Dengue cases have multiplied in the last two months.
It is present in 13 jurisdictions in the country and
the weekly average number of infected is 2,000
, while the total number of people who have contracted the disease since the beginning of the outbreak is already around 10,000.
The expansion of one of the viruses with the greatest presence in Argentina and the region and, mainly, the detection of serious cases alarms the entire population.
A report from the Buenos Aires Ministry of Health states that "due to previous outbreaks and the circulation of more than one serotype in the province of Buenos Aires, the detection of cases with warning signs is extremely important to anticipate severe forms of
dengue
”.
“The
warning signs
occur within the first 48 hours after the fever curve has dropped.
You have to observe the patient within that period of time because they are the critical hours within which severe dengue can be installed ”, Elena Obieta, infectious disease doctor and head of the Communicable and Emerging Diseases Service of San Isidro,
explains to Clarín
.
What are the symptoms that indicate severity?
"Feeling of intense tiredness, shortness of breath and drop in pressure, severe abdominal pain, vomiting (at least 3 times in 24 hours), bleeding from the nose, conjunctivae or gums, bleeding in the stool and drowsiness or confusion", mentions Luis Cámera, clinical doctor at the Italian Hospital and government adviser during the Covid pandemic.
Pablo Bonvehí, head of Infectious Diseases at CEMIC, adds that a doctor should evaluate the patient for signs of "fluid accumulation, mucosal bleeding, agitation or drowsiness, liver enlargement, laboratory data such as increased hematocrit or decreased platelets.
Infectious focus in Mataderos, where due to the rise in dengue cases they stopped testing.
Photo Constance Niscovolos
On the other hand, Leda Guzzi, infectious disease physician and member of the Argentine Society of Infectious Diseases (SADI), also mentions other clinical criteria that warn of the possibility of contracting severe dengue, such as difficulty breathing, lethargy, restlessness, and postural hypotension.
“When severe dengue occurs, patients may have extravasation of plasma into the tissues (edema) and peritoneum (ascites).
This happens due to an increase in the permeability of the blood vessels and then shock can ensue.
Severe hemorrhagic manifestations such as bloody vomits, bloody stools, gynecological bleeding are also common.
There may even be organ inflammation, myocarditis, encephalitis and pancreatitis”, he adds.
the second infection
Approximately,
between 5% and 10% of those infected acquire severe dengue
, but if the condition is treated on time, mortality drops to less than 1%.
It tends to be more common in children and pregnant women.
“The incidence of reinfection seems to be low, but there are no scientific papers that speak more precisely about the subject.
On the other hand, it has just been shown that in the face of an outbreak there are many cases of asymptomatic dengue.
Therefore, the individual does not know if he had dengue and, if he had it, it would not be known if it is a new infection or a reinfection”, points out Cámera.
The use of repellent is one of the ways to prevent the spread of dengue.
The specialists consulted agree that a second infection with a serotype different from the first increases the risk of suffering a more severe clinical form.
“The second event is not necessarily going to be serious.
It can be occasionally,
if the infection is by a different serotype than the initial one
.
The vast majority of dengue fever pictures are banal”, Guzzi details.
“People who are infected for the first time generally do not contract severe dengue.
When the fever disappears, vomiting appears, tiredness.
Dehydration
and bleeding
are the most alarming symptoms in severe dengue and this is seen more with the second infection”, adds Arnaldo Casiró, infectious disease doctor, director of Cemar 1, the first Center for Medical Specialties in the City.
For his part, Bonvehí argues: “A second infection may, in some cases, be more likely to worsen than someone who is infected for the first time.
This is because there are 4 dengue serotypes and the protection provided by infection against one serotype is transient against the other 3 serotypes and after that, if an infection with another serotype occurs, the antibodies from the first infection can facilitate entry of the virus into cells.
“If the second episode of dengue is acquired by the same serotype as in the first infection,
I will be protected as if I had been vaccinated.
The problem is when dengue is acquired for the second time with another serotype.
In this case, due to partial immunity, antibody complexes are produced that are deposited and can evolve into severe dengue hemorrhagic fever.
The bleeding causes multiple organ failure and eventually leads to death;
mainly in young children, pregnant people and those over 65 years of age or underlying pathologies
”, completes Obieta.
The key is in prevention
At this time, the humidity and temperature conditions are optimal for the activity of the vector, the Aedes aegypti mosquito that is present in Argentina.
Dengue is a disease that requires individual and community action against mosquito breeding sites.
Fumigation is a temporary solution in those regions where an outbreak is detected, but the
fight is against the vector reservoirs
, which are the places where these mosquitoes reproduce.
Eliminating containers where water accumulates is vital so that the mosquito that transmits dengue does not reproduce.
“The circulation of dengue in our country is highly dependent on what happens in the region.
If it increases in peripheral countries, it increases in ours.
We usually see cycles, that is, dengue epidemic outbreaks every 3 or 4 years.
The previous one of magnitude was in the first months of 2020”, says Guzzi.
"The circulation of mosquitoes is a consequence of climate change added to unplanned urbanization," Obieta assesses.
The recommendations are the same as always:
use repellent, prevent larvae from accumulating, use spirals, hot melt tablets and mosquito nets.
MG
look also
Dengue: due to the rise in cases, in a Buenos Aires neighborhood they will stop testing
Heat and humidity: what consequences for health can a more "tropical" climate bring
