Dengue fever is a common disease caused by a virus that humans get by being bitten by infected mosquitoes.Also known as ‘break bone fever’, it is a painful and debilitating disease spread by mosquitoes, caused due to the bite of an infected female aedes aegypti mosquito, the disease can be fatal. Mosquito breeding sites include artificial water containers such as discarded tires, uncovered water storage barrels, buckets, flower vases or pots, cans, and cisterns. The dengue mosquito has two peak periods of biting activity: in the morning for several hours after daybreak and in the late afternoon for several hours before dark. Nevertheless, the mosquito may feed at any time during the day, especially indoors, in shady areas, or when it is overcast. Symptoms No vaccine is available to prevent dengue, and there is no specific medicine to cure people who are sick with dengue. Those who become ill with dengue fever can be offered medications (acetaminophen) to reduce fever and may require oral rehydration or intravenous fluids and in severe cases, treatment to support their blood pressure. Once bitten it takes about four to ten days for the symptoms to show. The most common symptoms are high fever, severe headache, pain behind the eyes, nausea, vomiting, swollen glands, muscle and joint pain and in some cases a rash. The more severe forms of dengue are hemorrhagic fever and dengue shock syndrome. Prevention The best way is to prevent the disease from occurring at all. Here are a few simple and practical tips to keep dengue at bay:

1. Aedes aegypti mosquitoes are known to bite humans during the day and their most common breeding grounds are man made containers. Therefore, it is advisable to not have any stagnant water around. Remember to clean out empty flower pots and not to over water potted plants. If the container that contains water cannot be emptied, remember to cover it well when not in use.
2. Turn over empty pails and buckets, so that they do not collect excess water.
3. Use mosquito repellants regularly. Apply it well on all exposed areas, during the day as well as at night.
4. Make sure your window and door screens do not have any holes. If so, block those areas properly to eliminate mosquitoes.
5. If someone at home is ill with dengue, try to not let the mosquitoes bite them or others in the house.
6. Always sleep under a mosquito net.
7. If you use a cooler remember to empty out and clean the water tray regularly, even when not in use.
8. Always cover your trash can when not in use.
9. A natural method to keep mosquitoes at bay is to plant tulsi near your window. The plant has properties that do not allow mosquitoes to breed.
10. Using camphor as a repellant also works wonders. Light camphor in a room and close all the doors and windows. Leave it this way for about fifteen to twenty minutes to have a mosquito free environment.

It is important that we recognise the possibility of a patient possibly suffering from dengue. Even doctors should take these complaints seriously. This is important because if it is diagnosed early the complications are much lower and can be handled effectively. Medical tests A test called NS1 (a test for the presence of the viral antigen) and other tests for the antibodies against the dengue virus can be done. The NS1 test is more accurate on the first seven days of the infection. If the patient comes to us after seven days, then we perform serological tests, where we test for the presence of the antibodies against the virus. Since these antibodies are produced by the body only after five to seven days, they are more effective. The most important thing here is that this antigen can be tested at any point during the infection, unlike in malaria where the test yields proper results only while the patient is having fever. Of course, the tests give better results at the peak of the disease.  Patients may suffer from very low blood pressure and very low platelet count. The patient’s also likely to bleed from various orifices like the nose and mouth and they might even notice blood in their urine. When it gets worse, the patient is likely to suffer from dengue haemorrhagic fever and dengue shock syndrome.  Patients may suffer from very low blood pressure and very low platelet count. The patient’s also likely to bleed from various orifices like the nose and mouth and they might even notice blood in their urine. When it gets worse, the patient is likely to suffer from dengue haemorrhagic fever and dengue shock syndrome. Miracle of papaya leaf The young leaves from a fruit bearing papaya plant should be used. The leaves of the Red Lady papaya plant (found commonly in India) are more effective. The important fact is that one should choose leaves that are not too old, neither too young. Now, take only the leafy part and not the stalk and wash them well with water. Crush the leaves using a wooden mortar and pestle without any additives like water, salt or sugar. Once they are crushed, squeeze out the juice with clean hands and drink it two times a day. Do not add any salt or sugar to the drink. An adult should have 10 ml of the juice twice a day (or at eight hour intervals), children between the age of five and 12 should have 5 ml of the juice twice a day and those below 10 years of age should be given 2.5ml of the juice. At what stage should a patient ideally have the juice? It is best the patient start having the juice as early as possible. This means that when they notice the first symptoms of dengue fever (when their platelets show a decline in numbers below 150000 cu mm or when the packed cell volume goes above 10%). It is also beneficial at later stages, but if the condition has progressed and has led to organ failure, the juice is not very effective. Why you should not self-medicate with either Aspirin or Ibuprofen.  The infecting organism in dengue affects the platelets which are responsible for clotting (stopping bleeding) increasing the tendency of the person to bleed. Aspirin and Ibuprofen also have similar action. Both of them together could cause the person to bleed excessively pushing the patient into what is called the ‘Dengue Shock syndrome’. And once in this stage, medical treatment is needed in an emergency basis and hospitalization becomes necessary. You should use pain relievers with acetaminophen, some brands available in India are here.