Introduction

Dengue is a viral fever symptoms like disease, especially with severe joints and muscle pain, hence also previously known as break bone fever. This Dengue fever is primarily known for > 200 years, to health experts. Dengue is fast emerging pandemic prone viral disease affecting primarily Asian and Latin American countries.

Over the past 20-25 years, next to disease related to diarrhea and respiratory infection, dengue has become one of the leading causes for hospitalization and deaths among children. Today, dengue is one of the most important arthropods borne viral diseases in humans, as far as mortality and morbidity is concerned. It is also the number one killer worldwide amongst viral infection. Among travelers dengue is the second most diagnosed cause of fever after malaria. In 2015, Delhi ¹ India, recorded its worst outbreak since 2006 with over 15,000 cases (1996, which was the first major outbreak in Delhi). Globally the number of cases increased from 2.2million in 2010 to over 3.34 million in 2016².

 Dengue is found where Aedes mosquitoes are present. Aedes mosquitoes are found in tropical and subtropical regions. These mosquitoes cannot fly more than 200 meters horizontally and 1000 meters vertically. But now Dengue has become a global problem and is common in > 110 countries. Each year 10,000 to 25,000 die and between 50 and 528 million people get infected and 2.5 Billion people (2/5^th world population) at risk³ of infection.

Approximately 1 in every 13 patients of dengue reports to doctor. Mortality in Dengue fever is 1-2 %, in DHF (Dengue Hemorrhagic fever) is 10% and in DSS (Dengue Shock Syndrome) is 12-44% in various studies.

Death is because of low blood pressure, major bleeding or multi- organ failure.

The progress towards DHF/DSS occurs after 3 to 5 days of fever. When fever is coming down one may get mislead that the patient is heading towards recovery. In fact this is the most dangerous time that requires high vigilance and care⁴ .

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3. Darwin Scott Smith, Michael Stuart Bronze et al. Dengue: Practice Essentials, background, pathophysiology-medscape emedicine 2019.
4. Dengue virus net.com/dengue-haemorrhagic-fever.html
5. A.M.Kularatne, dengue fever:BMJ Best practice,Jun 2019.
6. Dengue shock: J Emerg Trauma shock, 2011 Jan – March; 4 (1) : 120 – 127).
7. Halstead SB. Is there an inapparent dengue explosion ? Lancet. 1999; 353: 1100- 1(Pub med).
8. Dengue: Practice essentials background pathophysiology, emedicine. Medscape.com/ article/215840-  overview.

Dr Srikant Sharma

Senior Consultant Physician, Department of Medicine, Moolchand Medcity, New Delhi