Dengue

Living in India, the arrival of monsoon heralded the return of mosquitoes, who would bring dengue with them. Dengue has a reputation of its own and we soon came to terms with its existence and when it came to protection from mosquitoes, the smell of mosquito coils and mosquito foggers was a suitable sacrifice to pay for. The country I now live in does not have these problems, but my memories still linger.

Dengue is the name of a virus typically spread by mosquitoes of the Aedes genus. These mosquitos are typically found in tropical regions and like all mosquitoes, they depend on stagnating pools of water for their reproduction. The disease is transmitted when an infected female Aedes mosquitos draws the blood of a person in order to feed. The virus present in the mouth of the mosquito now finds itself inside the body of a new host with the mosquito having behaved as a vector.

The incubation of the dengue virus can take as long as 3-14 days as the virus continues to reproduce in the body. Like other RNA viruses, dengue replicates itself by hijacking the pre-existing cells of the body to produce more. More specifically, the dengue virus infects the dendritic cells. After the hijacking of the dendritic cells, the dengue virus continues to replicate.

Some people may be asymptomatic and manage to overcome the infection without much struggle. Other people are not as lucky and begin to exhibit the main symptoms by day 7-9. Infection can lead to fevers with temperatures as high as 40°C. The infection is quite painful for most people as it leads to an inflammation of the muscles all throughout the body.

One of the most dangerous effects of the dengue infection is the reduction in the production of platelets. This is called thrombocytopenia and it leads to a reduction of platelets. This is because the Dengue virus attacks the bone marrow of the body which is responsible for making platelets. Platelets are absolutely vital to the normal functioning of a body. Without platelets, the body has no mechanism to seal up cuts, both internal and external.

A slightly undiscussed consequence of thrombocytopenia is also the fact that NSAIDs (Non-steroidal anti-inflammatory drugs) such as aspirin and ibuprofen cannot be used. Both of these drugs work as competitive inhibitors that block the enzyme cyclooxygenase which is responsible for inducing blood clotting amongst platelets. NSAIDs tend to be the most common over-the-counter drug used by people and this simple mistake could already ruin the precarious position of the platelets in the blood. Therefore, it is absolutely essential that people suffering from Dengue use Tylenol as an analgesic and antipyretic.

However, just as with most diseases, prevention is better than the cure. While certain vaccines such as Dengvaxia exist, they only tend to have a positive effect on people who had been infected with the virus in the past. Conventional measures include using pesticides, destroying stagnating pools of water, placing fish in water bodies to eat mosquito larvae and also screen nets to prevent mosquitoes from entering your homes. The most effective thing you as an individual can do is to wear mosquito repellants and long sleeves to lower surface contact.

Dengue, like most other tropical diseases, is extremely dangerous for people from third-world countries who tend to belong to a lower social stratum. Many people do not have access to the same resources that inhabitants of first-world countries have. However, the strides that we as a society have made have been tremendous. Certain developments such as a decrease in costs for genetic modification may allow us to nip the problem of mosquitoes becoming infected with the virus entirely.

By - Agastya Kantawala