Understanding Dengue: Risks, Vaccines, and Prevention Strategies
Dengue Cases on the Rise in India
As dengue infections surge across India, healthcare professionals are emphasizing the virus's potential dangers, which are often underestimated. While families may panic during episodes of high fever, experts warn that the real risks can emerge once the fever subsides. This critical phase can lead to severe complications such as internal bleeding, respiratory issues, dangerously low platelet counts, or even shock that can threaten life.
In a recent live discussion, eight leading doctors and critical care specialists addressed common misconceptions and frequently asked questions about dengue. They covered topics ranging from the possibility of dengue re-infection to the warning signs that parents should be vigilant about in their children, as well as the effectiveness of the vaccine against this mosquito-borne illness.
Among the experts were:
- Dr. NK Ganguly, former Director General, Indian Council of Medical Research
- Dr. Suranjit Chatterjee, Senior Consultant- Internal Medicine, Indraprastha Apollo Hospital, Delhi
- Dr. Vineeta Singh Tandon, Senior Consultant – Internal Medicine, ISIC Multi-speciality Hospital
- Dr. Anirban Chattopadhyay, Senior Consultant, Critical Care Medicine, CK Birla Hospitals, CMRI
- Dr. Diksha Goyal, Consultant, Internal Medicine, Marengo Asia Hospitals, Gurugram
- Dr. Sanjay Mahajan, Sr. Consultant Physician and Intensivist, Kailash Hospital, Noida
- Dr. Meenakshi Jain, Principal Director and HOD, Internal Medicine, Max Super Speciality Hospital, Patparganj
- Dr. Sushil Kalra, Director - Internal Medicine, CK Birla Hospitals, Jaipur
Current Status of Dengue Vaccines
What is the status of the indigenous dengue Vaccine?
Dr. Ganguly discussed the DengVac vaccine developed by Sanofi, noting its limited effectiveness and that it is only suitable for individuals over nine years old. He also mentioned a new vaccine from Takeda, which is expected to be effective across all age groups and against all dengue virus types, although ongoing surveillance is necessary for effective management of Dengue 3 virus infections.
Efficacy and Duration of Vaccine Protection
Which vaccine is likely to be rolled out?
Dr. Ganguly indicated that the Takeda vaccine, which has undergone extensive global testing, is anticipated to provide protection against all dengue strains. Previous vaccines faced challenges with efficacy and adverse reactions to certain strains.
How long will protection from vaccines last?
According to Dr. Ganguly, current data suggests that the vaccine's protection could last between two to five years.
Critical Phase After Fever Reduction
Can dengue become life-threatening even after the fever goes away?
Dr. Chatterjee confirmed that many mistakenly believe recovery starts once the fever subsides. However, the period immediately following fever reduction is crucial, as patients may enter a "critical phase" where serious complications can arise, including plasma leakage and significant drops in platelet counts. Close monitoring for at least 48 hours post-fever is essential to catch warning signs early, as emphasized by Dr. Mahajan.
Medications to Avoid During Dengue Treatment
Which medicines should be avoided during dengue treatment and why?
Dr. Chatterjee advised against self-medication with pain relievers like aspirin and ibuprofen, as they can heighten bleeding risks associated with dengue. He stressed the importance of consulting a doctor before taking any medication, including antibiotics and supplements. Dr. Chattopadhyay noted that paracetamol is generally safer for managing fever and pain, but should still be taken under medical guidance.
Preventing Dengue Mosquito Breeding
How can I protect my family from dengue mosquitoes during outbreak season?
Dr. Vineeta highlighted that dengue mosquitoes breed in clean, stagnant water and are most active during the day. To safeguard families, it is crucial to eliminate standing water in containers, regularly change stored water, and cover tanks. Additionally, using mosquito repellents, wearing protective clothing, and installing screens on windows can help reduce exposure, especially for vulnerable populations like the elderly and children.
Understanding Dengue Re-infection Risks
Can you get dengue more than once, and is the second infection more dangerous?
Dr. Kalra explained that individuals can contract dengue multiple times due to the existence of four distinct virus types. Immunity to one type does not protect against others, and subsequent infections can sometimes lead to more severe complications, including dengue hemorrhagic fever or shock syndrome.
Platelet Count Concerns in Dengue
Why is there a drop in platelet count, and when should one worry?
Dr. Goyal clarified that low platelet counts in dengue are due to the virus suppressing bone marrow production and an immune response that mistakenly targets platelets. Hospitalization is typically warranted if warning signs are present, regardless of platelet levels.
Physiological Challenges for Children with Dengue
What are the physiological disadvantages children have with dengue?
Dr. Jain noted that children are particularly vulnerable due to their smaller blood volume, which can lead to rapid drops in blood pressure from fluid loss. Their immune systems may also overreact, increasing the risk of severe conditions like Dengue Shock Syndrome. Additionally, younger children may struggle to communicate symptoms, resulting in delayed diagnosis of serious complications.