelet transfusion.”

No. Blood-product decisions are based on the patient’s clinical condition and medical assessment, not simply on a platelet number.

When Should You See a Doctor?

Consider medical evaluation if you develop:

• Sudden high fever
• Fever with severe body or joint pain
• Headache with pain behind the eyes
• Fever with rash
• Repeated vomiting
• Significant weakness or dehydration
• Fever after recent travel or residence in an area where dengue is circulating

Seek emergency medical care immediately if warning signs such as severe abdominal pain, persistent vomiting, bleeding, breathing difficulty, extreme weakness, confusion or unusual drowsiness develop.

Dengue: Key Takeaways

Dengue is common but should not be taken lightly.

The most important points to remember are:

• Dengue is caused by a virus transmitted mainly by infected Aedes mosquitoes.
• Fever, headache, body pain, nausea and rash are common symptoms.
• Symptoms can resemble other infections, so medical evaluation may be necessary.
• The period when fever comes down can still be dangerous.
• Severe abdominal pain, persistent vomiting, bleeding, breathing difficulty, extreme weakness or altered consciousness require urgent medical attention.
• There is no specific antiviral cure for dengue.
• Adequate fluids, rest, safe fever management and appropriate monitoring are central to care.
• Aspirin and NSAIDs such as ibuprofen should generally be avoided in suspected or confirmed dengue because of bleeding risk.
• A low platelet count alone does not determine whether dengue is severe.
• Preventing mosquito bites and eliminating stagnant water are essential to reducing transmission.

Dengue Care at Plexis Super Speciality Hospital, Sohna

If you are experiencing persistent fever or symptoms suggestive of dengue, timely medical assessment can help determine the appropriate investigations, monitoring and treatment.

Plexis Super Speciality Hospital is a 60-bed multispeciality hospital in Sohna with facilities including 24×7 Emergency Services, Laboratory, Medical ICU, Surgical ICU, Radiology (X-Ray & Ultrasound), Pharmacy and other medical services.

Typhoid fever is a bacterial infection caused by Salmonella Typhi. It mainly spreads when a person consumes food or water contaminated with the bacteria. Typhoid remains an important health concern in many parts of the world, including South Asia. With timely diagnosis and appropriate antibiotic treatment, most patients can recover well.

What Causes Typhoid?

Typhoid is caused by the bacterium Salmonella Typhi. The bacteria enter the body through contaminated food or water and can then multiply and spread into the bloodstream.

Poor sanitation, unsafe drinking water and inadequate food hygiene increase the risk of infection. The bacteria can also spread when an infected person does not wash their hands properly after using the toilet and then handles food.

Common Symptoms of Typhoid

Symptoms usually develop gradually and may include:

• Persistent or high fever
• Headache
• Weakness and tiredness
• Loss of appetite
• Nausea
• Abdominal pain
• Constipation or diarrhoea
• Sometimes cough
• Occasionally, small rose-coloured spots on the skin

Because these symptoms can occur with several other infections, medical evaluation may be needed to determine whether the illness is actually typhoid.

How Is Typhoid Diagnosed?

Doctors consider the patient’s symptoms, medical history and possible exposure to contaminated food or water. Blood culture is an important test for confirming typhoid fever. Other tests may be used depending on the patient’s condition.

A single test result should not be interpreted without considering the overall clinical picture.

Treatment of Typhoid

Typhoid is treated with antibiotics prescribed by a doctor. Starting appropriate treatment early can reduce the risk of complications.

Antibiotic resistance is an increasing concern, so patients should:

• Take antibiotics exactly as prescribed.
• Complete the prescribed course.
• Avoid taking antibiotics without medical advice.
• Return for medical review if symptoms do not improve or become worse.

The choice of antibiotic may depend on local resistance patterns and, where appropriate, laboratory results.

Adequate fluids, nutritious food and sufficient rest can also support recovery.

Can Typhoid Become Serious?

Yes. Untreated or severe typhoid can lead to serious complications, including intestinal bleeding, intestinal perforation and problems affecting other organs. Persistent fever, severe abdominal pain, repeated vomiting, bleeding, confusion or a significant deterioration in health requires prompt medical attention.

How Can Typhoid Be Prevented?

Simple hygiene and safe food and water practices can significantly reduce the risk:

• Drink safe or properly treated water.
• Wash hands thoroughly with soap after using the toilet and before eating or preparing food.
• Eat properly cooked food.
• Avoid food and drinks from unhygienic sources.
• Wash fruits and vegetables carefully.
• Keep drinking-water containers clean and covered.
• Follow recommended vaccination advice.

Typhoid vaccination is an important part of prevention, particularly in areas where typhoid is common or for people at increased risk. Vaccination does not replace good food, water and hygiene practices.

When Should You See a Doctor?

If you have a persistent fever, particularly when accompanied by weakness, headache, abdominal discomfort, diarrhoea or constipation, it is advisable to consult a healthcare professional rather than self-treating with antibiotics.

Remember

Typhoid is treatable, but timely diagnosis and appropriate treatment are important. Good hygiene, safe drinking water, properly prepared food and vaccination can help protect you and your family from typhoid.