The treatment of dengue fever primarily focuses on symptom relief, prevention of complications, and supportive care. Currently, there are no specific antiviral drugs that can directly eliminate the dengue virus, so treatment strategies are centered on managing symptoms. Patients need to closely monitor vital signs, especially within the critical 24 hours after the fever subsides, to reduce the risk of hemorrhagic symptoms or shock.
The goals of treatment include maintaining fluid balance, controlling pain and fever, and promptly managing severe cases. Mild cases can recover through home care, but if warning signs such as thrombocytopenia or severe abdominal pain appear, hospitalization for specialized medical treatment is necessary. The overall treatment process should be stratified according to the severity of the condition, emphasizing early recognition and immediate intervention.
Clinical treatment mainly involves supportive care, including fluid supplementation, fever reduction, and pain management. Patients with mild symptoms are usually advised to take oral rehydration solutions, while those with severe dehydration or bleeding tendencies require intravenous injections. The medical team will monitor blood counts and liver and kidney functions through blood tests, and assess for signs of internal bleeding.
The treatment process is adjusted in stages: antipyretics are used during the febrile phase to control temperature, and during the shock phase, volume resuscitation is intensified. Severe cases may require platelet or plasma transfusions, but the risks of bleeding and coagulation status must be carefully evaluated. Treatment plans should be individualized based on age, underlying conditions, and symptom severity.
Acetaminophen (Paracetamol) is the first-line antipyretic, with doses controlled within safe limits to avoid liver burden. The use of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) is strictly prohibited, as they may exacerbate bleeding tendencies. Medication use should be accompanied by temperature monitoring to prevent hypothermia.
For pain management, physical cooling methods such as cold compresses can be combined to reduce reliance on medication. Physicians will adjust dosages based on liver and kidney function, especially in patients with chronic illnesses.
Currently, there are no FDA-approved antiviral drugs, but several new drugs are in clinical trials. For example, Favipiravir has shown potential in laboratory tests to inhibit viral replication, but more data are needed to confirm clinical efficacy. Other research directions include interferon inducers and monoclonal antibody therapies, most of which are still in Phase III clinical trials.
Oral rehydration salts (ORS) are fundamental, with small frequent sips effectively preventing dehydration. Patients with severe dehydration require intravenous fluids containing glucose and electrolytes, avoiding hypertonic solutions to prevent tissue edema. Daily fluid intake should be dynamically adjusted based on body weight and urine output.
For nutritional support, it is recommended to consume small, frequent meals rich in potassium, such as bananas and coconut water, to replenish electrolytes lost due to fever. High-sugar beverages or caffeinated drinks should be avoided as they may worsen gastrointestinal discomfort.
During the acute phase, complete bed rest is necessary to prevent increased body temperature due to overactivity. During recovery, gradually increase activity levels but avoid vigorous exercise for at least two weeks. Physical therapists may design light rehabilitation exercises to help relieve muscle soreness.
Environmental adjustments include maintaining good ventilation in the patient’s room and using mosquito nets to prevent reinfection from other vector-borne diseases. Family members should strengthen mosquito prevention measures, such as using insect repellent and removing standing water containers.
Adopt the BRAT diet (Bananas, Rice, Applesauce, Toast) to alleviate gastrointestinal discomfort. In the advanced stage, gradually add easily digestible protein sources such as eggs and tofu. Avoid dairy products and high-fiber foods, as they may worsen vomiting.
The dengue vaccine Dengvaxia has been approved in some regions but must be administered cautiously due to antibody-dependent enhancement (ADE) mechanisms. Newer vaccines like TAK-003, which use a tetravalent virus formulation, are undergoing long-term follow-up studies in multiple countries, aiming to improve cross-serotype protection.
Small molecule inhibitors such as TMB-855 are in Phase III clinical trials, targeting the NS2B-3 protease essential for viral replication. Gene therapy approaches focus on disrupting viral RNA replication mechanisms, with BCX4430 showing reduced viral loads in animal experiments.
If the following warning signs occur, seek medical attention immediately:
If fever recurs after subsiding or blood pressure remains low, transfer to intensive care is necessary. Physicians will evaluate bleeding tendency indices based on WHO diagnostic criteria and may administer plasma volume expansion therapy.
If symptoms do not improve within 72 hours of home care, re-evaluate with a healthcare provider. Pregnant women and those over 65 require more stringent monitoring due to potential differences in immune response.
If the patient exhibits severe abdominal pain, persistent vomiting, rapid breathing, cold limbs with pallor, or significantly decreased urine output, it indicates progression to dengue hemorrhagic fever or shock, requiring immediate medical attention. Altered consciousness or agitation also constitute emergencies and should be taken to the hospital promptly.
Which pain relievers are safe during dengue infection?It is recommended to avoid aspirin, ibuprofen, and other NSAIDs due to their potential to increase bleeding risk. Paracetamol (acetaminophen) can be used to relieve headaches or muscle pain, but doses should follow medical instructions. Always consult a physician before medication use.
How effective is community-wide cleaning in preventing dengue transmission?Removing standing water containers effectively reduces mosquito breeding sites. Regular community cleaning, combined with outdoor spraying and public education, has been proven to significantly decrease outbreak risks and is an essential part of integrated vector control.
How long after recovery from dengue can one resume normal activities?It is recommended to rest for at least 1 to 2 weeks after recovery, until fatigue subsides and platelet counts normalize. Gradually resume light activities, avoiding strenuous exercise until the physician confirms full recovery, to prevent secondary bleeding risks.
Does previous dengue infection confer immunity to other serotypes?Dengue has four serotypes; infection with one provides immunity only to that serotype. Infection with a different serotype can occur again and may increase the risk of severe disease. Therefore, individuals who have had dengue should continue strict mosquito prevention measures and not underestimate the risk.
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