Dengue Fever, also known as breakbone fever or bone breaker fever, is a mosquito-borne infection that can lead to a severe flu-like illness.
There are four dengue viruses (DENV) that cause dengue fever mainly arbovirus; Dengue fever is systemic disease caused by one of four serotypes of virus from the genus Flavivirus, which also includes the pathogens responsible for yellow fever and Japanese encephalitis.
They are all spread by a species of mosquito known as Aedes aegypti, and more rarely by the Aedes albopictus mosquito.
Aedes aegypti found in tropical areas around the world, especially in and around areas of human population.
The virus is transmitted from an infected mosquito to a human. A healthy mosquito bites a person who is infected with the dengue virus, and the virus is passed on when the mosquito bites someone else. This is called human-to-mosquito-to-human cycle of transmission.
Dengue fever virus (DENV) is an RNA virus of the family Flaviviridae; genus Flavivirus. Most are transmitted by arthropods (mosquitoes or ticks) and are therefore also referred to as arboviruses (arthropod-borne viruses). Once the mosquito becomes infective, it remains so for life. The virus attacks the genital tract of mosquito and start transmitting in the fully developed eggs at the time of oviposition.
It is possible to have dengue fever more than once, and second infection carries a higher risk of developing a harsher form. Mosquitoes that transmit the disease are day-biting, so mosquito netting is of limited usefulness, and the only effective means of control has been to eliminate the Aedes vectors.
Symptoms
sudden onset of the fever five to eight days after a bite from one of several species of Aedes mosquito, including A. Aegyptii, A. albopictus, and A. scutellaris.
After two to four days of severe headache, fever, and muscle aches, the disease eases for 12 to 48 hours before returning with a skin rash, chills, swollen and reddened eyes, and the severe joint pains.
Symptoms range from mild to severe. Severe symptoms include dengue shock syndrome (DSS) and dengue hemorrhagic fever (DHF).
Symptoms include:
- Aching muscles and joints,
- Body rash that can disappear and then reappear,
- High fever,
- Intense headache,
- Pain behind the eyes,
- Vomiting or nausea.
Symptoms usually disappear after a week, and mild dengue rarely involves serious or fatal complications.
Dengue hemorrhagic fever (DHF)
At first, mild symptoms of DHF may be gradually worsen within a few days. As well as mild dengue symptoms, there may be signs of internal bleeding.
A patient with Dengue hemorrhagic fever may experience:
- Bleeding from the mouth, gums, or nose,
- Clammy skin,
- Damage to lymph and blood vessels,
- Internal bleeding, which can lead to black vomit and feces, or stools,
- A lower number of platelets in the blood,
- Sensitive stomach,
- Small blood spots under the skin,
- Weak pulse.
Without prompt treatment, dengue hemorrhagic fever can be fatal.
Dengue fever shock syndrome (DSS)
DSS is a severe form of dengue and can be fatal.
Apart from symptoms of mild dengue fever, the patient may experience:
- Intense stomach pain
- Disorientation
- Sudden hypotension (drop in blood pressure)
- Heavy bleeding
- Regular vomiting
- Blood vessels leaking fluid
Without treatment of course this can result in death, but a small number of cases will progress to the hemorrhagic form, in which bleeding from multiple organs and mucosal surfaces occurs, the mortality is about 5-7 percent.
Dengue is a virus, in allopathic drugs there is no specific treatment or cure (for all viruses). However, intervention can help, depending on how severe the disease is, while in Homoeopathic medicine there is very effective treatment for dengue.
P.S: Allopathic Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, are not advised, as they can increase the risk of internal bleeding.
Avoid blood transfusion, it will decrease patient’s immune system and of course lifespan. (Dr. Qaisar Ahmed MD, DHMS)
Hospitalization will allow the individual to be properly monitored, in case symptoms get worse.
High-risk areas
Dengue fever is most common in subtropical and tropical areas.
Unlike malaria, dengue can happen in both urban areas and rural areas but is more common in rural areas.
Diagnosis
The signs and symptoms of dengue fever are similar to typhoid fever and malaria. (This can sometimes delay an accurate diagnosis).
Patients with known or suspected dengue fever should have their platelet count and hematocrit measured daily from the third day of illness until 1-2 days after defervescence.
- NS1 is a diagnostic test for Dengue. The test is usually positive in first 4-5 days of fever.
