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According to the Pan American Health Office:«Dengue fever is transmitted through the bites of infected mosquitoes. The disease affects people of all ages with symptoms ranging from a mild fever to a disabling fever, accompanied by severe headache, pain behind the eyes, muscle and joint pain, and red spots. The disease can progress to a severe form characterized by shock, respiratory distress, and/or severe organ damage.1
The main vector in our country is Aedes aegypti.
In Guatemala, the trend is stable. It corresponds to the rainy and hot seasons, and the increase in cases in 2024 is global. Central America is no exception. Guatemala and Honduras seem to bear the brunt.
Without affecting statistical and epidemiological data, Given Given the large number of cases we have, I thought it would be noteworthy to focus this article on the most dangerous days of the disease.
According to the World Health Organization and the Pan American Sanitary Office, the disease can last up to 10 days (without complications) and is divided into three phases. The first three days are a febrile period; then there is a critical phase, from the fourth to the sixth day, and then a recovery phase, from the seventh to the tenth day. Before this, there is a symptom-free period, called the incubation period. It lasts from four to ten days.
There are several other phases that differ by a few hours. The clinical management guidelines for dengue fever of the Ministry of Public Health and Social Welfare of Paraguay state the following: “The febrile phase lasts 2-7 days, the critical phase lasts 3-7 days, and the recovery phase begins 24 hours after the critical phase.”2
According to the last cited source, there is another, more recent classification. It has nothing to do with the duration of illness, but with the clinical symptoms of the disease. Thus, the World Health Organization classifies these cases as “dengue without warning signs, dengue with warning signs, and severe dengue.”
I emphasize these divisions and classifications because many people have asked me about them and I think they are confusing. Therefore, I recommend you to pay attention to when and how to double your care when you have dengue fever. Let’s see them in the following paragraphs.
(frasepzp1)
At what time (when): It’s simple. From the moment the disease is diagnosed, it is necessary to be highly vigilant when warning signs appear. These symptoms include: persistent abdominal pain, persistent vomiting, bleeding from mucous membranes, the appearance of petechiae (brown or purple spots on the skin), bleeding gums, black stools, vaginal bleeding or menorrhagia, chest pain, heavy sweating, altered mental status, decreased platelet count (the latter requires monitoring of their number by clinical laboratories). Almost all of these signs appear during a critical phase, which according to one classification is from the fourth to the sixth day, and according to another, from the third to the seventh day. But be careful, some of these symptoms may begin to appear from the sixth day. There is no precision in its appearance or disappearance (punctual/very punctual).
How to double up on your care: Pay attention to the appearance of warning signs to prevent them and avoid leading to a serious dengue state. It is better if the patient is monitored by people who know the disease: health workers in the field of prevention, doctors, nurses and rural health technicians. Do not be swayed by the opinions of people without experience. It is important to remember that misinformation is never lacking as a hallmark of an epidemic or pandemic.
To determine when and how to be effective, consult an expert. When a fever develops, follow the guidance of health authorities, find your nearest care center or call your family doctor. If someone advises you to go against the tide of science, simply reply: “In times of crisis, obstructionists contribute a lot.”3
Until next week, God bless.
1 https://www.paho.org/es/temas/dengue
2 http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S1683-980320…
3 Same as above.
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