Dengue fever epidemic is complicated with many very serious cases
Last July, the Tropical Disease Center, Bach Mai Hospital continuously received severe cases of dengue fever, with complicated developments, many warning signs and dangerous complications, and a high risk of death.
According to Associate Professor, Dr. Do Duy Cuong, Director of the Center for Tropical Diseases, last July, the Center received dozens of cases of dengue fever with warning signs and were hospitalized.
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| Dengue fever patients are being treated at Bach Mai Hospital. |
The difference this year is that in suburban areas such as Hoai Duc, Dan Phuong, Phuc Tho, ... and provinces such as Hai Phong, Hai Duong, Thai Binh, ... dengue fever cases seem to occur earlier and more severely than every year.
A typical example is a 25-year-old male patient from Hoang Mai, Hanoi, who had a fever for 5 days and was hospitalized and tested positive for Dengue fever. During treatment, the patient developed severe liver failure, rapid platelet drop, and blood thickening.
Another patient, 66 years old, in Tuong Mai, Hoang Mai, Hanoi, had intermittent high fever (39 degrees), headache, body aches, knee pain, dry hemoptysis and blood in urine. Another patient, a 39-year-old male, in Hoai Duc, Hanoi, had a fever for 5 days and was admitted to the hospital in a serious condition, with blood concentration, cold, clammy skin and rapid pulse.
The patients were treated intensively at the Center for Tropical Diseases, according to specific protocols, and their condition has gradually improved and they can be discharged in the next few days.
However, there are also critically ill patients with poor prognosis, especially in the elderly and those with underlying diseases. A 62-year-old female patient, TTS, from Dan Phuong, Hanoi, was admitted to the hospital after nearly a week of intermittent high fever, fatigue, body aches, and poor appetite. The patient had a history of high blood pressure, arthritis, and regularly used painkillers and was diagnosed with severe dengue fever.
Through testing, this is Dengue type 2. After 1 day of hospitalization, the patient's condition worsened, platelets decreased sharply, liver enzymes increased, liver failure.
The patient had to be intubated, put on a ventilator, have continuous blood filtration, and receive additional antibiotics. However, due to multiple organ failure, the risk of death was very high.
According to Associate Professor Cuong, Dengue hemorrhagic fever is an infectious disease caused by the Dengue virus. The characteristics of Dengue hemorrhagic fever are fever, bleeding and plasma leakage, which can lead to hypovolemic shock, blood clotting disorders, organ failure, and if not diagnosed early and treated promptly, can easily lead to death.
There are four types of dengue virus: DEN-1, DEN-2, DEN-3 and DEN-4. The virus is transmitted from infected people to healthy people through mosquito bites. The Aedes aegypti mosquito is the main vector. The disease occurs in both children and adults, occurs year-round, and often increases during the rainy season.
Dengue fever has diverse clinical manifestations, progressing rapidly from mild to severe. The disease usually starts suddenly and progresses through three stages: febrile stage, critical stage and recovery stage.
Early detection of the disease and understanding the clinical problems in each stage of the disease helps in early diagnosis, correct and timely treatment, to save the patient's life.
Fever stage: Clinical symptoms include: Sudden, continuous high fever. Headache, loss of appetite, nausea. Skin congestion. Muscle pain, joint pain, pain in both eye sockets. Often there are petechiae under the skin, bleeding gums or nosebleeds. Paraclinical: Hematocrit (Hct) is the index of red blood cells in the blood. Platelet count is normal or gradually decreasing (but still above 100,000/mm3). White blood cell count is often reduced.
Dangerous stage: usually on the 3rd - 7th day of the disease. The patient may still have a fever or the fever may have subsided. There may be the following symptoms: Severe and continuous abdominal pain or increased pain, especially in the liver area. Vomiting.
Plasma leakage due to increased vascular permeability (usually lasting 24-48 hours). Pleural effusion, interstitial fluid (can cause respiratory failure), peritoneum, eyelid edema. If plasma leakage is large, it will lead to shock with symptoms of restlessness, restlessness or lethargy, cold extremities, rapid and weak pulse, stuck blood pressure or low blood pressure, unmeasurable blood pressure, undetectable pulse, cold skin, purple veins (severe shock), and little urine.
Subcutaneous hemorrhage: Scattered petechiae or hemorrhages usually on the front of the legs and inner sides of the arms, abdomen, thighs, flanks or purple patches.
Mucosal bleeding such as bleeding gums, nosebleeds, vomiting blood, black or bloody stools, vaginal bleeding or blood in the urine.
With severe bleeding: Severe nosebleeds (need to be packed with wicks or hemostatic gauze), severe vaginal bleeding, bleeding in muscles and soft tissues, bleeding in the digestive tract and internal organs (lungs, brain, liver, spleen, kidneys), often accompanied by shock, thrombocytopenia, tissue hypoxia and metabolic acidosis can lead to multiple organ failure and severe intravascular coagulation.
Severe bleeding can also occur in patients taking anti-inflammatory drugs such as acetylsalicylic acid (aspirin), ibuprofen or corticosteroids, a history of gastric or duodenal ulcers, or chronic hepatitis.
Some severe cases may have organ failure such as severe liver damage/liver failure, kidney, heart, lung, brain, impaired consciousness, failure of other organs. These severe manifestations can occur in patients with or without shock due to plasma leakage.
Recovery phase: Usually from day 7 to day 10: Fever decreases, platelet count gradually increases again, frequent urination, appetite returns. The recovery period can last for months.
According to Associate Professor, Dr. Do Duy Cuong, Director of the Center for Tropical Diseases, when there are signs of sudden, continuous high fever that does not subside, headache, body aches, patients need to go to medical facilities for doctors to examine, test and evaluate the signs and symptoms. Dengue fever needs to be diagnosed and treated early, avoid taking medicine and infusion at home.
The Aedes egypti mosquito is the main source of disease transmission. Mosquitoes often live in areas close to human habitation and urban areas. It is necessary to pay attention to handling and eliminating dark, humid areas and stagnant water environments that create favorable conditions for mosquitoes to breed and develop.
In addition, it is necessary to spray insecticides, kill mosquitoes, use mosquito repellents and traps, install mosquito screens on windows and use mosquito nets when sleeping.
Currently in Vietnam there is no vaccine or specific medicine for dengue fever. Therefore, when suspecting or having dengue fever, the patient should seek medical help, rest and drink plenty of water.
“Patients can take Paracetamol to reduce fever and relieve pain. Absolutely do not take Aspirin or Ibuprofen because these two drugs can increase the risk of bleeding,” Associate Professor, Dr. Do Duy Cuong emphasized.
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