Dengue Fever Prevention and Management in 2023

    This week, our focus is on disease prevention, specifically regarding Dengue fever. Although this disease has been a longstanding concern, it demands our continued vigilance to safeguard ourselves. This year, there has been a significant surge in Dengue fever cases compared to previous years, warranting heightened attention.

    As of the 25th week of 2023, the Department of Disease Control has reported 27,377 accumulated Dengue fever patients and 23 deaths in Thailand. Shockingly, this indicates that one Thai person is dying from Dengue fever every week, nearly three times higher than the previous year.

    The rainy season is when Dengue fever is most prevalent, and it's essential to remember the case of a young actor who lost his life to this disease. This incident served as a wake-up call, reminding us that Dengue fever can be severe, contrary to the past belief that it was not particularly dangerous.

    As we know, Aedes mosquitoes are the carriers of the Dengue virus. When they bite an infected person and subsequently bite another individual, the virus spreads. The symptoms of Dengue virus infection range from mild or asymptomatic to severe, causing shock and, in extreme cases, death. Common symptoms include high fever, fatigue, headache, body aches, loss of appetite, nausea, vomiting, and abdominal pain, with bleeding spots on limbs and torso in severe cases.

    Currently, there is no specific antiviral treatment for Dengue fever. Management mainly involves symptom relief, such as using painkillers and staying hydrated. However, if there's no improvement within 2-3 days, especially in vulnerable groups, immediate medical attention is crucial to prevent complications like shock or bleeding, often associated with thrombocytopenia, a significant symptom of Dengue fever.

    Paracetamol is the recommended analgesic for reducing fever in Dengue fever patients, while non-steroidal anti-inflammatory pain relievers (NSAIDs) like Ibuprofen and Aspirin are strictly prohibited due to their potential to cause bleeding.

    The best preventive measure against Dengue fever is to avoid mosquito bites. This involves using mosquito nets, wearing long-sleeved clothes and long pants, using mosquito repellents, and eliminating breeding sites for mosquito larvae by eliminating stagnant water and maintaining a clutter-free environment.

    For individuals who have had Dengue fever before, it's essential to be aware that it can recur, as there are four strains of the Dengue virus. Vaccines have been developed for prevention but are recommended for people aged 9-45 years who have had Dengue fever before, offering approximately 60% protection against recurrence and reducing hospitalization risk by around 90%. However, the vaccine is relatively expensive, requires multiple injections, and is a live vaccine, so it must be carefully considered under the guidance of a doctor.

    In summary, 2023 is witnessing a severe Dengue fever epidemic in Thailand. To minimize the impact of Dengue fever, it's crucial to prevent mosquito bites, use appropriate antipyretic medications, and consult healthcare professionals about vaccination options if living in an epidemic-prone area. These measures will contribute to reducing the burden of Dengue fever and the Dengue virus on individuals and communities.

Assoc. Prof. Dr. Nattada Areepiam and Asst. Prof. Dr. Bodin Tiwasuwan

Faculty of Pharmacy Chulalongkorn University