Dengue is most risky just as the fever falls.
Dengue is a virus spread by the Aedes mosquito, which bites in the daytime and breeds in clean, still water: coolers, pots, tyres and flower vases. Most people get better within a week or so. A few become seriously ill, and it happens at a moment that surprises people: when the fever is settling.
In plain words.
Dengue runs in three stages. First, two to seven days of high fever with body ache, pain behind the eyes, headache and sometimes a rash. Then, around the time the fever comes down, a critical stage of a day or two, when in some people fluid leaks out of the blood vessels. Last, recovery, often with an itchy rash and tiredness.
The danger in the critical stage is the leak: the blood thickens and blood pressure can drop. That is why the warning signs below matter more than the platelet count. Platelets usually fall in dengue and rise again on their own; a platelet transfusion is needed only rarely, for example with serious bleeding.
At home: rest, plenty of fluids (water, ORS, coconut water, soups, dal water), enough to pass urine at least every four to six hours. For fever and pain, paracetamol only. Papaya-leaf juice, goat’s milk and kiwi are often suggested; none has been shown to prevent the dangerous stage, and they must never delay going to hospital.
How dengue runs, day by day
Days 1 to 3: high fever and aches. The NS1 blood test works best now. Rest, fluids and paracetamol.
Around days 3 to 7, as the fever falls: platelets are lowest and, in some people, fluid leaks from the vessels. This is when to watch hardest for warning signs.
The leak stops, the fluid comes back into the blood, platelets climb, and appetite returns. Tiredness can last a few weeks.
Go to hospital now if
- Severe tummy pain, or vomiting again and again: go to hospital now.
- Bleeding from the gums or nose, unusually heavy periods, vomiting blood, or black stools: go to hospital now.
- Restlessness, unusual drowsiness or confusion: go to hospital now.
- Cold, clammy hands and feet, fainting, or feeling faint on standing: call 112.
- No urine for six hours or more, or breathlessness: go to hospital now.
- These signs often come around the time the fever falls. Feeling cooler does not mean the danger has passed.
Call 112 or go to the nearest emergency department. Ambulance: 108 (102 in some states).
See a doctor within a day if
- You have a fever with body ache and eye pain, above all in or after the monsoon
- You are pregnant, over 65, or have diabetes, kidney, liver or heart disease
- You cannot drink enough to pass urine regularly
- You live alone, or far from a hospital
Tests that help.
Not everyone needs every test. He decides which ones are worth doing for you.
| Test | What it tells |
|---|---|
| Dengue NS1 | Finds the virus itself. Works best in the first five days of fever. |
| Dengue IgM | The body’s antibody. Turns positive after about day five. |
| Complete blood count (CBC) | Platelets and haematocrit (how thick the blood is). Often repeated daily in the critical days: rising haematocrit with falling platelets is a warning sign. |
| Liver tests | Often mildly raised in dengue; more so in severe illness. |
| Malaria and other fever tests | When the picture is not clear, as they can look alike at first. |
Have it ready.
Tick them off as you gather them. The ticks stay on this phone only.
Online, or in person?
Take paracetamol only, and keep to the dose on the pack. Do not take ibuprofen, diclofenac, nimesulide or aspirin, and avoid injections into the muscle: they raise the risk of bleeding. Steroid injections are not a treatment for dengue.
A video call can
- Confirm whether dengue is likely and which test to do on which day
- Read the daily blood counts with you and watch the trend
- Guide fluids and fever care at home
- Tell you plainly the moment home care is no longer safe
Needs a visit in person
- Blood tests, at a laboratory or by home collection
- A drip (IV fluids) and hospital monitoring when warning signs appear
- A platelet transfusion, in the rare cases that need one
- Any sign in the red box: that is an emergency
Talk it through with Dr. Arya.
Bring your reports and medicines to a video consultation. He goes through them with you, in plain words, and says clearly if you need to be seen in person.
Book a video consultationDr. Prabhat Arya · MBBS, MD (Internal Medicine) · Delhi Medical Council Reg. No. DMC-83759