STOP DENGUE
WITH
HOMOEOPATHY
I NTRODUCTION: Dengue is a highly endemic infectious
disease of the tropical countries and
is rapidly becoming a global burden. It is wide spread in all regions in recent
years. Severe dengue was first recognized in 1950s during dengue epidemics in
the Philippines and Thiland.Today, severe dengue affects most Asian and Latin American
countries and has become a leading cause of hospitalization and death among
children and adults.
Dengue is a mosquito borne viral infection causes flue like illness,
and occasionally develops in to a potentially lethal complication called severe
dengue. Dengue is caused by a virus of the Flaviviridae family and there are 4 distinct,
but closely related, serotypes of the virus that cause dengue (DEN-1, DEN-2,
DEN-3, DEN-4).Recovery from infection by one provides lifelong immunity against
that particular serotype.However,cross-immunity to other serotypes after
recovery is only partial and temporary. Subsequent infections (secondary
infections) by other serotypes increase the risk of developing severe dengue.
GLOBAL BURDEN OF DENGUE:-
Dengue is wide spread through the topics,
with the local variations the in the risk influenced by rainfall, temperature,
and unplanned rapid urbanization. The incidence of the dengue has grown
dramatically around the world in recent decades. The vast majority of cases are
asymptomatic and hence actual numbers of dengue cases are under repeated and
many cases are misclassified or misdiagnosed, other feather of the disease include
its epidemiological patterns, including hyper-endemicity of multiple dengue
virus serotypes in many countries and the alarming impact on both human health
and the global and national economics, Dengue virus is transported from one
place to another by infected travelers.
TRANSMISSION
·
Dengue
virus is transmitted by female mosquitoes mainly of the species Aedes aegypti
and Aedesalbopictus (really).Aedes aegipti also transmits chikungunia, yellow fever
and Zica infection.
These mosquitoes can be
easily distinguished as they are larger in size and have black&white
stripes on their body, so they are sometimes called tiger mosquitoes.
The Aedes aegipti mosquito
is the primary vector of dengue. The virus is transmitted to humans through the
bites of infected mosquitoes.
After virus incubation for
4-10 days, an infected mosquito is
capable
Of transmitting the virus
for the rest of its life. Infected symptomatic or asymptomatic humans are main
carriers and multipliers of virus, serving as a source of virus for uninfected mosquitoes.
Patients who are already infected with the dengue virus can transmit the infection
(4-5 days maximum 12) via Aedes mosquitoes after their first symptoms appear.
·
The
Aedes aegipti mosquito lives in urban habitats and breeds mostly in manmade containers.
The mosquitoes breeds in artificial accumulation of water in and around human
dwellings,such as water found in discarded tins, broken bottles, fire buckets,
flower pots, coconut shells ,earthen pots, tree holes etc ,during
&immediately after rainy season.
The life
cycle of Aedes mosquito depending upon the extent of feeding lasts for 8 to 10
days at room temperature. It consists of two phases: Aquatic (Larvae, pupae)
and terrestrial (Eggs, adults) phase.
ADULT MOSQUITO---EGGS----LARVAE—PUPAE
and vice versa.
·
The
Aedes aegypti mosquito lives in urban habitats and breeds mostly in man-made containers.
Unlike other mosquitoes, Aedes aegypyi is daytime feeder, its peak biting
periods are early in the morning and in the evening before dusk. Female
Ae.egypti bites multiple people during each feeding period.Aedes eggs can
remain dry for over a year in their breeding habitat and hatch when in contact
with water.
·
During
natural dengue infection in humans, the mosquito delivers virus in skin
epithelium where it infects and replicates in the cells of mononuclear lineage
like monocytes, dendritic cells, macrophages and Langerhans cells. These
infected cells carry the virus to lymph nodes, where it replicates, resulting
in viremia, which is followed by systemic infection of liver, lungs and spleen.
SYMPTOMS:-
Symptoms
usually begin 4 to 7 days after the mosquito bite and typically last 3 to 10 days.
Symptoms vary depending on the severity of the disease.
Common Symptoms-- can appear up to 7 days after
being bitten by the mosquito that carries the virus. They include:-
Aching
muscle and joints; body rash that can disappear & then reappear, high fever
(40C/104F), intense headache, and pain behind the eyes, vomiting & feeling
nauseous.