- CBC is used to monitor patients suffering from Dengue fever.
- Molecular tests for dengue virus (PCR)—detect the presence of the virus itself; these tests can diagnose dengue fever up to 7 days after the onset of symptoms and can be used to determine which of the 4 different serotypes of dengue virus is causing the infection.
- Antibody tests, IgM and IgG—detect antibodies produced by the immune system when a person has been exposed to the virus; these tests are most effective when performed at least 4 days after exposure.
- Complete blood count (CBC)—to look for low platelet count typical of the later stages of the illness and to detect the decrease in hemoglobin, hematocrit, and red blood cell (RBC) count (evidence of anemia) that would occur with blood loss associated with severe dengue fever.
- Basic metabolic panel (BMP) – to monitor kidney function and look for evidence of dehydration that can occur with severe illness.
For milder forms, treatment includes:
Preventing dehydration:
A high fever and vomiting can dehydrate the body. The person should drink clean water, Rehydration salts can also help replace fluids and minerals, if needed intravenous (IV) fluid transmission should be advised.
Allopathic Treatment for Dangue Fever 
No specific antiviral medication is available to treat dengue. The treatment of dengue fever is symptomatic and supportive in nature. Bed rest and mild analgesic-antipyretic therapy often are helpful in relieving lethargy, malaise, and fever associated with the disease. Acetaminophen (paracetamol) is recommended for treatment of pain and fever. Aspirin, other salicylates, and nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided.
Patients with clinical signs of dehydration and patients with a rising hematocrit level or falling platelet count should have intravascular volume deficits replaced under close observation. Those who improve can continue to be monitored in an outpatient setting, and those who do not improve should be admitted to the hospital for continued hydration.
Intravascular volume deficits should be corrected with isotonic fluids such as Ringer lactate solution. Boluses of 10-20 mL/kg should be given over 20 minutes and may be repeated. If this fails to correct the deficit, the hematocrit value should be determined. If it is rising, limited clinical information suggests that a plasma expander may be administered. Starch, dextran 40, or albumin 5% at a dose of 10-20 mL/kg may be used. One study has suggested that starch may be preferable because of hypersensitivity reactions to dextran. If the patient does not improve after infusion of a plasma expander, blood loss should be considered. Patients with internal or gastrointestinal bleeding may require transfusion, and patients with coagulopathy may require fresh frozen plasma.
Intravenous fluids should be stopped when the hematocrit falls below 40% and adequate intravascular volume is present. Platelet and fresh frozen plasma transfusions may be required to control severe bleeding. Anti-D globulin administration to raise platelet counts.
Dengue vaccine (Dengvaxia)
Indicated for prevention of dengue disease caused by dengue virus serotypes 1, 2, 3, and 4 in individuals aged 9-16 years with laboratory-confirmed previous dengue infection who live in endemic areas. It is approved only in individuals previously infected by any dengue virus serotype or in whom this information is unknown. Persons not previously infected are at an increased risk of severe dengue disease when vaccinated and subsequently infected with dengue virus. Immunization is a series of 3 SC injections administered 6 months apart.
Vaccine Dengvaxia (CYD-TDV) has bad results (not successful results).
Plasma volume expanders are used in the treatment of intravascular volume deficits or shock to restore intravascular volume, blood pressure, and tissue perfusion.
Dextran 40 (LMD)
Dextran 40 is a polymer of glucose. It increases intravascular volume, blood pressure, and capillary perfusion. It is used to restore intravascular volume when isotonic crystalloid administration is inadequate for that purpose.
Albumin (Albuminar-5, Buminate, Plasbumin 5)
Human albumin solution is the major plasma protein responsible for the colloid oncotic pressure of blood. Infusion of albumin results in a shift of fluid from the extracellular space into the bloodstream, thereby decreasing hemoconcentration and blood viscosity.
Albumin may be administered wide open when treating shock. Patient response must be assessed before repeating the dose.
Hetastarch (Hespan, Hextend)
Hydroxyethyl starch solution is responsible for the colloid oncotic pressure of blood. Hetastarch produces volume expansion through its highly colloidal starch structure.
Homeopathic Treatment of Dengue Fever 
Homeopathy has successful and well proven medicine for dengue fever from years.
