Dengue Fever Part One

Majid Ali, M.D.

Part One: Critical Needs for Public Education and Effective Health Policies

Dengue fever (also known as breakbone fever) is a flu-like infection caused by the dengue virus. Most people suffer much but recover to reach the state of health prior to the infection. Those in poor general health or suffering from inflammatory, immune, and nutritional disorders can develop the dreaded, sometimes fatal conditions called dengue hemorrhagic fever and dengue shock. This form of infection is associated with low count of blood corpuscles (white and red blood cellsand platelets), bleeding events, fall in blood pressure, and shock. Unless controlled, these changes in the circulating blood lead to pulmonary edema (fluid in lungs), small hemorrhages in the various organs, kidney failure, and death. I explain how the virus damages blood cells and the endo lining cells of blood vessels later in this tutorial.

A Global Perspective

Dengue fever deserves special attention by doctors, nurses, public health policy-makers, educators, and the international community for the following reasons:

* First, dengue fever is the most frequent arthropod-borne viral infectionthat can be effectively managed by controlling the mosquito populations in areas in which it is endemic. Some years ago, it was estimated that 50–100 million people worldwide are infected yearly. With recent pandemics of the disease in some highly populous Asian countries (Pakistan, India, and others), this estimate is clearly far too low. It is now endemic in more than 110 countries.

* Second, the incidence of dengue fever in the various regions of the world rises with increasing frequency of exposure to infected mosquitos. Yet larger rises in incidence seem certain until vigorous efforts are made to improve public health issues to control, if not eradicate, the vector arthropod spread in Asian and African countries. To cite one example, in the summer of 2011, in Lahore, Pakistan, the government of Punjab closed all the educational institutions as a safety measure against the dengue pandemic that took many lives. All institutions were sprayed with the dengue insecticide.

* Third, there are no effective drugs or vaccination against this virus. Fortunately, the four main types of dengue virus, unlike an enormous number of strains of influenza viruses, seem not to mutate readily so far. This is likely to change with the rising incidence of the disease. But so far there is a possibility of good control if international efforts on the scale that the World Health Organization employed against the small pox virus can be undertaken.

* Fourth, there are effective natural nondrug therapies for acute viral infections which have been vigorously suppressed by the mega-drug-industrial complex. Dengue fever epidemics create an opportunity to test such time-tested empirical therapies (described in Part Two of this tutorial). We can study such measures with modern scientific methods (looking through the prisms of the molecular biology of oxygen, blood corpuscles, the endo cells that line blood vessels, for instance). By diligent and authentic clinical observations, we can better define the clinical benefits of such therapies and advance this field.


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