Dengue defense: Simple home tips, key symptoms to watch, and when to seek emergency care

Signs and Symptoms

The Department of Health (DOH) also noticed an upward trend with 28,234 cases or a 40% increase from the previous year as of Feb. 1. 

According to the health agency, the risk of weather-induced diseases like dengue increases as the country experiences increased rainfall and thunderstorms due to the Shear Line, Intertropical Convergence Zone (ITCZ), and easterlies.

Nonetheless, the Case Fatality Rate (CFR) decreased as of Feb. 1 with a CFR of 0.35%, compared to last year’s higher CFR of 0.42% in the same period. 

But how can we know if we are experiencing dengue? 

World Health Organization (WHO) said that most people with dengue have mild or no symptoms and will get better in 1–2 weeks. In rare cases, dengue can be severe and can lead to death.

Symptoms usually begin four to 10 days after infection and last two to seven days. These include the following: 

• high fever (40°C)
• severe headache
• pain behind the eyes
• muscle and joint pains
• nausea
• vomiting
• swollen glands
• skin rashes

Take note that individuals who are infected for the second time are at "greater risk of severe dengue symptoms," which often come after the fever has gone away. These symptoms include severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums or nose, fatigue, restlessness, blood in vomit or stool, being very thirsty, pale and cold skin, and feeling weak.

According to WHO, people recovering from dengue may feel tired for several weeks.

When do you need to go to the hospital?

Citing DOH Clinical Practice Guidelines for Dengue, Jan Michael Eli Bautista, a general practitioner based in Las Piñas, says dengue with the following warning signs act as red flags and is a signal for in-hospital management: persistent vomiting, abdominal pain or tenderness, lethargy or restlessness, mucosal bleeding, impaired consciousness, enlargement of the liver (hepatomegaly), and acute renal failure. 

"All these are subject to the medical judgment of a doctor, and therefore, it is highly encouraged to seek early consultation in order to avoid developing life-threatening complications," he told PhilSTAR L!fe. 

On the same manner, DOH also classified three groups of dengue patients: patients who may be sent home, patients who should be referred for in-hospital management, and patients with severe dengue requiring emergency treatment and urgent referral. 

Group A or patients who may be sent home are patients who can: 

• Tolerate adequate volumes of oral fluids
• Pass urine every 6 hours
• Do not have any of the warning signs, particularly when the fever subsides
• Have stable hematocrit

Meanwhile, group B or patients who should be referred for in-hospital management if they have the following conditions:

• Warning signs
• Without warning signs but with co-existing conditions that may make the case more complicated (such as pregnancy, infancy, old age, obesity, diabetes mellitus, hypertension, heart failure, renal failure, chronic hemolytic diseases such as sickle- cell disease, and autoimmune diseases, etc.)
• Social circumstances include living alone or far from a health facility or without a reliable means of transportation.
• The referring facility has no capability to manage dengue with warning signs and/or severe dengue.

Lastly, group C or patients with severe dengue who require emergency treatment and urgent referral (critical phase) have the following

• Severe plasma leakage leading to dengue shock and/or fluid accumulation with respiratory distress
• Severe hemorrhages
• Severe organ impairment (hepatic damage, renal impairment, cardiomyopathy, encephalopathy or encephalitis)

What can you do to prevent dengue at home? 

The mosquitoes that spread dengue, Aedes aegypti and Aedes albopictus, are active during the day but may also bite at night. 

For DOH, there are 4-S that you can do to prevent and control at home. 

1. Search and Destroy Mosquito Habitats

Searching and destroying mosquito habitats is one effective way to combat dengue. This includes covering water drums and pails to prevent mosquitoes from accumulating in water; covering, emptying, and cleaning domestic water storage containers weekly; cleaning the gutter to prevent water from becoming stagnant; and collecting and disposing of all unusable containers that can collect and hold water. You can also apply appropriate insecticides to outdoor water storage containers.

"Individuals must seek and search ideal mosquito breeding grounds, such as still water in water tanks at home that is exposed to open air, and dispose of the water and clean the reservoirs," Bautista added. 

2. Self-protect

When there is an increased risk for dengue, self-protection is key. You can keep yourself safe from mosquito bites by wearing long pants and long-sleeved tops and applying mosquito repellant regularly that contains DEET, Picaridin or IR3535. You can also use mosquito nets if sleeping during the day, ideally nets sprayed with insect repellent.

3. Seek early consultation

Consult a physician immediately if the fever persists or recurs after two days and/or if any other symptoms appear. Bautista said that it is important to seek early consultation "in order for symptoms to be treated earlier and for proper and adequate management to be given at an earlier time and to prevent further complications of the dengue virus." 

4. Say no to indiscriminate fogging

Fogging is only applicable when there is an impending outbreak or a hotspot. As per Bautista, one should also say "no to indiscriminate fogging as it can collect mosquitoes and segregate them into certain areas, which may increase the likelihood of outbreaks."

"Fogging is the last resort for control of mosquito populations," he said.