These
symptoms usually disappear after a week, and a mild dengue rarely involves
serious or fatal complications (DSS-Dengue shock syndrome, DHF-Dengue hemorrhagic
fever).
Dengue Hemorrhagic
Fever(DHF)—Dengue fever also known as break bone fever, is a mosquito borne
infection that can lead to a severe flue like illness. At first, symptoms of
DHF may be mild, but they gradually worsen within a few days. As well as mild
dengue symptoms, there may be signs of internal bleeding.
A person
with dengue hemorrhagic fever may experience:-bleeding from the mouth, gums or
nose;calmy skin; damage to lymph and blood vessels; Internal bleeding which can
lead to black vomit and feaces or stools; lower number of platelets in the blood;
sensitive stomach; small blood spots under the skin; weak pulse.
Without
prompt treatment, DHF can be fatal.
Dengue
Shock Syndrome (DSS) ---DSS is a very severe form of dengue. It can be fatal. A
part from symptoms of mild dengue fever, the person may experience:-
Intense
stomach pain, disorientation, sudden hypotension or a fast drop in blood pressure,
heavy bleeding, regular vomiting, blood vessels leaking fluid without treatment,
this can result in death.
DIAGNOSIS:-
·
Laboratory
diagnosis of dengue is best made during the acute phase of illness. Dengue
infection is usually confirmed by identification of viral genomicRNA, antigens or
the antibodies that elicit.
·
ELISA-based
serological tests are easy to perform and are cost effective for dengue detection.
This is the confirmatory test of dengue.
·
Blood
test for leukocyte, platelet &hematocrit are conducted to diagnose dengue
fever and for assessment of prognosis of the patient.
·
The
diagnosis of dengue Hemorrhagic fever is made on the basis of the following
triad of symptoms and signs:-
1. Hemorrhagic manifestations.
2. A platelet count of less than 100,000
per cubic millimeter
3. Objective evidence of plasma leakage,
shown either by fluctuation of packed –cell volume (greater than 20 percent
during the course of illness) or by clinical signs of plasma leakage, such as
pleural effusion, ascites or hypoproteinemia.
MANAGEMENT:-The following do’s and Don’ts must be advised to all the
patients.
DO’s:--
§ Take adequate rest.
§ Rehydration plays major role and all
efforts must be directed to maintain adequate fluid intake.
§ Patients who are able to tolerate
oral fluids must take oral rehydration solution, fruit juice, lime water (sikanji),
coconut water or plain water to prevent rehydration.
§ Patient who are not tolerate oral
fluids need intravenous fluid therapy.
§ Take normal regular diet. Diet should
be low in fat, low fibre, non-irritating and non-carbonated.
§ If the fever is more than 102 degree
F, do continuous cold sponging, till it recovers. If it is not controlled
suitable antipyretics, can also be given safely with Homoeopathic Intervention.
Don’ts—
§ Do not panic; Aspirin/Dispirin/ibuprofen
or other non-steroidal anti-inflammatory agents (NSAIDs) must be avoided, as
these may aggravate gastritis or bleeding.
Management Without Warning Signs:-
The
approach towards patients suffering from dengue/suspected to be suffering from
dengue involves detailed history taking and examination, which includes details
of onset &nature of fever/illness and assessment for warning signs
(hemorrhage from any orifice,hypotension,persistent vomiting, in ability to
tolerate oral fluids).Conditions, in which, dengue is likely to be more severe
must also be identified.
Examination includes assessment of hydration and hemodynamic status
(pulse, systolic and diastolic blood pressure), checking for tachypnoea,
pleural effusion, examination of rash and bleeding manifestations, assessment
of abdominal tenderness, ascites and hepatomegaly.Appropriate investigations
are advised for diagnosis and assessment of disease severity. Individual
characterizing symptoms specially physical and mental generals should be
recorded for the selection of appropriate Homeopathic regimen.
Follow up
of the patients requires strict monitoring for temperature pattern, volume of
fluid intake and losses, urine output (volume and frequency) and appearance of
warning signs. The investigations for hematocrit and platelet counts are
important to assess the progress of each case.
HOMEOPATHIC MEDICINES:-
§ EUPATORIUM PERF:-The chief indication is severe
pains in the bones as if broken all over.Bryonia
is the nearest analogue, having free sweat but pains keep patient quiet, while
eupatorium has scanty sweat and pains make patient restless.
