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Treatment for Dengue Fever

Hospitalization
Treatment

HOSPITALIZATION

Not all dengue fever patients are admitted to hospitals for treatment. The symptoms that warrant hospitalization of patients include:

Fever for 3 days or longer with lethargy, vomiting and diarrhea
Evidence of plasma leakage such as low blood pressure of below 20 mm Hg
Haemorrhagic tendency such as spontaneous bruising and bleeding from the nose
Neurology manifestation such as irritability, short term memory loss, restlessness and agitation
Difficulty in breathing due to fluid in the lungs. Re-absorption of fluid into blood vessels causes excessive fluid in the lung.
Pain in the abdomen, indicating liver complication or enlarged liver

For patients that are not admitted due to absence of obvious symptoms, they are advised to return to the hospital as soon as some of the following symptoms appear:

Nausea, vomiting, diarrhea
Lethargy or a feeling of laziness
Dizziness or fainting
Breathlessness or difficulty in breathing
Bleeding
Behavioural change such as restlessness
Abdominal pain
Cold sweating skin
Cold hands and feet
Reduced or no urine output for over 6 hours (oliguria)

Early detection, treatment and close monitoring determine the chance of survival of dengue haemorrhagic fever patients.

TREATMENT
There is no specific antiviral treatment for dengue fever or dengue haemorrhagic fever. Only supportive treatment is given to such patients.

If the patient is dehydrating, adequate fluids are to be taken to keep the patient hydrated. Patients are advised to drink plenty of water. Intravenous fluid is administered if the patient is unable to maintain oral intake, that is, if the patient vomits or purges.
For severe body ache, painkillers may be needed. For severe headache and for joint and muscle pain, acetaminophen and codeine may be given.
If there is significant bleeding, blood or platelet transfusion will be carried out.
At the re-absorption or convalescent phase, the intravenous drips must be removed to prevent excessive water in the blood and lung.

Typical dengue haemorrhagic fever does not result in death. It is fatal in less than 1% of cases. The critical phase of high fever and plasma leakage last about one to two weeks. In the hospital, close monitoring of patient is required in order to provide timely supportive treatment. Full recovery often takes several weeks.

Early detection, clinical treatment and close monitoring determine the chance of survival of dengue haemorrhagic fever patients.

References:

WHO (2002). Guidelines for treatment of dengue fever/dengue haemorrhagic fever in small hospitals. (http://www.searo.who.int/LinkFiles/Dengue_Guideline-dengue.pdf). Retrieved on 09/02/2008.
WHO (2006). Dengue haemorrhagic fever: Early recognition, diagnosis and hospital management. (http://www.who.int/csr/don/archive/disease/dengue_fever/dengue.pdf). Retrieved on 09/02/2008.
Dr Asmahan Mohamed Ismail (2008). Selayang Hospital, Malaysia. Question and Answer.
Ministry of Health, Malaysia (2004). Clinical practice guidelines: Management of dengue fever in children. December 2004. MOH/P/PAK/95.04.


Dengue Fever The Disease Symptoms Treatment Preventive Steps Conclusion Q&A
About Us References Acknowledgement		Home > Treatment Treatment for Dengue Fever Hospitalization Treatment HOSPITALIZATION Not all dengue fever patients are admitted to hospitals for treatment. The symptoms that warrant hospitalization of patients include: Fever for 3 days or longer with lethargy, vomiting and diarrhea Evidence of plasma leakage such as low blood pressure of below 20 mm Hg Haemorrhagic tendency such as spontaneous bruising and bleeding from the nose Neurology manifestation such as irritability, short term memory loss, restlessness and agitation Difficulty in breathing due to fluid in the lungs. Re-absorption of fluid into blood vessels causes excessive fluid in the lung. Pain in the abdomen, indicating liver complication or enlarged liver For patients that are not admitted due to absence of obvious symptoms, they are advised to return to the hospital as soon as some of the following symptoms appear: Nausea, vomiting, diarrhea Lethargy or a feeling of laziness Dizziness or fainting Breathlessness or difficulty in breathing Bleeding Behavioural change such as restlessness Abdominal pain Cold sweating skin Cold hands and feet Reduced or no urine output for over 6 hours (oliguria) Early detection, treatment and close monitoring determine the chance of survival of dengue haemorrhagic fever patients. TREATMENT There is no specific antiviral treatment for dengue fever or dengue haemorrhagic fever. Only supportive treatment is given to such patients. If the patient is dehydrating, adequate fluids are to be taken to keep the patient hydrated. Patients are advised to drink plenty of water. Intravenous fluid is administered if the patient is unable to maintain oral intake, that is, if the patient vomits or purges. For severe body ache, painkillers may be needed. For severe headache and for joint and muscle pain, acetaminophen and codeine may be given. If there is significant bleeding, blood or platelet transfusion will be carried out. At the re-absorption or convalescent phase, the intravenous drips must be removed to prevent excessive water in the blood and lung. Typical dengue haemorrhagic fever does not result in death. It is fatal in less than 1% of cases. The critical phase of high fever and plasma leakage last about one to two weeks. In the hospital, close monitoring of patient is required in order to provide timely supportive treatment. Full recovery often takes several weeks. Early detection, clinical treatment and close monitoring determine the chance of survival of dengue haemorrhagic fever patients.

References: WHO (2002). Guidelines for treatment of dengue fever/dengue haemorrhagic fever in small hospitals. (http://www.searo.who.int/LinkFiles/Dengue_Guideline-dengue.pdf). Retrieved on 09/02/2008. WHO (2006). Dengue haemorrhagic fever: Early recognition, diagnosis and hospital management. (http://www.who.int/csr/don/archive/disease/dengue_fever/dengue.pdf). Retrieved on 09/02/2008. Dr Asmahan Mohamed Ismail (2008). Selayang Hospital, Malaysia. Question and Answer. Ministry of Health, Malaysia (2004). Clinical practice guidelines: Management of dengue fever in children. December 2004. MOH/P/PAK/95.04.