Find out which groups are at risk for severe dengue – 02/18/2024 – Health

Data from the Ministry of Health released on Thursday (15) show that Brazil passed the mark of half a million cases of dengue, with 532,921 people possibly infected by the Aedes aegypti mosquito.

The evolution of cases and worsening of the disease depend on a series of factors. While common dengue fever is usually self-limiting and can be controlled with treatment to alleviate symptoms, the most serious type of the disease, popularly known as hemorrhagic dengue fever —although the person does not necessarily experience visible bleeding— requires immediate medical intervention and, in some cases, , intensive care to prevent fatal complications.

It is common for, at first, the symptoms of conventional and severe dengue fever to be the same, such as fever, body pain, headache and pain behind the eyes, explains Filipe Piastrelli, coordinator of the Hospital Infection Control Service at Hospital Alemão Oswaldo. Cross. The time when severe forms are most likely to develop is when the fever begins to disappear.

“After four or five days from the onset of symptoms: that’s when the patient has to pay attention to warning signs such as severe abdominal pain, persistent vomiting, postural hypotension [queda súbita na pressão arterial quando o indivíduo se levanta ao estar sentado ou deitado] and possible bleeding”, says Piastrelli.

According to the Butantan Institute, if the symptoms above appear, urgent medical attention should be sought, as the period between 24 and 48 hours later is crucial to avoiding complications and death.

Groups of risk

According to experts interviewed by the report, risk groups for severe dengue include individuals who are already dealing with changes in their blood or have a weakened immune system, such as:

• Elderly;

• Children up to 2 years old;

• Pregnant women;

• Diabetics;

• Hypertensive;

• People with cardiovascular and/or respiratory problems;

• Individuals with a neoplasia problem (such as lymphomas and leukemia).

The greatest likelihood of severe dengue infections, says Filipe Piastrelli, is from the second infection. This happens because there are four serotypes of the dengue virus.

It is only possible to be infected with each subtype once in a lifetime, after which permanent immunity is created for that subtype. However, this immunity does not transfer to the other three.

In a second infection with the virus, there is an increase in the inflammatory response. In an attempt by the person’s immune system to control the infection, it produces an exaggerated response that contributes to a more accelerated progression of the severity of the disease.

The doctor explains, however, that this is not an exact science. This does not mean that a person experiencing the first episode of dengue cannot have a more severe condition and a second infection will not necessarily always be serious.

How to treat a critically ill patient

With regard to prevention, Álvaro Furtado, director of the Sociedade Paulista de Infectologia (SPI) comments that care for risk groups must be the same as that of the population, such as using appropriate repellents, taking care of the house to avoid breeding sites and seeking a service emergency in case of complications.

Treatment needs to be according to the severity of the condition. Hydration is essential and medications must be used individually, with medical supervision, says Silvio Bertin, infectious disease specialist at Hospital Japonês Santa Cruz.

“Today we do not have a specific antiviral treatment for dengue fever. And specific groups, such as patients with heart failure or kidney failure, need individualized guidance, as they cannot receive large volumes of liquid per day due to underlying diseases. People who make regular use of AAS [aspirina] They also need to report this to the doctor”, explains the coordinator of the Hospital Infection Control Service at Hospital Alemão Oswaldo Cruz.

Patients who already have a predisposition need, as with other diseases —such as Covid—, to take care of the underlying disease. “For example, a diabetic patient who does not control the disease properly, when infected, tends to worsen the dengue condition, he will dyscompensate”, explains Bertin.