§ BRYONIA ALBA:-Gradual onset of symptoms. Fever
with chilliness predominating, frequently with heat of head, red cheeks and thirst.
Sluggishness, stitching pains, aggravated by motion. Great thirst for large
quantities of cold water at long intervals.
§ GELSEMIUM:-Fever accompanied with dizziness,
drowsiness, dullness, and trembling, patient went to be held because he shakes
so much. Chill without thirst.
§ RHUSTOX:-Fever
with low grade of muttering delirium. Triangular red tip of tongue, loss of appetite,
aversion for food, great thirst.
§ ACONITUM NAPELLUS:-Indicated in the beginning of the disease
when complaints are sudden, violent, with anguish and restlessness. To be
prescribed for fever with skin dry and hot, face red, or pale and red
alternately.
§ BELLADONNA:-Fever
accompanied with heat, redness, throbbing and burning. No thirst with fever.
Cold extremities and throbbing headache
§ ARSENICUM ALBUM:-High temperature. Periodicity marked with marked weakness.
§ FERRUM PHOS:-Remedy
for first stage of fever.Sensitive, pale, Anemic with easy flushing of face.
High fever, skin hot and dry, quick pulse, thirst increased. It can be used
frequently in biochemic doses in 3x/6x potencies in all cases as supportive
drug during fever
§ IPECACUANHA:-Fever
is accompanied with gastric disturbances. Persistent nausea in one or all stages.
Indicated when tongue is clean and there is thirstlessness.
§ NATRUM MURIATICUM:-Fever appears with chill at morning. Violent thirst which increases with
fever. Tongue mapped.
§ NUX VOMICA:-COLD
STAGE PREDOMINATES, PAROXYSMS ANTICIPATED IN THE MORNING.CHILLY ON LAST
MOVEMENT, FROM BEING UNCOVERED, MUST BE COVERED IN EVERY STAGE OF FEVER, CHILL
HEAT OR SWEAT. Frequent desire for stool, ineffectual.
§ PULSATILLA:-Chilliness,
even in warm room, without thirst. Symptoms ever changing. Rapidly shifting
from one part to another. One sided sweat, pains during sweat, during apyrexia,
headache, diarrhea, loss of appetite. Nausea.
The following medicines given on
symptomatic basis help in reducing the hemorrhagic tendency and can improve
platelet counts:-
Crotallus
horridus, Secale cor, Carbo veg, Lachesis, Ipecac, Hamamelis, Ferrum met,
Cinchona off, Millifolium, Phosphorus, Sulphuric acid
PREVENTION OF DENGUE FEVER:-
General Measures-
1.
Personal prophylactic measures:--
§ Use mosquito repellent, creams,
liquids, coils, mats etc.
§ Wear full sleeve shirts and full
pants with socks.
§ Use bed nets for sleeping infants and
young children to prevent mosquito bite.
2. Environmental management source reduction
methods:-
§ Identify & eliminate mosquito
breeding sources.
§ Prevent
collection of water on roof tops, porticos and sunshades.
§ properly cover stored water
§ Frequently change water in water pots, flower vases,
water coolers etc.
§ Waste must be disposed properly and should
not be allowed
3. Biological&chemical control for control of mosquitoes breeding –
§ Use larvivorous fishes in ornamental tanks,
fountains etc.
§ Use biocides or chemical larvicides
for control of mosquitoes breeding.
§ Aerosol space spray.
4. Health education –
Impart knowledge to common people
regarding measures to reduce vector breeding and safeguards for preventing
mosquito bites.
HOMOEOPATHIC MEDICINE-
As per principles of homeopathy,
a genus epidemicus (a drug capable of preventing the diseases) can be
identified in for the sporadic and epidemic situations. The process of
selection of genus epidemicus is a specialized based on analysis of totality of
symptoms; the medicine, which is most frequently indicated and has potential of
providing the quick treatment to the patient, is the genus epidemicus. According
to CCRH (Central council for
Research in Homoeopathy), Eupatorium perf 30 is the
preventive medicine for the majority of the sporadic and epidemic situations
that can be safely taken twice daily for three days as prophylactic.
*Homoeopathy is based on totality of symptoms (TOS), which is thoroughly studied
and a group medicines to be identified. These medicines are required to be
given to the cases on the basis of individualization.