Homeopathic nosod “Dengueinum” in regular therapy and as Vaccine (advise in heigh) gives best results.
Eupatorium Perfoliatum:
Back, pain in. Bilious fever. Bones, pains in. Cough. Dengue, Intermittent fever, Relapsing fever, Remittent fever, Spotted fever, Bilious fever, Jaundice, Hepatomegalia, Hepatic pain, Hepatic digestion problems. Diarrhea. Gout. Hiccough. Hoarseness. Indigestion. Influenza. Measles, Herpes zoster, Ringworms, Mouth/lips cracking. Ophthalmia. Rheumatism. Syphilitic pains. Thirst.
Gelsemium:
Anterior corral neuralgia. Aphonia. Brain affections like Cerebro-spinal meningitis. Hysteria. Locomotor ataxia. Mania. Meningitis. Hydro-salpingitis. Nystagmus. Nystagmus. Paralysis. Paralysis agitans. Paraplegia. Convulsions. Puerperal convulsions. Fright. Tremors. Deafness. Insomnia.
Choroiditis. Colds. Dengue fever, Bilious fever, Influenza, Remittent fever, Enteric fever or Typhoid fever. dengue fever. Intermittent fever. Jaundice. Hay-fever. Sun stroke and sun headache. Labour. Liver affections. Dysentery. Diarrhea. Diphtheria. Constipation. Measles. Dupuytren’s contractions.
Bryonia Alba
Bilious attack. Bronchitis. Chlorosis. Coryza. Influenza. Cough. Dyspepsia. Eczema. Enteric fever. Dengue fever. Intermittent fevers. Miliaria. Eruptions. Jaundice. Joints pain. Hepatic malfunctioning. Lumbago. Measles. Meningitis. Menstruation, vicarious. Milk fever. Myalgia.
Rhus Tox
Dengue fever. Low appetite. Bones pain. Dyspepsia. Cyanosis. Enteric fever or Typhoid. Typhus. Intermittent fever. Relapsing fever. Measles. Herpes zoster. Influenza. Pneumonia. Hepatic abscess. Scarlatina. Smallpox. Urticaria.
China Officianalis
Debility from exhausting discharges, from loss of vital fluids. Fever – Intermittent, paroxysms anticipate; return every week. Dengue fever – any stage. Chill generally in forenoon, commencing in breast; thirst before chill, and little and often. Debilitating night-sweats. Free perspiration caused by every little exertion, especially on single parts. Hay fever, watery coryza, pain in temples.
Margosa Bark or Azadirachta Indica
An afternoon fever and rheumatic pains in various parts are caused by this remedy. Pain in sternum and ribs, in back and shoulders and extremities; heat, pricking and aching in hands, especially palms, fingers, also toes. Splenomegaly. Spleen congested. Dengue fever. It is especially useful in cases previously maltreated with allopathic quinine.
Granatum 
Partial and semi-lateral shuddering, sometimes with semi lateral headache. Dry, burning heat over the whole body, with inclination to throw off all covering. Dengue fever. The shuddering and shivering commonly take place in the morning; the heat manifests itself in the evening. Sweats on the least movement. Appetite alternately diminished and increased.
Phosphorus
Chilly every evening. Cold knees at night. Adynamic with lack of thirst, but unnatural hunger. Hectic, with small quick pulse; viscid night-sweats. Stupid delirium. Profuse perspiration. Sour mouth taste and sour eructation after every meal. Dengue fever. Liver congested. Acute hepatitis. Fatty degeneration. Jaundice. Pancreatic disease. Large yellow spots on abdomen.
Tinosporia Cardofolia
Fevers; seminal debility; dyspepsia, jaundice, urinary problems, skin diseases, diarrhea and dysentery; heart diseases; leprosy; helminthiasis and rheumatoid arthritis; splenic affections; secondary syphilis; Genito-urinary problems; gonorrhea. In malaria (acute and chronic) it is more efficacious than quinine, also used in intermittent fever and dengue fever.
Trigonella foenum graecum
Mucilaginous, demulcent, diuretic, tonic, carminative, emmenagogue, astringent, emollient and aphrodisiac. Useful for fatigue, weight loss colic, flatulence, dysentery, diarrhea, anorexia, cough, dropsy, enlargement of liver and spleen, dengue fever, rheumatism, lymphatics, rickets, anemia, and diabetes. External swellings and burn.
