Dr. Muhammad Mahtab Hossain Mazed

Dengue is going to take shape like an epidemic. Aedes mosquito-borne disease is killing people every day. Dengue fever on 17 September 2023. 18 people died across the country in 24 hours. With this, the number of people who have died due to dengue this year has reached 822. In addition, 3 thousand 122 people were newly admitted to the hospital in 24 hours. From January 1 to September 17 of the current year, one lakh 67 thousand 684 people were admitted to the hospital due to dengue.

Among them, 73 thousand 233 people have been admitted to various hospitals in the capital and 94 thousand 451 people have been admitted to hospitals outside Dhaka. So far this year, 822 people have died of dengue in the country. Among them, 564 are from Dhaka and 258 are from outside Dhaka. At present, 10,437 dengue patients are admitted to the hospital. Among them, 4 thousand 66 people are in Dhaka and 6 thousand 371 people are outside Dhaka.

During the same period of the year, 1 lakh 56 thousand 425 people were discharged from the hospital. Among them, 68 thousand 603 are residents of Dhaka and 87 thousand 822 are outside Dhaka.

In 2022, 281 people died of dengue, the highest in the history of the country. 27 people died of dengue in the last month of that year, December. At the same time, 62 thousand 382 people were admitted to the hospital due to dengue in the year under discussion.

During the corona epidemic in 2020, dengue infection was not seen much, but in 2021, 28 thousand 429 people were infected with dengue throughout the country. In the same year, 105 people died due to dengue throughout the country. Dengue is considered a re-emerging disease in Bangladesh. According to a recent (2000) report by the World Health Organization, the dengue outbreak in this country is at an explosive level.

The incidence of dengue is increasing all over the world and the number of dengue victims may reach a record high this year. One of the reasons for this could be global warming and climate change. Recently, the World Health Organization has expressed this concern. Basically, the incidence of dengue is increasing all over the world. After 2000, the number of dengue patients doubled and reached 42 million in 2022. Dengue patients are increasing at an alarming rate in Europe.

A state of emergency has been declared in most regions of Peru. Meanwhile, dengue vaccines have been approved in several regions and countries. These include the European Union, the United Kingdom, Brazil, Argentina, Indonesia, and Thailand. In the United States, the FDA has approved only one dengue vaccine. However, it is not for all ages. In 2019, the World Health Organization included dengue fever as the tenth health risk. About half of the world's population lives in areas where the risk of dengue is high. Every year, 40 million people in the world are affected by dengue. At the moment, Peru is struggling to deal with dengue. The country has never faced so many dengue patients before.

Caetano Heredia University of Peru Associate Professor of Medicine. Coralith Garcia said dengue cases are now more common in urban areas than before. Experts blame the warm temperatures and heavy rainfall. But despite Lima being the world's second-largest desert city, dengue is rampant. Because the population of the city is so high, anything can happen here.

Dengue basically has three stages. The first stage or 'febrile phase'. The second phase is the 'critical phase' and the third phase is the recovery period. Among these three steps, the second step is the most difficult.

A survey of school children in Dhaka metropolitan area conducted between 1982-83 found dengue symptoms in 278 out of a total of 2,456 blood samples. In 1984-86, all 21 blood samples collected from a Dhaka city hospital were found to be infectedIn 1997, about 11% (27 out of 250) of outpatients at Chittagong Medical College Hospital had positive antibody titers to dengue antigen.

In 1999 at the Mohakhali Health Institute in Dhaka, dengue was found in 98 out of 241 suspected blood samples sent from different districts. In the detailed information provided by the institute, some of them included information on hemorrhagic dengue. From the information given by the doctors of Dhaka city, the existence of a significant number of hemorrhagic dengue has been known. Bangladesh is facing the worst dengue outbreak in history in 2019. Earlier in the history of Bangladesh, so many dengue patients were never admitted to the hospital in one season. Even this number is more than twice the total number of dengue cases in the country in the last 19 years.

According to the information of the Health Emergency Operation Center and Control Room of the Department of Health, in 2018, a maximum of 10,148 people were infected with dengue in the country. In the last 19 years, a total of 50 thousand 176 patients admitted to the hospital due to dengue. In 2002, dengue patients were first widely seen in the country. At that time 5 thousand 511 patients were admitted. In 2001, the incidence of dengue decreased slightly, but in 2002, the number of cases exceeded 6,000. Since then, the number of dengue patients has gradually increased. It is a viral infectious disease mainly in the tropical regions of Asia.

