John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the treatment is purely concerned with relief of the symptoms. Rest and fluid intake for adequate hydration is important. Aspirin and nonsteroidal anti-inflammatory drugs should only be taken under a doctor's supervision because of the possibility of worsening
bleeding complications. Acetaminophen (Tylenol) and codeine may be given for severe headache and for joint and muscle pain (myalgia).
What is the prognosis for typical dengue fever?
Typical dengue is fatal in less than 1% of cases. The acute phase of the illness with fever and myalgias
lasts about one to two weeks. Convalescence is accompanied by a feeling of weakness (asthenia), and full recovery often takes several weeks.
What is dengue hemorrhagic fever?
Dengue hemorrhagic fever (DHF) is a specific syndrome that tends
to affect children under 10 years of age. It causes abdominal pain, hemorrhage
(bleeding), and circulatory collapse (shock). DHF is also called
Philippine, Thai, or Southeast Asian hemorrhagic fever and dengue
shock syndrome.
DHF starts abruptly with high continuous fever and headache. There
are respiratory and intestinal symptoms with sore throat, cough,
nausea, vomiting, and abdominal pain. Shock occurs two to six days after
the start of symptoms with sudden collapse, cool, clammy extremities
(the trunk is often warm), weak pulse, and blueness around
the mouth (circumoral cyanosis).
In DHF, there is bleeding with easy bruising, blood spots in the
skin (petechiae), spitting up blood (hematemesis), blood in the stool
(melena), bleeding gums, and nosebleeds (epistaxis). Pneumonia is
common, and inflammation of the heart (myocarditis) may be present.
Patients with DHF must be monitored closely for the first few days
since shock may occur or recur precipitously (dengue shock syndrome). Cyanotic (bluish)
patients are given oxygen. Vascular collapse (shock) requires
immediate fluid replacement. Blood transfusions may be needed to
control bleeding.
The mortality (death) rate with DHF is significant. With proper treatment, the World Health Organization estimates a 2.5% mortality rate. However, without proper treatment, the mortality rate rises to 20%. Most deaths occur in children. Infants under a year of age are especially at risk of dying from DHF.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Nosebleed is common in dry climates during winter months, and in hot dry climates with low humidity. Individual taking blood clotting medications, aspirin, or antiinflammatory medications may be more prone to nose bleeding. Other factors that contribute to nosebleed are trauma (including nose picking), rhinitis, and high blood pressure. Treatment depends on the severity of the condition.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Myofascial pain syndrome is muscle pain in the body's soft tissues due to injury or strain. Symptoms include muscle pain with tender points and fatigue. Treatment usually involves physical therapy, massage therapy, or trigger point injection.
Myocarditis is an inflammation of the heart muscle and can be caused by a variety of infections, conditions, and viruses. Symptoms of myocarditis include chest pain, shortness of breath, fatigue, and fluid accumulation in the lungs. Treatment mainly involves preventing heart failure with medication and diet, as well as monitoring for heart rhythm abnormalities.
Medical shock is a life-threatening medical condition. There are several types of medical shock, septic shock, anaphylactic shock, cardiogenic shock, hypovolemic shock, and neurogenic shock. Causes of shock include heart attack, heart failure, heavy bleeding (internal and external), infection, anaphylaxis, spinal cord injury, severe burns, chronic vomiting or diarrhea. Low blood pressure is the key sign of sock. Treatment is dependant upon the type of shock.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Bioterrorism is a form of terrorism where there is the intentional release of biological agents such as viruses, germs, or bacteria. Diseases caused by bioterrorism agents include anthrax, botulism, plague, smallpox, tularemia, brucellosis, food poisoning, Q fever, ricin toxin poisoning, cholera, epidemic typhus, viral encephalitis, XDR TB, and MDR TB.
Viral hemorrhagic fever(s), or VHFs are a group of illnesses caused by distinct families of viruses. Many of these viruses are life-threatening, and classified as biosafety level four (BSL-4) pathogens. Viral hemorrhagic fever viruses are caused arenaviruses, filoviruses, bunyaviruses, and flaviviruses. The viruses are carried in rodents and transmitted through urine, fecal, saliva, or other body excretions from the infected rodents. Symptoms of viral hemorrhagic fever include marked fatigue, dizziness, muscle aches, loss of strength, fever, and exhaustion. Severely ill patients may also suffer shock coma, seizures, delirium, kidney failure, or nervous system malfunction. There is no established cure for viral hemorrhagic fever.
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