Exclusive: Doctor Shares Who Is At Most Risk Of Getting Dengue Fever, Why Elderly People Must Be More Careful

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According to the National Center For Vector Diseases Control, in India, the number of dengue cases and deaths in 2023 stands at 2,89,235. Also, as of 30 April 2024, over 7.6 million dengue cases have been reported to WHO in 2024, including 3.4 million confirmed cases, over 16,000 severe cases, and over 3000 deaths. This gives us a clear image of how precarious the situation is.

While anyone can contract dengue fever, certain groups are more susceptible to severe outcomes and so it is essential to know everything about this disease.

In a conversation with Boldsky, Dr Jagadeesh KH, Consultant - Internal Medicine, Manipal Hospital, Sarjapur shares who is at risk when it comes to dengue fever, emphasizes the heightened vulnerability of the elderly and why they should be particularly cautious.

What Is Dengue Fever?

Dengue fever is caused by the dengue virus, which is transmitted to humans through the bite of an infected Aedes mosquito, primarily Aedes aegypti. The virus has four serotypes (DEN-1, DEN-2, DEN-3, and DEN-4), meaning a person can be infected up to four times in their lifetime. Symptoms range from mild flu-like signs to severe dengue (also known as dengue hemorrhagic fever), which can be fatal without proper treatment.

"Dengue fever is a mosquito-borne (Aedes aegypti mosquitoes) viral infection that poses a significant health threat, particularly during the monsoon season. The disease is characterized by a sudden onset of high fever, severe headaches, muscle and joint pains, rash, and mild bleeding tendencies," says Dr Jagdeesh KH.

Dengue fever presents three categories of symptomatic infection

1. Dengue Fever: The classic form of dengue, characterized by high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, and mild bleeding (e.g., nose or gum bleeding, easy bruising).
2. Dengue Hemorrhagic Fever (DHF): A more severe form that includes the symptoms of classic dengue fever but also involves bleeding, blood plasma leakage, and low platelet count, leading to shock.

3. Dengue Shock Syndrome (DSS): The most severe form, which includes symptoms of DHF and progresses to severe plasma leakage, fluid accumulation, severe bleeding, and organ impairment, potentially leading to death.

According to Dr. Jagadeesh, these are the warning signs one must look for

• Abdominal pain or Abdominal distention,
• Persistent vomiting,
• Breathing difficulty,
• Mucosal bleeding,
• Lethargy or restlessness,
• And a Rapid decrease in the platelet count.

"Early diagnosis and management are crucial to prevent complications such as Dengue Hemorrhagic Fever or Dengue Shock Syndrome, which can be life-threatening, says Dr. Jagadeesh KH. It is essential to seek medical attention if any severe symptoms, such as persistent vomiting, abdominal pain, or difficulty breathing, are observed".

The groups at the highest risk for dengue fever include:

1. Young Children, Pregnant women, and the Elderly person due to the weaker immune system.­
2. Individuals with Previous Dengue Infections.
3. People with weakened immune systems or chronic health conditions such as diabetes and hypertension.
4. People Engaging in Outdoor Activities especially during peak mosquito activity times (early morning and late afternoon), are at increased risk.
5. Densely populated areas with poor sanitation and high mosquito populations (urban and semi urban area).
6. Residents of Endemic Areas- Tropical and sub-tropical regions.

Why Elderly People Are At Risk?

Elderly people are at greater risk for dengue fever and its severe complications because of the following reasons.

1. Weakened Immune Systems

As people age, their immune systems naturally weaken, making it more difficult for the body to fight off infections, including dengue fever. An older person's immune response to the virus can be less effective, increasing the likelihood of severe symptoms and complications.

2. Higher Risk of Severe Complications

Elderly individuals are at a higher risk of developing severe dengue, which can lead to complications such as internal bleeding, organ failure, and shock. These complications are often more challenging to manage in older adults due to their decreased physiological resilience.

3. Pre-existing Health Conditions

Many elderly people have pre-existing health conditions, such as cardiovascular disease, diabetes, or chronic respiratory illnesses. These conditions can exacerbate the severity of dengue fever and complicate the treatment process, making recovery more difficult.

4. Delayed Diagnosis and Treatment

Elderly individuals may not always recognize the symptoms of dengue fever promptly or may attribute them to other age-related health issues. This delay in seeking medical attention can result in the disease progressing to a more severe stage before appropriate treatment is administered.

5. Hospitalization and Mortality Rates

Studies have shown that hospitalization and mortality rates from dengue fever are higher among the elderly. The combination of a weakened immune system, pre-existing conditions, and the potential for delayed diagnosis contributes to poorer outcomes in older adults.

How To Prevent Dengue

'Dengue is the most rapidly spreading mosquito borne viral disease in the world. It is self-limiting viral disease, it can show mild symptoms and recovers without any specific treatment, sometimes it can be fatal if undiagnosed or delayed treatment. Fighting dengue requires a community effort. Everyone has a role to play in preventing the spread of this disease,' he Dr Jagadeesh.

Here are few ways to protect yourself from dengue.

1. Eliminate Breeding Sites

Aedes mosquitoes breed in standing water, so it's crucial to eliminate potential breeding sites around your home and community. Regularly empty and clean containers that can collect water, such as flower pots, buckets, bird baths, and pet dishes. Ensure water storage containers, tanks, and cisterns are tightly covered to prevent mosquitoes from laying eggs. Properly dispose of items that can collect rainwater, such as old tires, bottles, and cans.

2. Use Mosquito Repellents

Use repellents containing DEET, picaridin, oil of lemon eucalyptus, or IR3535 on exposed skin and clothing. Wear long-sleeved shirts, long pants, socks, and shoes when outdoors, especially during peak mosquito activity times (early morning and late afternoon).

3. Install Barriers

Sleep under insecticide-treated bed nets, particularly in areas with high mosquito activity. Fit windows and doors with fine mesh screens to prevent mosquitoes from entering your home. Keep windows closed and use air conditioning when possible to minimize mosquito entry.

4. Community-Wide Efforts

Join or organize community clean-up campaigns to remove potential breeding sites. Support government and community programs aimed at mosquito control, such as fogging and larviciding. Raise awareness about dengue prevention methods in your community through schools, local organizations, and social media.

5. Personal Protection

Minimize outdoor activities during early morning and late afternoon when Aedes mosquitoes are most active. Maintain a tidy environment inside and outside your home to reduce mosquito habitats. Apply insecticide sprays or coils in areas with high mosquito activity, but follow safety guidelines to avoid health risks.

6. Travel Precautions

Choose hotels or lodgings with effective mosquito control measures. Bring mosquito repellent, insecticide-treated bed nets, and appropriate clothing.

7. Medications

'Oral rehydration solutions or intravenous fluids to prevent dehydration in case you have contracted the disease. You can take (paracetamol) for pain and fever and avoid nonsteroidal anti- inflammatory drugs (NSAIDs) like aspirin and ibuprofen, as they can increase the risk of bleeding,' says Dr Jagadeesh.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.