Dengue belongs to the virus family, which includes about 70 types of viruses, including yellow fever and several types of encephalitis. An epidemic of a disease similar to dengue fever was first reported in medical textbooks in 1779 and 1780. Dengue fever was first detected in Calcutta in the early nineteenth century. In 1871-72 the disease appeared in epidemic form. Since then outbreaks of the disease have occurred frequently in the subcontinent. From 1939-45, dengue fever appeared every 10 to 30 years in the entire continent. Dengue epidemics did not occur repeatedly in any one particular place. During World War II, co-circulation of multiple dengue virus serotypes occurred in Southeast Asia and the incidence of epidemics increased. Large-scale dengue epidemics occurred in the Caribbean (1977–1981), South America (early 1980), the Pacific (1979), and Africa, affecting millions of people.

The first outbreaks of hemorrhagic dengue fever and dengue shock syndrome occurred in Manila in 1953–54 and in most of Southeast Asia with regular intervals during 1975. In the 1980s and 1990s, epidemics of hemorrhagic dengue spread to India, Bangladesh, Pakistan, Sri Lanka, the Maldives and eastward to China. Dengue hemorrhagic fever and shock-syndrome Dengue is now a leading cause of hospitalization and infant mortality in Asia. Dengue is carried by mosquitoes. Four types of dengue virus 1.2.3.4 cause dengue and hemorrhagic dengue and are genetically closely related.

Any one serotype confers lifelong immunity against a particular virus, but not against other viruses. Dengue virus is established in the tropical OUP-tropical urban cycle. That is why the disease is more in urban people. Daytime biting mosquitoes associated with human habitations are carriers of these viruses. In some areas, other species of mosquitoes also cause infection. The mosquito becomes infectious two weeks after biting the patient and remains infectious for life.

> Symptoms of dengue fever

The primary symptom of dengue is fever. Many people ignore it as a viral fever. Although dengue fever and viral fever are different from each other, dengue fever is relatively dangerous. As the initial symptoms are similar, it can be difficult to know exactly what you are suffering from at first.

With proper treatment it is possible to cure this disease at home. Only in special cases does the patient need to be hospitalized. In that case too there is every possibility that the patient will get better within one to two weeks.

In most cases, a patient with dengue for the first time does not show any special symptoms or signs. This is known as classical dengue. Only in few cases is the effect of the disease profound.

> Common symptoms of dengue are-High fever (104°F or 40°C), severe headache, pain behind the eyes, muscle and joint pain, nausea, dizziness, swollen glands and skin rashes.

These symptoms appear between four and 10 days after infection. Symptoms usually last from two to seven days. A second exposure to dengue increases the severity of the disease. That's why people with previous dengue fever are asked to take extra precautions. This type of dengue is called hemorrhagic dengue fever.

> Severe symptoms of dengue are severe abdominal pain, persistent vomiting, bloody or nosebleeds, blood in the urine and stools, irregular bowel movements, bleeding under the skin (which may look like bruises), rapid breathing, fatigue, irritability and restlessness. .And the dengue virus damages the blood vessels of the human body. As a result, holes are formed in the blood vessels. The number of clot-forming cells (platelets) in the bloodstream decreases. This can cause shock to the human body, bleeding from different parts of the body, damage to any organ and ultimately death of the patient.

If any of the serious symptoms appear in the patient's body, the doctor should be contacted immediately or the patient needs to be admitted to the nearest hospital. Otherwise the patient's life may be in danger. It is best to be alert at the onset of serious symptoms.

> Dengue if bitten by Aedes mosquito?

The simple answer to such a question is that Aedes mosquito bites do not cause dengue. Doctors say that if a virus present in the environment is transmitted to an Aedes mosquito, only then is there a possibility of contracting dengue through the bite of that mosquito. Female Aedes act as a carrier of dengue virus. They spread the virus from an infected person to a healthy person.

If a person is bitten by a dengue-carrying mosquito, the person develops dengue fever within 4 to 6 days. Now if this affected person is bitten by a sterile Aedes mosquito, that mosquito also becomes a mosquito that carries dengue fever. This is how dengue spreads from one person to another.

The Aedes mosquito responsible for dengue fever does not bite in the dark. Aedes mosquitoes are usually active in the early morning and early evening. But can bite at any time of the day in a dark environment. Aedes mosquitoes are relatively large, with long, striped legs.

> How to recognize Aedes mosquito?

Anyone can spot the Aedes mosquito that carries the dengue virus with the naked eye. This medium-sized black-and-white striped mosquito has hairy trunks. They also have a white spot on the back of their heads, so they can be easily distinguished from common mosquitoes.

