Bleeding Gums: A Serious Indicator of Dengue Fever

As the rainy season sets in, the specter of dengue fever looms large, with the potential for rapid outbreaks. While many cases can be managed at home with rest and self-care, it is crucial to recognize warning signs, particularly bleeding gums, vomiting blood, and black stools, as they signify severe dengue fever and require immediate hospital attention.

1. Understanding Dengue Fever

Dengue fever, a prevalent infectious disease caused by the Dengue virus, poses a considerable health challenge. The virus has four distinct types—DEN-1, DEN-2, DEN-3, and DEN-4. Strikingly, individuals can contract dengue fever multiple times in their lives, as cross-immunity does not develop. Each subsequent infection tends to be more severe due to the presence of antibodies against various Dengue virus types.
Typically lasting 7-10 days, dengue fever manifests with a range of symptoms, from high fever and fatigue to muscle aches, and can escalate to severe symptoms, including severe vomiting, bleeding gums, bloody urine, and black stools.

2. Identifying Severe Dengue Fever Symptoms

Around 4-7 days after a mosquito bite introduces the Dengue virus, patients may experience various symptoms, such as sudden high fever, fatigue, muscle and joint pain, severe headache, and eye socket pain.

Nausea and vomiting are also common.

Erythema, a red rash, typically appears on the third day after fever onset. Distinguishing it from mosquito bite-related red spots is simple: gently stretch the skin with the rash using two fingers. Mosquito bite-related spots will disappear and reappear upon release, while hemorrhagic rash spots will persist.

Between the third and seventh day of illness, the rash spreads across the body. Patients may believe their fever has subsided and that their condition is improving. However, this stage is perilous. Patients should closely monitor for severe signs, including mucosal bleeding (nosebleeds, bleeding gums, bloody urine, abnormal vaginal bleeding), internal bleeding (evident through symptoms like excessive vomiting, blood in vomit, liver or epigastric pain, black stools, fatigue, cold extremities), and plasma leakage from blood vessels, which can lead to shock, hypotension, and cardiovascular collapse. Failure to address these issues promptly can result in fatal outcomes.

When bleeding gums and other severe dengue fever symptoms manifest simultaneously, immediate medical attention is imperative.

3. Prevention and Management of Dengue Fever

Currently, no specific medication exists for treating dengue fever. Treatment primarily focuses on managing symptoms and preventing complications. When dealing with mild dengue fever, patients can rest at home and should adhere to their doctor's guidance:

• Rest and sleep under mosquito nets to prevent further transmission.
• When the fever exceeds 39°C, wear loose clothing and use warm water to cool down. Paracetamol is an appropriate fever reducer; however, it should be administered cautiously (10-15mg/kg every 4-6 hours, with a total daily dose not exceeding 60mg/kg of body weight). Avoid using ibuprofen or aspirin, as they may increase bleeding risk.
• Consume easily digestible foods like porridge and soup, stay well-hydrated with oral rehydration solutions, fruit juices, and water.
• Antibiotics are ineffective against Dengue virus, so avoid using them.

4. Preventing Dengue Fever

Preventing dengue fever requires a concerted effort:

• Eliminate breeding grounds for mosquitoes by clearing bushes, maintaining clean sewers, and addressing stagnant ponds to eradicate larvae.
• Use mosquito repellents in your home and surroundings.

• Sleep under mosquito nets and apply mosquito repellent creams or essential oils.
• Boost vitamin C intake to enhance resistance when exposed to infected individuals.
• Families and individuals must stay vigilant for signs of dengue fever. If symptoms emerge, seek immediate medical attention for timely intervention and care.