Dengue Fever Symptoms — Signs, Treatment and Prevention Pakistan

What Is Dengue Fever?

Dengue is a viral infection spread by the bites of Aedes aegypti and Aedes albopictus mosquitoes. In Pakistan, it peaks from August to November — following the monsoon season when mosquito breeding increases dramatically.

Identifying the Dengue Mosquito

• Aedes aegypti: Black with distinctive white stripes
• Daytime biters (peak activity at dawn and dusk)
• Breeds in clean stagnant water — flower vases, water tanks, AC drip trays
• More prevalent in urban environments

Classic Dengue Symptoms

Phase 1 — Febrile Phase (Days 1–7):

• Sudden very high fever 102–105°F
• Very severe headache (especially behind the eyes)
• Intense joint and muscle pain ("breakbone fever")
• Bone pain
• Nausea and vomiting
• Loss of appetite
• Red skin rash (in some cases)
• Red eyes
• Swollen lymph glands

Phase 2 — Critical Phase (Days 3–7):

After the fever drops, some patients enter a critical phase that can be life-threatening:

• Abdominal pain
• Persistent vomiting
• Bleeding from nose or gums
• Bruising on the skin
• Blood in stool
• Unusual drowsiness or restlessness
• Cold and clammy skin
• Shortness of breath

These are signs of Dengue Haemorrhagic Fever or Dengue Shock Syndrome — a medical emergency.

Phase 3 — Recovery (Days 7–10):

• Symptoms gradually improve
• Energy slowly returns
• A recovery rash may appear on the skin
• Fatigue can persist for weeks

Diagnosis

Diagnostic Tests:

• NS1 antigen test: Effective in the first 5 days
• IgM/IgG antibodies: Accurate from day 5 onwards
• CBC (Complete Blood Count): Platelet count is critical
• Haematocrit: To detect plasma leakage

Platelet Count Guide:

Treatment for Dengue Fever

No Specific Cure — Supportive Care Only:

There is no specific antiviral treatment for dengue. Management focuses on:

• Fever control
• Hydration
• Pain relief
• Close monitoring
• Management of complications

Use Panadol Only!

CRITICAL: In dengue fever, use only Paracetamol (Panadol).

STRICTLY AVOID:

• Ibuprofen (Brufen) — increases bleeding risk
• Aspirin (Disprin) — increases bleeding risk; causes Reye's syndrome
• Diclofenac (Voltral) — causes kidney damage
• Mefenamic acid (Ponstan) — NSAID, avoid
• Arinac Forte — contains ibuprofen
• Any NSAID pain reliever

Panadol dose: 500–1000 mg every 6 hours, maximum 4 grams per day.

Hydration Is Critical:

• Large amounts of water
• ORS (oral rehydration salts)
• Coconut water
• Fresh fruit juices
• Chicken broth
• Target 2–3 litres of fluids per day

Recommended Foods:

• Papaya (papaya leaf juice is a traditional remedy — limited evidence but considered safe)
• Pomegranate
• Kiwi
• Citrus fruits (vitamin C)
• Soft, easy-to-digest foods
• Khichri (rice and lentil porridge)

Rest:

Complete bed rest for 7–10 days, then gradual return to activity.

Warning Signs — When to Go to Hospital

Go to ER Immediately If:

• Severe abdominal pain
• Persistent vomiting (3 or more times)
• Bleeding from nose or gums
• Blood in stool or black tarry stool
• Blue or red spots on the skin
• Unusual drowsiness or restlessness
• Cold and clammy hands and feet
• Shortness of breath
• Loss of consciousness
• Reduced or absent urination
• Platelet count below 50,000
• Any pregnant woman with fever — go immediately
• Infants under 1 year or elderly people over 65 — higher risk category

Preventing Dengue

Mosquito Bite Prevention:

• Mosquito repellent: DEET-based (Odomos, Off!)
• Long sleeves and long trousers
• Mosquito coils or electric repellent devices
• Window screens
• Bed nets — especially for children and the elderly
• Use air conditioning — mosquitoes avoid cooler air
• Avoid going outdoors at dawn and dusk (peak biting times)

Eliminating Breeding Sites:

• Remove all stagnant water:
  • Flower vases (change water weekly)
  • AC drip trays
  • Roof water tanks (keep covered)
  • Old tyres
  • Garden buckets and containers
  • Bird baths
• Clear blocked drains
• Prevent water collection at construction sites
• Remove water containers from cemeteries

Community Action:

• Neighbourhood clean-up drives
• Support government fogging operations
• Awareness campaigns
• Education in schools

Re-infection and Severe Dengue

There are 4 different dengue strains (DENV 1–4). After infection with one strain, you have permanent immunity to that strain only — but:

• Re-infection with a different strain is possible
• Second infections are often more severe (Antibody-Dependent Enhancement)
• All 4 strains circulate in Pakistan
• If you have had dengue before, be extra cautious

Dengue Vaccine

Dengvaxia vaccine exists but is not in routine use in Pakistan:

• Only for people aged 9–45 years
• Safe only if a previous dengue infection has been confirmed
• May increase risk of severe dengue in those with no prior infection
• WHO conditional recommendation only

Dengue vs Other Fevers

Dengue in Pregnancy

• Higher risk of severe dengue
• Increased bleeding complications during delivery
• Risk of pre-term labour
• Vertical transmission to the baby is possible
• Hospital admission is almost always required
• Use only paracetamol (Panadol)

Conclusion

Dengue is Pakistan's seasonal public health crisis affecting tens of thousands every year. Use only Panadol, maintain high fluid intake, and monitor platelet counts regularly. Go to hospital immediately for warning signs (abdominal pain, vomiting, bleeding). Prevention is most important — avoid mosquito bites and eliminate all breeding sites. Consult a doctor on Ilaaj AI for lab test guidance and monitoring plans from home.