Aedes mosquitoes bite from dusk to sunset. Aedes mosquitoes are usually active in the early morning and just before dusk. Many people think that the Aedes mosquito probably only bites the legs. This is also a misconception. Because the feet are exposed compared to other parts of the body, they choose to bite there.

> What is the normal number of platelets in dengue?

A normal healthy adult has a platelet count of 1.5 to 4.5 million platelets per microliter of blood. The number of high-risk dengue-infected patients may drop below 20,000. This is when the risk of bleeding is highest. Moderate risk patients have a platelet count of 21 to 40 thousand.

However, in many cases of dengue infection, the platelet count changes rapidly. Platelet transfusion is required only when the platelet count is low and signs of bleeding appear. Platelet count naturally increases in our body as infection subsides.

> How to avoid dengue?

Prevention is better than cure. Only good is said less. This is the best way to live. If someone gets dengue in this grinding state of corona, what the situation can be will be understood by the person who will be there. But those who did not should think about it. Therefore, there is no alternative to stop mosquito breeding and eliminate mosquitoes to save from dengue. Care should be taken that there is no situation where water can accumulate. All kinds of can shells, car tires, broken bottles, abandoned flower tubs, etc. should be removed on your own initiative. It is not possible for the government alone to find or remove the broken bottles, glasses, cans, buckets, tires of 17 crore people. In order to live, everyone has to participate in them at their own initiative. Remember, the mosquitoes next to your house will attack you.

> Diet of dengue patient:-

Foods that are important to feed dengue patients
It is important to eat nutritious food during the increase of dengue outbreak. Because the platelets in the body started to decrease in dengue. Apart from this, various physical problems may increase.

Therefore, if you have dengue fever, you should increase the intake of nutrients in the body through nutritious food. According to nutritionists, it is important to take care of eating nutritious food if you have dengue. Many people stop eating and drinking when they have a fever.

This can lead to dehydration. Platelet count may also decrease. Therefore, it is important to feed a few foods when someone has dengue fever at home. Know which foods to feed dengue patients -

* Pomegranates are rich in vitamins and minerals. At this time, eating pomegranate will increase the number of platelets. Consuming this beneficial fruit will also remove the feeling of tiredness and fatigue.

* Bottled water is very beneficial for physical health. Dehydration is caused by lack of fluid in the body when dengue fever occurs. So drink more bottled water at this time. It contains essential nutrients like electrolytes.

* Orange or malta juice is rich in vitamin C and anti-oxidants. These two ingredients are beneficial in controlling dengue fever. * Kiwi fruits are also rich in vitamins. It also contains potassium. Eating this fruit keeps electrolyte levels and high blood pressure under control. Also, eating kiwi increases the level of red blood cells in the body.* Turmeric is an ingredient in the kitchen. Which has been used for ages in treatment. If you have dengue fever, mix a pinch of turmeric with a glass of milk and drink it. Consuming turmeric milk has multiple health benefits.

* Fenugreek must be in everyone's house! This ingredient helps in reducing excessive fever in case of dengue. However, before taking fenugreek, you must consult a doctor.

* Broccoli is a good source of vitamin K. Vitamin K, on the other hand, helps increase blood platelets. If a person is infected with dengue; Then he must be fed broccoli.

* Spinach is rich in iron and omega-3 fatty acids. This vegetable also helps in strengthening the immune system of the body. Eating spinach will increase the platelets of dengue patients faster.

* In case of dengue, avoid oily and fried food along with nutritious food. Also avoid spicy food. Also, avoid caffeinated drinks. These foods are not beneficial to the body but increase fatigue and illness.
> Homeopathy:-
The patient is treated, not the disease, so an experienced doctorAccording to Hahnemann's homeopathic rules, treatment of any complex and difficult disease including dengue, if the individual is treated according to individual characteristics, physical symptoms, and metallurgy, by God's grace, dengue can be treated in homeopathic treatment.
Treatment of the patient is possible.
> Homeo treatment:-
Aconite, belladonna, bryonia, rastox, eupterium perf, arsenic album, carbovage, gelsium, nux, ipicac, sulphur, and many other remedies may come upon the symptoms, so remember that homeopathy is a Symptom-based treatment regimens. In this case, the medicine varies from person to person. So if the severity of the disease is very high, do not take medicine on your own, consult a specialist doctor.

Finally, dengue fever is a common disease. But if neglected, this disease can be fatal. Its prevalence is higher in urban areas. So the city dwellers have to be more alert and aware. Especially those who have dengue should be extra careful. A second dengue infection can be fatal. Stay aware, stay healthy and stay well.

The writer is a, Columnist and researcher Founder Chairman, Jatiya Rogi Kallyan Society