Many cases of severe dengue fever and dangerous complications across the country

Currently, in some localities, the dengue fever situation is increasing rapidly with many outbreaks and "hot spots" of the disease. Hospitals in many localities have recorded many severe cases, complicated developments, dangerous complications with high risk of death.

The epidemic is increasing rapidly.

According to the Dak Lak Provincial Center for Disease Control, since the beginning of the year, the province has recorded more than 1,230 cases of dengue fever in 15/15 districts, towns and cities. The epidemic situation has increased very quickly, especially in July and early August.

Director of the Dak Lak Province Center for Disease Control Hoang Hai Phuc said that dengue fever is increasing rapidly with many alarming outbreaks. The area with the highest number of cases is Buon Ma Thuot city; followed by Krong Pac, Ea Kar and Cu M'Gar districts.

These are the four “hot” areas for dengue fever. In particular, last week, in Cu M’Gar district, dengue fever patients increased rapidly, small outbreaks spread, recorded in many places.

According to Mr. Hoang Hai Phuc, the reason for the sudden increase in dengue fever is that this is the rainy season in the Central Highlands provinces. Continuous rain in July causes mosquitoes to breed and develop strongly, leading to an increase in the number of cases.

In Hai Phong, in July 2024, the city recorded 4,307 cases of dengue fever, an increase of 1,890 cases compared to the previous month. Districts with high numbers of cases include: Le Chan (1,900 cases), Hai An (745 cases), Ngo Quyen (663 cases), Kien An (195 cases), An Duong (192 cases).

In the first 7 months of 2024, Hai Phong recorded 7,118 cases, an increase of 7,007 cases compared to the same period last year. The cases were mainly concentrated in inner-city districts such as: Le Chan (3,574 cases), Hai An (1,160 cases), Ngo Quyen (901 cases), Kien An (295 cases), An Duong (307 cases)...

Also in July, the city recorded 501 new dengue fever outbreaks, bringing the total number of outbreaks to 2,242 (accumulated from the beginning of the year until now), of which the number of active outbreaks was 352, the number of outbreaks that had stopped operating was 1,890 (with 456 outbreaks recording secondary patients).

Notably, the main vector of the disease is the Ae. Aegypti mosquito, which was previously only recorded in Cat Ba, but has now been discovered in many inner and outer city districts (such as Le Chan, Ngo Quyen, Hai An, Hong Bang, An Duong, Vinh Bao...).

In July and early August, many hospitals in the localities received severe cases of dengue fever, with complicated developments, many warning signs and dangerous complications, and a high risk of death. The Department of Infectious Diseases of the Central Highlands General Hospital received and treated more than 300 patients with dengue fever; of which, nearly 50 patients had severe dengue fever, more than 130 people had warning dengue fever.

The Department of Pediatric and Neonatal Intensive Care (Tay Nguyen General Hospital) also received 41 cases of severe dengue fever. Compared to the same period last year, the number of hospitalizations was lower, but all cases were in serious condition, shock and re-shock.

At the Tropical Disease Center, Bach Mai Hospital, in July, dozens of dengue fever cases with warning signs were admitted to the hospital.

“The difference this year is that in suburban areas of Hanoi such as Hoai Duc, Dan Phuong, Phuc Tho,… and provinces such as Hai Phong, Hai Duong, Thai Binh… dengue fever cases seem to occur earlier and more severely than in previous years,” said Associate Professor, Dr. Do Duy Cuong, Director of the Center for Tropical Diseases.

A male patient (25 years old, in Hoang Mai, Hanoi) had a fever for 5 days and was hospitalized. He tested positive for Dengue fever. During treatment, the patient developed severe liver failure, rapid platelet drop, and blood thickening.

Another patient, 66 years old, in Tuong Mai, Hoang Mai (Hanoi), had intermittent high fever (39 degrees), headache, body aches, knee pain, dry hemoptysis and blood in urine.

Another patient is a 39-year-old male, Hoai Duc (Hanoi), with a fever for 5 days, admitted to the hospital in a serious condition, with blood concentration, cold, moist skin, and rapid pulse.

