Misconceptions on Dengue
7:53 AMDENGUE. You will be a frog under a coconut shell (katak di bawah tempurung) if you haven't heard about it. Throw a stone randomly and it will hit at least one person who had Dengue. I had Dengue back in 2007 when I was still a student. It was bad. It was the worse fever I have ever experienced. I was aching everywhere. Thankfully it was just Dengue Fever.
Despite all the awareness campaign initiated by HE WHO SHALL NOT BE NAMED, there are still some misconceptions about Dengue.
1. Definition
Doktor, saya mau check darah. Takut kene Denggi
No fever. No myalgia and arthalgia. No headache. Not from Dengue endemic area.
In an ideal world, where resources are unlimited and chemical reagents are as cheap as a bottle of mineral water, I can kau tim and do it. Mo man tai! But the truth is, HE WHO SHALL NOT BE NAMED's resources are already stretched to its limit.
The reason why it is called Dengue FEVER or DEMAM Denggi is because...your typical presentation would be to have FEVER.
Dengue fever goes through 3 phases; febrile phase, critical phase and recovery phase.
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Self explanatory diagram |
Updated on 27/2/2014
- Despite it being common practice to take FBC on Day 3 of fever, it IS recommended for FBC to be taken to get a baseline hematocrit and platelet. Hemoconcentration is when it is elevated more than 20% of the baseline value. Increase in hematocrit with concurrent rapid decrease in platelet IS A WARNING SIGN.
Updated on 27/2/2014
- I have been made aware of a test called NS1 antigen test that can be used to detect Dengue on the first day of fever. Its detection is via enzyme linked immunosorbent assay. This test was introduced in 2006. I have personally never used this test before and it is certainly not available in my clinic located in ceruk kampung.
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Aedes aegypti |
However, eradication of Aedes mosquito plays a big part in controlling as these mosquitoes are the main vectors of Dengue Virus. So please, do your part in keeping your surrounding free of free standing water.
- Despite all the test and clinical evaluations I failed to mention regarding the warning signs that the public should be made aware of (thanks to Msforty5). If there is persistent fever with the following symptoms, please come and seek treatment.
- Abdominal pain and tenderness
- Persistent vomiting
- Mucosal bleed - gum bleed, per rectal bleed etc
- Restlessness and lethargy
8 comments
haha betul betul lagi bagus tampal besar besar
ReplyDeletethough I agree with your views MO frust, let me share this experience by a friend who has just been admitted to ICU at private hospital last nite when it was confirmed she really had dengue. Day 1-sat, she went to private clinic & the doctor assured her the fever accompanied by purging is because of food poisoning. Take the medication after third or 4th day come back if still got fever. So friend (63yo) went thru fever, nausea, tired, purging stage until day 4. She regain her appetite but still had fever despite paracetamol. Last nite we insisted she ask her adult children seek treatment at the emergency ward of private hospital, which thankfully they did, so now all we can hope is she will recover from this disease. Another friend shared her friend's mom was not so fortunate, she too had continuous fever, went to clinics (JB) the doctors prescribed panadol until almost a week later, finally seek treatment at hospital. Blood tests were taken, unfortunately she passed away the same day. I too had dengue fever last year but due to my medical history (ca) I promptly went to emergency ward of private hospital the very next day because of sudden onset of high fever & nausea with headaches. The attentive medical officer casually ask "your area got dengue cases" I wasn't sure but said maybe. So he proceeded & ask if its ok to run blood tests for dengue & H1N1. I did & less than 2hrs later I was admitted when it was confirmed as dengue +. So pls as care provider, not everyone is as knowledgeable as you all are. Some people can be very annoying with little complains they run to seek medical attention while others like the friend say, its ok the doctor say food poisoning so I should be fine.
ReplyDeleteThanx msforty5 for pointing it out. I have missed out something here, regarding warning signs. I will update after office hours
DeleteI dont want to say that private care is not good but there are some who treat dengue as normal. In dengue we have this term that is close monitoring. Most privates dont do that because only Specialist see their patient twice a day and even worst once a day. Not so many MOs in private hospitals. So there is lacking of close monitoring. Severe ill cases dont send to private, instead sent them to general hospital. At least there is a doctor who always present in the ward for 24/7.
ReplyDeleteThank you for this post. I find that it is very educational to the normal laymen like myself despite the heavy usage of jargon. I had a scary experience with my son, whose temperature fluctuated for about 4 days, but it wasn't accompanied by any vomiting or the sort. Oh and he also had a slight rash and he was a little too tired all the time. Of course he cannot yet talk properly so he couldn't tell me if he had the other symptoms like sengal-sengal badan, headache and all that. Of course I was scared to death of losing him, if he was in fact, infected but due to so much complaint from doctors about people hogging the ED and KK unnecessarily, I just decided not to seek for medical help just in case I became of those hoggers. I read up and asked some people who have been infected/had family members who have been infected before and they said that their family members didn't have a fever when dengue FEVER was detected. So, I start to wonder if fever is the only indication or if that rash was just a rash or an indication of dengue without the fever? And what's up with this so called new strain of dengue, is that even true to begin with? So, you see, MOFrust, I know you are frustrated with the people as you mentioned in your post, but the rest of us aren't doctors and I think we have every right to be concerned about our health (and our loved one's as well) and that's why we need doctors to diagnose our illnesses. For people like us who don't deal with illnesses like it's run-of-the-mill kind of thing, every sign/symptom is a potential illness so I hope you will be granted patience to deal with your patients. Thank you.
ReplyDeleteYes it is patient's right to concern about their health & their loved one, but i think what mofrust trying to convey here is please make a brilliant complaint, don't complain without any knowledge & accuse doctor blindly.
ReplyDeleteI got 1 baby which was referred to ED from KK for neonatal jaundice with Serum Bilirubin (capillary) of 250. However the parents only brought their son to ED after 24 hours. Repeated serum bilirubin was 350. The father was very angry and accuse the doctor in KK for not properly check the baby. I explained to him the differences between venous & capillary blood and also the time frame which he still cannot accept & keep accuse the doctor!
Rainy season has more possibilities of getting infected with various diseases like dengue, chikungunya etc. Once should take more precautions during this season. Every country has similar issue for this mosquito spreading diseases and everyone is affected by this.
ReplyDeletethanks for so in-depth information and knowledge. Really appreciate your work.
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