Dengue Fever: Treatment

Dear Auntie:

I know all this talk about Dengue Fever has you worried. The following is the flow-chart clinicians use to determine the clinical picture for a patient with dengue.

That is super complicated and scary! So let's talk about treatment in place and simple terms.

Dengue patients are categorized into three groups - Group A, group B, and group C.

Patients in Group A may be sent home while they recover. Patients are categorized intro group A if they can take oral fluids and pass urine at least every 6 hours. These patients require a lot of rest too. They may be offered acetaminophen (tylenol) at no more than 4 grams a day to manage the pain and other side effects of acute infection, but generally it will resolve on its own with adequate rest and hydration.

Patients in Group B require encouragements and close monitoring for oral fluid intake to prevent dehydration. They may need IV fluid therapy with normal saline to keep their fluid volume in the blood at an appropriate level and prevent dehydration if they cannot drink enough fluid. After the fluid volume is correct, as evidenced by a normal blood pressure and heart rate, the patient can be sent home just like a Group A patient.

Patients in Group C have a more difficult course of treatment, usually in the hospital. These patients are generally hemorrhagic, so they are losing a lot of blood. They require an IV to be started right away for administration of either normal saline OR a blood transfusion. If a lab value called the hematocrit is low, they need blood that is type and cross matched to their blood in order to save their life. They will continue receiving blood until their hematrocrit starts to increase and remain stable without blood transfusions. The patient can be sent home, like a group A patient, when their hematrocrit is stable and they are able to manage without IV fluids.

Aunite, the very best treatment for Dengue Fever is prevention! We really want to keep from getting sick altogether. The following video outlines some basic Dengue Fever prevention strategies.

References:

1. World Health Organization (2012). Handbook for Clinical Management of Dengue.  Accessed from the World Health Organization Web site. http://www.wpro.who.int/mvp/documents/handbook_for_clinical_management_of_dengue.pdf