Alstonia Sclerosis or Alstonia Constricta
Malarial diseases, with diarrhea, dysentery, anemia, feeble digestion. Gone sensation in stomach and sinking in abdomen, with debility. A tonic after exhausting fevers. Violent purging and cramp in bowels. Heat and irritation in lower bowels. Diarrhea from bad water dengue fever and malaria. Painless watery stools. Diarrhea immediately after eating.
Aletris Farinosa
Late stages of dengue fever. Anemic, relaxed condition, the patient is tired all the time, and suffers from prolapsus, leucorrhea, rectal distress, etc. Chlorotic. Power and energy weakened. Confused feelings. Cannot concentrate mind. Fainting, with vertigo.
Much frothy saliva. Disgust for food. Least food causes distress. Fainting spells, with vertigo. Vomiting. Nervous dyspepsia. Flatulent colic. Rectum loads up with feces-paretic condition. Stool large, hard, difficult, great pain.
Premature and profuse menses, with labor-like pains. Uterus seems heavy. Prolapse, with pain in right inguinal region. Hepatomegaly. Splenomegaly. Leucorrhea due to weakness and anemia. Muscular pains.
Cedron
Periodicity is the most marked characteristic of this medicine. Its particularly useful in tropical or in damp, warm, marshy countries. It has been found curative in dengue fever, malarial affections, especially neuralgia. Adapted to persons of a voluptuous disposition, excitable, nervous temperament. Antidoting snakebites and stings of insects. Mania.
Severe headaches. Migraine – pain over whole right side of face. Roaring in ears produced by Cinchona. Whole body seems numb with headache. Lancinating pain in joints; worse, feet and hands. Chilliness towards evening; then frontal headache extending into parietal region. Dengue fever. Heat, with itching of eyes, tearing in limbs, numbness of limbs.
Ceanothus Americanus 
Specific for the spleen. Ague cake of malaria. Dengue fever. Anemic patients where liver and spleen are at fault. Active hemostatic, materially reducing the clotting of blood. Enormous enlargement of the spleen. Splenitis; pain all up the left side. Deep-seated pain in left hypochondrium, hypertrophy of spleen. Leukemia. Violent dyspnea. Menses profuse, and yellow weakening leucorrhea. Unable to lie on left side – splenomegaly. Hepatic pain. Diarrhea. Constant urging to urinate. Green; frothy; contains bile, sugar.
Cornus Circinat
Chilliness, with nausea, dull pain in head, debility, and languor. Chilly – followed by transient flushing. Flushes of heat and coldness in alternation, followed by cold perspiration. Paroxysm preceded for days by sleepiness, dull, heavy headache, sluggish flow of ideas; slight exercise causes sweat and great fatigue: during apyrexia, debility and painful diarrhea; first moderate heat, then light sweat, ending with a crawling sort of chill; when all the stages seem aborted, and the patient says the chills amount to nothing; weak, languid, and loss of appetite. Dengue fever. Chronic ulceration of mouth and throat. Liver derangement with aching eyeballs. Disturbed sleep.
Leptandra
Chilly along spine and down arms – in wet and damp weather. Shivering, or dry, hot skin; limbs cold and numb; tongue black down center. Bilious typhoid fever. Dengue fever. Dry, hot skin. Weary, can hardly walk. Chilly sensation in shoulders and down back. Back pain. Burning distress in back part of liver and spine. Periodical liver derangement, every two or three months. Malignant disease of liver with black, tarry stools. Deliriousness; complete prostration; heat and dryness of skin; cold extremities; fetid, tarry stools; tongue thickly coated with black streak down center. Jaundice with clay-colored stools. Sharp, distressing pains between navel and epigastrium (hepatic). Profuse watery stools, followed by severe cutting pains in small intestines.
Fagopyrum
Chills along back in afternoon. Liver diseases. Heat and restlessness after retiring. Face, head, and hands burn in afternoon. Hands and feet alternately hot and cold. Cold, clammy sweat at night; very profuse. Soles of feet moist; disagreeable odor in axillae. Dengue fever. During the day occasional eructation of scalding, acid, watery substance, so hot as almost to cause strangulation. Nausea. Uneasy, empty feeling in stomach.
