Dengue is one of the most widespread diseases in the world with a 30-fold increase in incidence in the last 50 years. In India, dengue is endemic to almost all states and is one of the leading causes of hospitalization. There are approximately 50 million dengue cases yearly all over the world out of which 4.4% are older adults. Older adults are also more likely to have hepatomegaly (enlarged liver) and lethargy as compared to younger people. Seniors are also likely to have a more severe infection accompanied by dengue haemorrhagic fever (DHF), severe dengue (SD), and hence may need hospitalization. This increases their chance to contract hospital-acquired infections (HAI) too.
What are the typical symptoms of dengue?
- Sudden high fever
- Severe headaches
- Severe joint pain
- Muscle pain
- Pain behind the eyes
- Rash that appears two to five days after the fever
- Mild bleeding from nose or gums
In older adults, symptoms like joint pain and muscle pain might be passed off as age-related aches and pains, thus delaying diagnosis. In general, older adults and people with weakened immune systems are at greater risk of developing dengue haemorrhagic fever. Multiple appearances of dengue in earlier years also increases the risk of DHF.
How can dengue be managed in older adults?
Management of dengue and prevention of dengue-related mortality is difficult as symptoms of dengue present atypically in older people. Typically, early diagnosis and intervention are necessary. Many times, fever is the only symptom and leukopenia (deficiency of white blood cells) is not as common as in younger adults. In general, older adults have reduced sensitivity and because of the absence of typical dengue symptoms, there is the likelihood of delayed diagnosis. The absence of typical symptoms is due to age-related decline in immune function that changes disease presentation.
Treatment for Dengue
There is no specific treatment for dengue. If you think you have dengue, consult your doctor who will confirm the infection after a few blood tests. They will prescribe you painkillers. The two most important things to do during a dengue infection is to take plenty of rest and keep yourself hydrated. Coconut water is best for older adults with dengue.
Papaya leaf extracts, garlic, tulsi, kiwi and fruit juices also work wonders in curing dengue. In extreme cases of leukopenia, your doctor may suggest platelet transfusions as well.
Here are some papaya leaf extracts that can be purchased online:
How can dengue be prevented?
Prevention is always better than cure for dengue. In India, mosquitoes are a real menace and the chances of getting bitten by an infected mosquito are very high. Therefore, it is important to protect yourself.
- Wear full-sleeved clothes while stepping out of the house, especially in the evenings.
- Keep all doors and windows closed after 6 pm.
- Use mosquito repellents generously while going out and before sleeping at night.
- Keep your home clean and clear out any stagnant water around your place. This includes flowerpots, unused tyres or pots and pans lying around collecting water, and the water collection unit of your refrigerator.
Here are some repellents available in the market:
Dengue in the elderly is an important yet greatly understudied area. In 2009-10, the Department of Health Research (DHR), Government of India and the Indian Council of Medical Research (ICMR) started the process of establishing a nationwide network of virology diagnostic laboratories for strengthening the laboratory capacity in the country. This will aid the timely detection of infection and subsequent intervention, thus reducing morbidity.
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