Dengue Fever: Symptoms, Warning Signs and Safe Medicines

Every year from late August to November, dengue cases climb across Pakistan, especially in Lahore, Rawalpindi, Karachi and Peshawar. Most people recover at home with rest and plenty of fluids, but a small number develop severe dengue, which can become dangerous quickly. Knowing the symptoms, the safe medicine to take and the warning signs can make a real difference.

How dengue spreads

Dengue is a viral infection spread by the bite of the Aedes mosquito. Unlike the mosquitoes that bite at night, Aedes mosquitoes bite mainly during the day, especially in the early morning and late afternoon. They breed in small amounts of clean, standing water: flower pots, water coolers, old tyres, buckets and roof tanks. Dengue does not spread directly from person to person.

Common symptoms of dengue

Symptoms usually start 4 to 10 days after the mosquito bite and include:

• Sudden high fever, often 39 to 40°C
• Severe headache and pain behind the eyes
• Strong muscle, joint and bone pain (the reason it is called “bone-break fever”)
• Nausea, vomiting and loss of appetite
• A skin rash that may appear 2 to 5 days after the fever starts
• Extreme tiredness

A blood test confirms the diagnosis. Doctors usually order an NS1 antigen test in the first few days, and a complete blood count (CBC) to check the platelet count and haematocrit.

The critical phase: when the fever goes down

Many people feel relieved when the fever breaks, usually around day 3 to 7. This is exactly the time to be most careful. In a small number of patients, fluid starts leaking from the blood vessels during this phase, which can lead to shock. That is why doctors watch the platelet count and fluid levels closely during these days.

Warning signs: go to hospital straight away

• Severe or constant stomach pain
• Vomiting that does not stop, or being unable to keep fluids down
• Bleeding from the gums or nose, blood in vomit or stool, or black stools
• Very little or no urine for 6 hours or more
• Feeling very sleepy, confused or restless
• Fast breathing, or cold, clammy hands and feet

Children, pregnant women, older adults and people with diabetes, heart or kidney disease should be seen by a doctor early, even if the illness seems mild.

Which medicine is safe for dengue fever?

Paracetamol is the medicine recommended for fever and body pain in dengue. Take it at the dose written on the pack or advised by your doctor, and do not take more than the maximum daily dose, as too much paracetamol can harm the liver.

Avoid ibuprofen, aspirin, diclofenac, mefenamic acid and other NSAID painkillers. These medicines can increase the risk of bleeding when platelets are low. Also avoid injections and drips from unqualified providers.

Fluids are the most important treatment

There is no specific antiviral medicine for dengue, so the main treatment is supportive care. Drink plenty of fluids: water, ORS, fresh juices, soup and coconut water. A good sign that you are drinking enough is passing light-coloured urine every few hours. If you cannot drink because of vomiting, you need hospital care.

What about papaya leaf juice and platelet boosters?

Papaya leaf extract is widely used in Pakistan. A few small studies suggest it may help platelet counts, but the evidence is limited and it does not replace medical monitoring. Platelet transfusions are only needed in specific situations decided by a doctor, not simply because the count is low.

How to prevent dengue at home

• Empty, clean or cover anything that holds water at least once a week, including coolers, pots and tanks.
• Use mosquito repellent on exposed skin during the day.
• Wear long sleeves and full trousers, especially for children going to school.
• Use window screens, nets and coils or mats indoors.
• If someone at home has dengue, protect them from mosquito bites so the virus does not spread to others.

Key takeaways

• Dengue causes high fever, severe body pain and pain behind the eyes.
• Use paracetamol only; avoid ibuprofen, aspirin and diclofenac.
• Drink plenty of fluids and watch for warning signs, especially when the fever drops.
• Seek hospital care immediately for bleeding, severe stomach pain, persistent vomiting or drowsiness.

You can order fever and pain relief medicines, ORS and mosquito repellents from Medimart with delivery across Pakistan.

This guide is for general information and does not replace advice from a doctor. If you think you or your child has dengue, see a doctor promptly.