Dengue infections in Malaysia nearly doubled in 2023 compared to 2022 amid a global surge in dengue cases.
According to the Malaysian government’s iDengue portal, a total of 123,300 dengue cases were reported from January 1st to December 31st 2023, 86.5% more compared to 2022 (66,102 cases). This was the highest number of recorded cases since 2019 when 130,101 dengue cases were reported.
Dengue Can Lead To Death
An 18-year-old Sabahan recently passed away due to dengue hemorrhagic fever. He was seen at Tuaran Hospital’s emergency department on the 25th of December 2023 due to epigastric pain and vomiting the day for a day. According to Dr Asits Sanna, Sabah’s state health department director, the patient did not have a fever, diarrhoea, chest pain or breathing difficulties. His vital signs were normal upon examination. He was treated with anti-emetics and medication for gastritis. The patient was then allowed to go home after being monitored in the observation zone for an hour. He was discharged with painkillers and medication for gastritis.
The patient returned to the hospital on the 28th of December due to nosebleeds, fever, vomiting, diarrhoea, and loss of appetite. The patient was confirmed to be positive for dengue. However, his condition was unstable and he had to be referred to Queen Elizabeth Hospital for critical care. Unfortunately, he passed away in the intensive care unit (ICU) the following morning.
Misconceptions Regarding Dengue
You can only get dengue once
An individual can get infected by dengue up to four times as there are four existing serotypes. Total immunity is possible only if an individual has been infected with each one of those serotypes. It is also important to note that each subsequent dengue infection tends to be more serious than the first, with an increased risk of developing severe dengue. Severe dengue can be life-threatening, so it would be wise to be aware of dengue warning signs.
There is no danger if you do not feel sick
There are three different stages of dengue fever. During the first phase (febrile phase), patients tend to develop high fever that is associated with body aches, headaches with pain around/behind the eyes, flushed face and occasionally rashes (isles of white in a sea of red).
The critical phase (second phase) starts when the fever subsides, and many patients tend to feel much better. However, it is vital to note that this is when patients can have plasma leakage from their capillaries, leading to an abrupt drop in blood pressure. This increases the risk of going into shock, which is life-threatening.
Once the critical phase has passed, then comes the recovery phase. This is when patients recover as they are able to absorb fluids well and their pulses stabilise.
Dengue is just a common and mild illness
While dengue is a self-limiting viral illness, it does not mean that it should be taken lightly. An estimated 1% of dengue patients will experience dengue hemorrhagic fever, which will definitely require hospitalisation and close monitoring. Patients with a healthy immune system tend to recover within a day or two. However, some patients who experience inflammation in organs such as the heart, liver or brain may take longer (a week or more), especially if there are complications.
One can only test after three days
The S1 dengue rapid antigen test is able to detect dengue on the first day itself. Do not delay seeking medical help, especially if you suddenly develop a high fever. Since the febrile phase only lasts for a day or two, it is important to get diagnosed early and take precautions (especially proper hydration and rest).
Dengue Warning Signs
Signs of dengue hemorrhagic fever (DHF) include:
- Bleeding from the mouth/gum/nose
- Cold, clammy skin
- Blackish vomit/stool
- Abdominal pain
- Bruising of the skin
- Weak, rapid pulse
Call For Action
While prevention is easier said than done, there are things that we can do to mitigate the effects of the illness. These include:
- Seeking medical attention immediately when high fever suddenly develops
- Adequate rest and lots of fluids to rehydrate
- Avoid taking painkillers, especially non-steroidal anti-inflammatory drugs (NSAIDs) as they increase capillary plasma leakage.
- Paracetamol can be taken to alleviate fever and body aches.
- Look out for dengue warning signs within three to seven days after symptoms appear.