That feverish feeling
The monsoon may be over but it has left behind the rash of mysterious illnesses it brought with it. All across the country, people are still suffering from high fever, rashes and head and body ache — but the causes are different. There have been deaths from dengue, encephalitis (brain fever) and malaria. While not fatal, chickungunya, influenza, jaundice and typhoid too are making their presence felt.
If someone you know “feels sick and feverish”, don’t panic. Get a digital thermometer and check the temperature. Body temperature varies, depending on age, physical activity and time of day. An early morning temperature higher than 37.2°C (>98.9°F) or a late afternoon temperature higher than 37.7°C (>99.9°F) is considered fever.
There has been an upsurge in the number of dengue cases this year with reports of fatalities. Four distinct types of viruses cause dengue. So just because you had it once doesn’t mean you are immune.
Dengue starts with high fever, red rash, headache, painful blood shot eyes, and severe backache. The fever subsides on its own after 3-4 days, only to return with a vengeance a few days later. The dangerous dengue haemorrhagic fever is caused by two or more sequential infections of different types. The fever is followed by bleeding, falling blood pressure, circulatory collapse and shock. The diagnosis of dengue is confirmed by enzyme linked immunoassay (Elisa) and haemagglutination blood tests.
There is no specific treatment or immunisation. Symptomatic treatment with paracetamol helps. If there is bleeding or a falling platelet count, blood transfusions may be required.
Malaria sets in with headache, high temperature and diarrhoea. The fever returns every alternate or third day with shivering and sweating. It is diagnosed by checking blood smears. Medication is curative. It is important that treatment be given as soon as possible.
Chickungunya sets in suddenly with high fever, red rashes, muscle aches and excruciating pain in the small joints of the hands and feet. Once the fever subsides, the joint pain remains for around 10-15 days in the young, 1-2 months in the middle-aged and 3-6 months or even up to five years in older people. There is no specific curative treatment.
Colds occur several times a year, usually when the weather changes. It causes a runny nose, cough, headache, chills, fever and body ache. Influenza or “flu” starts with fever (102-104°F) and symptoms similar to the common cold except in a more severe form.
Encephalitis means high fever that may cause seizures or loss of consciousness.
The monsoons cause flooding in urban areas. Water stagnates and sometimes the water supply gets contaminated. This leads to diarrhoea, dysentery and hepatitis. In addition, the rodents who get flushed out of their habitat can spread leptospirosis. This is characterised by high fever, severe headache, chills, muscle aches, and vomitting. It may include jaundice, red eyes, abdominal pain, diarrhoea, and rash.
There is a lot of overlap between the symptoms of these illnesses. So blood tests are required for an accurate diagnosis.
Influenza, typhoid and hepatitis A can be prevented with immunisation. The influenza vaccine has to be taken every year, usually in November. The typhoid vaccine has to be repeated every three years. The hepatitis A vaccine is administered in two doses six months apart for lifetime immunity. Immunisation is also available for Jap B encephalitis.
Dengue, malaria, chickungunya and viral encephalitis spread through mosquito bites. Breeding of mosquitoes should be prevented. Mosquito repellent gels, especially ones containing lemon grass oil, are fairly efficient. It is better to apply it to clothes than on skin. Don’t use them on children younger than a year or on pregnant women.
• As you walk, turn over discarded tyres, bottle caps and coconut shells so that water does not stagnate inside
• Put a handful of salt into air conditioning and cooler trays so that mosquitoes cannot breed
• Do not place trays under potted plants. Empty pots and vases regularly
• Fix mosquito meshes on open tanks, wells, and doors and windows
• Ornamental fish that eat mosquito larvae, such as Gabusia and Poecili (guppy) should be added to public ponds, canals and sewers
• Sleep inside a mosquito net to prevent bites. Wear full-sleeved shirts, full pants and covered shoes for the same reason
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at firstname.lastname@example.org