The Hidden Dangers of Dengue: It’s More Than Just a Fever

WORDS LIM TECK CHOON

FEATURED EXPERT DR SHANTHI RATNAM Consultant Physician and Intensivist Thomson Hospital Kota Damansara

Many people think of dengue as a mild illness, but the reality can be far more serious.

Severe dengue often requires hospitalization and can lead to internal bleeding, organ damage, and even death. What’s more, a second infection is more likely to be severe.

However, there’s another aspect of dengue that’s less well-known: post-dengue syndrome. This condition can leave lasting effects long after the initial infection has passed.

BAHWANEE’S LONG ROAD TO RECOVERY

Bahwanee Muthusamy’s experience with dengue fever was the beginning of a challenging journey that has lasted over 6 months.

“This was my second bout of dengue,” Bahwanee recalls. “At first, it seemed like just a mild fever but within a day, I had a terrible headache, vomiting, and diarrhoea. My platelet count dropped dangerously low.”

Bahwanee’s condition quickly became critical, affecting her liver. She spent 2 weeks in the hospital and another 2 months on medical leave.

Even simple tasks like driving or sitting up for long periods were impossible due to nerve compression in her lower back.

WHAT IS POST-DENGUE SYNDROME?

Dr Shanthi Ratnam explains that Bahwanee’s experience is known as post-dengue syndrome (PDS).

“It’s when symptoms of dengue fever persist for more than 6 weeks after the acute phase,” she says. “We’re still learning about how common it is, but some studies suggest it could affect between 18% and 50% of dengue patients.”

PDS can cause a range of symptoms, including:

• Mild to overwhelming fatigue
• Muscle and joint pain
• Swelling of the joints (reactive arthritis)
• Poor concentration
• Dizziness

The challenge with PDS is that there’s no specific test to diagnose it. Doctors must rule out other possible causes before concluding that a patient has PDS.

LONG-TERM IMPACT OF PDS

PDS has turned Bahwanee’s life upside down.

“It’s affected everything,” she says. “Simple actions like climbing stairs are now exhausting. I can’t work like I used to. I’m dealing with hormonal issues, hair loss, and a weakened immune system. It’s been a nightmare.”

Dr Shanthi points out that PDS can also take a toll on mental health.

“It can severely affect a person’s quality of life,” she explains. “This is true especially for young, active people. The constant fatigue, pain, and inability to resume normal activities can be depressing.”

WHO IS AT RISK OF PDS?

While anyone can develop PDS, some groups are at higher risk:

• Elderly patients
• People with existing health conditions like hypertension, heart disease, obesity, or autoimmune diseases
• Those who have had dengue before

RECOVERING FROM PDS

For people that are recovering from dengue, Dr Shanthi recommends the following:

• Get plenty of rest. It is good to get 8 to 10 hours of sleep per night.
• Eat a balanced diet rich in fruits and vegetables.

She also offers advice for caregivers of the following groups of people.

• Children. Keep them home from school for a week before gradually resuming normal activities.
• Older adults. Encourage frequent naps and sufficient nighttime rest.
• People with diabetes or high blood pressure. Monitor blood pressure closely and consult with a doctor about medication adjustments.
• People at high risk of bleeding. Watch for warning signs like dark, sticky stools.

GIVEN THE LONG-TERM IMPACT OF DENGUE, PREVENTION IS CRUCIAL

Dr Shanthi emphasizes the need for a comprehensive approach such as:

• Eliminate mosquito breeding grounds, such as standing water in containers and rain gutters.
• Consider innovative preventive strategies like the dengue vaccine.

About the Dengue Vaccine

The dengue vaccine, recently approved in Malaysia, is now available in private clinics and hospitals.

It’s given in 2 doses, 3 months apart.

Dr Shanthi recommends it for high-risk groups such as:

• Elderly people with other health conditions
• Obese individuals
• People with high blood pressure, heart disease, or autoimmune conditions
• People taking medications that can affect their immune system

Even those who have had dengue before, like Bahwanee, can get the vaccine 6 months later for protection against other strains of the dengue virus.

A CALL TO ACTION

Both Dr Shanthi and Bahwanee stress the importance of taking dengue seriously.

“We need to renew our commitment to fight dengue on all fronts,” says Dr Shanthi.

Bahwanee adds: “Dengue is often dismissed as merely a fever but look at what happened to me. I’m so glad there’s a dengue vaccine now because dengue is everywhere, so no one is safe. We need to take it seriously and be proactive to combat this threat together.”