management of dengue infection
Treatment for dengue fever is supportive.
- there is no specific antiviral therapy available for dengue infection
- adequate hydration (in dengue fever) and fluid replacement therapy (in dengue haemorrhagic fever and dengue shock syndrome) is the only recognised treatment
Early diagnosis and treatment will reduce the morbidity and mortality associated with the condition.
WHO has developed practical treatment plan based on the severity of the infection. Patients are divided into three groups according the clinical presentation:
- group A patients – can be managed at home
- patients without warning signs and
- who are able to
- to tolerate an adequate volume of oral fluids
- to pass urine at least once every six hours
- near normal blood counts and haematocrit
- group B patients – require hospital admission
- patients with warning signs
- patients with co-existing conditions e.g – pregnancy, extremes of ages, obesity, diabetes, renal impairment, haemolytic disease
- patients with poor social support e.g – living alone, living far from a medical facility without reliable transport
- increasing haematocrit or a rapidly decreasing platelet count
- group C patients – require emergency medical treatment
- patients with severe dengue who are in the critical phase of the disease and have:
- severe plasma leakage leading to dengue shock and/or fluid accumulation with respiratory distress
- severe haemorrhages
- severe organ impairment e.g – hepatic damage, renal impairment, caridomyopathy, encephalopathy (1,2)
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