Prevention for Dengue Fever
There is no tested and approved vaccine for the dengue flavivirus. There are many ongoing vaccine development programs. Among them is the Pediatric Dengue Vaccine Initiative set up in 2003 with the aim of accelerating the development and introduction of dengue vaccine(s) that are affordable and accessible to poor children in endemic countries. Thai researchers are testing a dengue fever vaccine on 3,000–5,000 human volunteers after having successfully conducted tests on animals and a small group of human volunteers. A number of other vaccine candidates are entering phase I or II testing. As of July 2010, the National Institutes of Health reported on their ClinicalTrials.Gov Web site that there were 11 vaccines undergoing testing or recruiting for participants. Because exposure to one of dengue's four serotypes provides no immunity against infection by the other types, and may make the patient susceptible to more severe disease symptoms, testing vaccines must be performed carefully, and usually not in areas where the disease is endemic for fear that even attenuated virus vaccines may cause severe reactions.
In 1998, scientists from the Queensland Institute of Medical Research (QIMR) in Australia and Vietnam's Ministry of Health introduced a scheme that encouraged children to place a water bug, the crustacean Mesocyclops, in water tanks and discarded containers where the Aedes aegypti mosquito was known to thrive.[24] This method is viewed as being more cost-effective and more environmentally friendly than pesticides, though not as effective, and requires the continuing participation of the community.
Even though this method of mosquito control was successful in rural provinces, not much is known about how effective it could be if applied to cities and urban areas. The Mesocyclops can survive and breed in large water containers but would not be able to do so in small containers that most urban dwellers have in their homes. Also, Mesocyclops are hosts for the guinea worm, a pathogen that causes a parasite infection, and so this method of mosquito control cannot be used in countries that are still susceptible to the guinea worm. The biggest dilemma with Mesocyclops is that its success depends on the participation of the community. This idea of a possible parasite-bearing creature in household water containers dissuades people from continuing the process of inoculation and, without the support and work of everyone living in the city, this method will not be successful.
Treatment for Dengue Fever
The mainstay of treatment is timely supportive therapy to tackle circulatory shock due to hemoconcentration and bleeding. Close monitoring of vital signs in the critical period (up to 2 days after defervescence - the departure or subsiding of a fever) is critical. Oral rehydration therapy is recommended to prevent dehydration in moderate to severe cases. Supplementation with intravenous fluids may be necessary to prevent dehydration and significant concentration of the blood if the patient is unable to maintain oral intake. A platelet transfusion may be indicated if the platelet level drops significantly (below 20,000) or if there is significant bleeding. The presence of melena may indicate internal gastrointestinal bleeding requiring platelet and/or red blood cell transfusion.
Aspirin and non-steroidal anti-inflammatory drugs should be avoided as these drugs may worsen the bleeding tendency associated with some of these infections. All kinds of Intramuscular injections are contraindicated. Patients may receive paracetamol, acetaminophen, preparations to deal with these symptoms if dengue is suspected.
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