Bad taste in mouth in morning. Taste of ingesta after dinner with eructation. Hepatic pain. Abdomen distended with flatulence; tympanitic. Soreness in hypogastrium; sharp pains through hypogastric region extending into left inguinal region. Burning in rectum after stool; creeping; urging; tenesmus. Diarrhea with tenesmus; stools watery or pappy; with flatulence; very offensive.
Myrica Cerifera
Marked action on the liver, with jaundice and mucous membranes. Dull liver pain. Persistent sleeplessness. Irritable, indifferent. Gloomy. Headache, with drowsiness; yellow sclerotic; aching in eyeballs. Pressure in vertex and forehead. Dull, heavy aching in temples and forehead. Pain and stiffness in nape of neck.
Tongue furred, with bitter taste in mouth, and nausea, offensive breath. Tenacious, thick, nauseous secretion. Tender, spongy and bleeding gums. Constant desire to swallow. Stringy mucus; detached with difficulty. Complete loss appetite. Weak, sinking feeling in the epigastrium. Dengue fever.
Urinary dark, frothy, scanty, high-colored, biliary. Staggering gait. Pain under shoulder-blades and back of neck, in all muscles, in hollow of right foot.
Ferrum Metallicum 
Frequent shivering of short duration. Shivering with violent thirst, preceded or accompanied by headache. Chill with thirst and red, hot face. Dry heat, with urgent inclination to throw off all covering. Pulse full and hard. Fever, with congestion in the head, puffing round the eyes, swelling of the veins, vomiting of food, short respiration and paralytic weakness. Dengue fever. Copious perspiration, excited by the least movement during sleep. Nocturnal perspiration of a strong smell. Colliquative, clammy sweat.
Berberis Vulgaris
Shivering before dinner, and sometimes after, with feet icy cold, mouth dry and clammy, and pains in the left side of the epigastrium. Splenomegaly. Dengue fever. Shivering, followed by burning heat, with giddiness and violent shooting pains in the head, and sore throat; on the third day, sweat, smelling like urine. temperature, continuing for several days. Pulse slow and weak, or full, hard and rapid.
Phosphoricum Acidium
The common acid “debility” is marked in this medicine. Nervous exhaustion. Mental debility first; later physical. Whenever the system has been exposed to the ravages of acute disease, excesses, grief, loss of vital fluids, we obtain conditions calling for it. Pyrosis, flatulence, diarrhea, diabetes, rachitis and periosteal inflammation. Neurosis in stump, after amputation. Hemorrhages in typhoid, dengue fever.
Ipecac
Severe headache, Nausea, Vomiting, State of vision constantly changing, Cyanotic, Coreza, Severe cough, cough with sputum, Intermittent fever, Chill, ever body pain sometimes with jerking, Dysentery.
Arsenic Album
Abscess. Anemia, Bronchitis. Cholera Asiatica. Cholera. Cold. Coldness. Delirium tremens. Diarrhea. Diphtheria. Dropsy. Dengue fever. Duodenum. Vomiting. Glandular swellings. Enteric fever. Typhoid. Fainting. Traumatic fever. Typhus. Fever. Headache. Hectic fever. Intermittent fever. Shivering, Yellow fever, jaundice. Neuralgia. Remittent fever. Rheumatic gout. Rheumatism. Rickets. Ringworm. Scalded. Scarlatina. Scrofulous affections.
China
Hectic fever. Dengue fever. Intermittent fever. Hectic fever. Traumatic fever. Jaundice. Liver diseases, cirrhosis. Meniere’s disease, Psoriasis, Spleen affections, Gall-stone colic. Debility. Delirium. Diarrhea. Dropsy. Dyspepsia. Ears – deafness, tinnitus. Empyema. Erysipelas. Facial neuralgia. Hemorrhages. Hemorrhoids. Headache.
Carica Papaya
Severe temperature, breathing problem, severe vomiting, red skin, shivering, sever body pain and high blood pressure, lachrymation, vomiting, low appetite, fatigue, hepatomegaly, splenic affections and pain. Dengue fever.
Many plants extracts including Spilanthes calva, Sterculia guttata, Balanites aegyptiaca, Vitex negundo, Solanum xanthocarpum, Artemisia annua, Fagonia indica, Nerium indicum, in different solvents have been reported to exhibit activity against Aedes aegypti L., a vector of dengue fever.
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