Patients who are being treated intensively at the Tropical Disease Center, according to specific protocols, have gradually improved and can be discharged in the next few days. Besides, there are also patients in critical condition, with poor prognosis, especially in the elderly, those with underlying diseases...

Stages of the disease

Dengue fever is an infectious disease caused by the dengue virus.

Dengue hemorrhagic fever is characterized by fever, hemorrhage and plasma leakage, which can lead to hypovolemic shock, coagulation disorders, organ failure, and if not diagnosed early and treated promptly, can easily lead to death. Dengue virus has 4 types: DEN-1, DEN-2, DEN-3 and DEN-4.

The virus is transmitted from infected people to healthy people through mosquito bites. The Aedes aegypti mosquito is the main vector. The disease occurs in both children and adults, occurs year-round, and often increases during the rainy season.

“Dengue fever has diverse clinical manifestations, progressing rapidly from mild to severe. The disease usually starts suddenly and progresses through three stages: the febrile stage, the dangerous stage and the recovery stage.

Early detection of the disease and understanding the clinical problems in each stage of the disease helps in early diagnosis, correct and timely treatment, to save the patient's life," said Associate Professor, Dr. Do Duy Cuong.

According to Associate Professor, Doctor Do Duy Cuong, the clinical fever stage will have symptoms such as sudden, continuous high fever. Headache, loss of appetite, nausea. Skin congestion. Muscle pain, joint pain, pain in both eye sockets. Often there are petechiae under the skin, bleeding gums or nosebleeds.

Paraclinical Hematocrit (Hct) is the index of red blood cells in normal blood. Platelet count is normal or gradually decreasing (but still above 100,000/mm3). White blood cell count is often decreased.

The dangerous stage is usually on the 3rd to 7th day of the disease. The patient may still have a fever or the fever may have subsided. There may be the following symptoms: Severe and continuous abdominal pain or increased pain, especially in the liver area. Vomiting. Signs of plasma leakage due to increased vascular permeability (usually lasting 24 - 48 hours). Pleural effusion, interstitial fluid (can cause respiratory failure), peritoneum, eyelid edema.

If there is a lot of plasma leakage, it will lead to shock with symptoms such as restlessness, restlessness or lethargy, cold extremities, rapid and weak pulse, stuck blood pressure or low blood pressure, unmeasurable blood pressure, undetectable pulse, cold skin, purple veins (severe shock), and little urine.

Subcutaneous hemorrhage: Scattered petechiae or hemorrhages usually on the front of the legs and the inside of the arms, abdomen, thighs, flanks or purple patches. Mucosal hemorrhage such as bleeding gums, nosebleeds, vomiting blood, passing black or bloody stools, vaginal bleeding or hematuria.

Severe bleeding: Severe nosebleeds (requiring packing or hemostatic gauze), severe vaginal bleeding, bleeding in muscles and soft tissues, bleeding in the gastrointestinal tract and internal organs (lungs, brain, liver, spleen, kidneys), often accompanied by shock, thrombocytopenia, tissue hypoxia and metabolic acidosis that can lead to multiple organ failure and severe intravascular coagulation.

Severe bleeding can also occur in patients taking anti-inflammatory drugs such as acetylsalicylic acid (aspirin), ibuprofen or corticosteroids, a history of gastric or duodenal ulcers, or chronic hepatitis.

Some severe cases may have organ failure such as severe liver damage/liver failure, kidney, heart, lung, brain, impaired consciousness, failure of other organs. These severe manifestations can occur in patients with or without shock due to plasma leakage.

Recovery phase: Usually from day 7 to day 10. Fever decreases, platelets gradually increase again, frequent urination, appetite returns. The recovery period can last for months.

The Director of the Center for Tropical Diseases noted that when there are signs of sudden, continuous high fever that does not subside, headache, body aches, patients need to go to medical facilities for doctors to examine, test and evaluate the signs and symptoms.

Dengue fever needs to be diagnosed and treated early, avoid taking medicine and IV fluids at home on your own.