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        With the recent rain and the monsoon season drawing near, the sceptre of the outbreak of various diseases looms large. Hence, as a precautionary measure, the National Vector Borne Disease Control Program me, Directorate of Health Services, Ministry of Health and Family Welfare has clearly prescribed dos and don'ts for managing dengue fever/dengue haemorrhagic fever cases.

        How to recognise dengue fever/dengue haemorr- hagic fever Dengue Fever (DF) is an acute febrile illness of 2/7 days duration (sometimes with two peaks) with two or more of the following manifestations:

        Headache, retro-orbital pain, rashes, haemorrhagic manifestation (petechiae and positive tourniquest test) and leucopenia.

        In children, DF is usually mild. In some adults DF may be the classic incapacitating disease with severe bone pain and recovery may be associated with prolonged fatigue and depression.

        Dengue Haemorrhagic Fever (DHF) is a probable case of dengue and haemorrhagic tendency evidenced by one or more of the following:

        Positive tourniquet test, petechiae, ecchymosis or purpura, bleeding from mucosa (mostly epstaxis or bleeding fromm gums), injection sites or other sites, haematemesis or melena, thrombocytopaemia (platelets 1,00,000/cu.mm or less) and evidence of plasma leakage due to increased capillary permeability manifested by one or more of the following:

        A more than 20 per cent rise in haemotocrit for age and sex; A more than 20 per cent drop in haemotocrit following treatment with fluids as compared to baseline; signs of plasma leakage (pleural effusion, ascites or hypoproteinaemia) Dengue Shock Syndrome (DSS).

        All the above criteria of DHF plus signs of circulatory failure manifested by rapid and weak pulse, narrow pulse pressure (less or equal to 20 mm Hg); hypertension for age, cold and clammy skin and restlessness.

        The above descriptions of DF/DHF/DSS are adequate for guiding doctors to treat the disease. However, for reporting of the disease, cases should be classified as suspected DF/DHF/DSS on the basis of above criteria. Added serological evidence would categorise them into probable and confirmed cases.

        Dos and don'ts for patients If you or any family member is suffering from suspected dengue fever, it is important to carefully watch yourself or relative for the next few days, since this disease can rapidly become very serious and lead to a medical emergency.

        The complications associated with dengue fever/dengue haemorrhagic fever usually appears between the third and fifth day of illness. You should therefore watch the patient for two days even after fever disappears.

        What to do Keep body temperature below 30 degree celsius. Give the patient paracetamol. Give large amounts of fluids (water, soup, milk, juice) along with the patient's normal diet.

        The patient should take complete rest.

        Immediately consult a doctor if any of the following manifestions appear:

        Red spots or points on the skin; bleeding from the nose or gums; frequent vomiting; vomiting with blood; black stools; sleeplessness; constant crying; abdominal pain; excessive thirst (dry mouth); pale, cold or clammy skin and difficulty in breathing.

        What not to do Do not wait in case the above symptoms appear. Immediately consult a doctor. It is crucial to quickly get treatment in case of these complications. Do not take Aspirin or Brufen or Ibubrufen.