LAHORE: The acquired-immunity from recovery from maiden dengue attack only provides partial and transient protection (up to two to three months) against subsequent infection by other three serotypes of the virus. .ads_between_content{ height:auto; width:auto; clear: both; text-align: center; } .ads_between_content .story_ads{ } /*@media (max-width:600px){ .ads_between_content{ float:none; margin:0px auto; text-align: center; } }*/
In human’s recovery from infection by one dengue virus provides lifelong immunity against that particular virus serotype. “Secondary infections put people at greater risk of severe dengue leading to hospital admissions, something called “antibody-dependent enhancement”, said Dr Masood Sheikh, President General Cadre Doctors Association (GCDA) Punjab and a public health consultant while addressing the seminar at Special Kids in Lahore, under the auspices of GCDA.
Dr Masood Sheikh added that this condition occurs when the immune response actually makes the clinical symptoms of dengue worse, increasing the risk of severe dengue. Some develop dengue hemorrhagic fever after the initial fever declines — a more severe form of the illness that can cause organ damage, severe bleeding, dehydration and even death. Certain chronic diseases — including asthma, sickle cell anemia, and diabetes mellitus — can increase a person’s risk of developing a severe form of the disease. Dr Sheikh added that in Asian regions, the predominant dengue serotype of DEN-2 has been replaced with DEN-3. General Secretary GCDA Dr Rana Rafique said that this phenomenon can also happen in children who received antibodies against dengue from their mothers while in the womb the consequence of antibody-dependent enhancement is that the body’s immune system response actually makes the clinical symptoms of dengue worse and raises the risk of severe dengue illnesses. People sickened by dengue virus develop dengue fever, a weeklong bout of joint and muscle pain. But many who suffer repeat infections have it worse. They come down with dengue hemorrhagic fever and suffer massive internal bleeding and liver damage. Oddly, the virus causing dengue fever comes in four strains, and immunity to one seems to make infection by a second strain more dangerous. Dr Shahbaz said that patients remaining ill despite normalisation of temperature progress to DHF. Onset of plasma leakage is characterised by tachycardia and hypotension. The patient sweats, becomes restless, and has cold extremities. In less severe cases, the changes are minimal and transient, reflecting a mild degree of plasma leakage. Most patients recover from this stage spontaneously or after a short period of fluid and electrolyte replacement. In severe cases with high plasma leakage, patients may develop full blown circulatory shock characterised by prolonged capillary refill time and narrow pulse pressures.
Dr Assad Abbas Shah said that in DHF, bleeding may occur from any site and does not correlate with the platelet count. Hemorrhagic manifestations occur after fever has settled. The commonest site of hemorrhage is the gastrointestinal tract (which manifests as hematemesis or melena), followed by epistaxis. Vaginal bleeding has been reported in females despite high platelet counts.
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