Dengue fever: symptoms, warning signs and what to do

Dengue is a viral infection spread by the Aedes mosquito, which bites mostly in the early morning and late afternoon and breeds in clean standing water. In Pakistan, cases usually rise after the monsoon, from late summer into autumn. Most people recover well with rest and fluids, but a small number develop severe dengue, so knowing the warning signs matters.

Common symptoms

• Sudden high fever
• Severe headache and pain behind the eyes
• Muscle, joint and bone pain (“break-bone fever”)
• Nausea, vomiting, loss of appetite
• A skin rash

The critical phase: when the fever goes down

Surprisingly, the riskiest time is often around day 3 to 7, when the fever starts to fall. This is when fluid can leak from blood vessels and platelets can drop. Do not assume the person is better just because the fever is gone. Keep watching closely.

Warning signs: go to hospital immediately

• Severe stomach pain or constant vomiting
• Bleeding from gums or nose, blood in vomit or stool, or black stools
• Fast breathing, cold clammy skin
• Extreme tiredness, restlessness or confusion
• Very little urine

The painkiller mistake to avoid

If dengue is possible, do not take ibuprofen (Brufen), aspirin or other NSAIDs. They can increase the risk of bleeding. Paracetamol is used for fever and pain, at the dose on the label or as your doctor advises.

What about platelets?

A normal platelet count is roughly 150,000 to 450,000 per microlitre. In dengue it often falls, and your doctor may repeat a CBC test every day or two. A low count alone does not always mean a transfusion is needed; doctors decide based on the whole picture, especially bleeding and signs of fluid leakage. Papaya leaf juice and other home remedies are popular, but they are not a substitute for medical care.

Care at home (if your doctor says it is safe)

• Rest, and drink plenty: water, ORS, soups, coconut water.
• Keep a record of fever, fluids taken and urine passed.
• Follow up as your doctor asks, especially in the critical phase.

Prevention

• Empty water from coolers, pots, tyres and flower vases every few days.
• Use mosquito repellent, nets and window screens.
• Wear long sleeves in the morning and evening.