With a sharp rise in dengue cases across Nepal, especially during the post-monsoon season, understanding the disease is more important than ever. The combination of increasing temperatures and stagnant water from rains creates the perfect breeding ground for Aedes aegypti mosquitoes — the primary carriers of the Dengue virus. This Viral infection which is more common in tropical and subtropical climates. Most of the infected ones will not have symptoms but for those who do, high fever, headache, body aches, nausea and rash. Most will get better in 1-2 weeks and some severe conditions need hospital care and in some cases it can be fatal. Curative treatments for dengue currently do not exist.

🌍 Did you know?

Every year, over 390 million people are infected with the Dengue virus globally. The global incidence of Dengue in the past 2 decades (2000-2019) has surged tenfold from 0.5 million to 5.2 million spreading in 129 countries. In 2023 alone, a historic high of over 6.5 million cases affecting more than 80 countries with more than 7300 dengue related deaths reported

Dengue in Nepal

Monthly trend of dengue shows the dengue cases keeps rising from July and reaches its pear during august and September. In 2024 alone more than thirty-four thousands of cases were reported with 13 verified deaths due to dengue, but epidemiologist suggest it is way beyond the actual data. Bagmati and Gandaki province were hit hard with almost 80% of cases in those two provinces.

🦟 What is Dengue Fever?

Dengue is a mosquito-borne viral illness that spreads rapidly, especially between July and October. The virus is primarily transmitted through the bite of infected Aedes mosquitoes and can range from mild to severe in presentation.

❗Common Symptoms of Dengue Fever

Be alert for the following signs:

• High-grade fever (often above 102°F or 40°C)
• Intense headache
• Pain behind the eyes
• Joint and muscle pain
• Skin rash
• Nausea and vomiting
• Extreme fatigue and weakness

These symptoms can often be confused with flu, malaria, or chikungunya, so a proper diagnosis is crucial.

🔍 Three Phases of Dengue Fever (As per WHO)

1. Febrile Phase (2–7 Days)

Symptoms may include:

• Sudden high fever
• Headache and eye pain
• Muscle and joint pain
• Nausea, vomiting, and loss of appetite
• Skin rashes and facial flushing
• Mild respiratory symptoms like sore throat or cough

2. Critical Phase

• Fever subsides around Day 3–7, but this is when complications may start
• Sudden drop in platelet and WBC count
• Risk of internal bleeding and organ damage
• Extreme tiredness and dehydration

3. Recovery Phase (Next 48–72 hours)

• Appetite improves
• Gastrointestinal symptoms reduce
• Skin rash may reappear temporarily
• Gradual return to normal health

⚠️ Warning Signs of Severe Dengue (Seek Immediate Help)

According to the CDC, 1 in 20 dengue cases may become severe. Be vigilant if you notice:

• Severe abdominal pain
• Persistent vomiting or blood in vomit
• Bleeding gums or nose
• Rash spreading over the whole body
• Difficulty breathing or rapid heart rate
• Low blood pressure
• Severe fatigue, drowsiness, or restlessness

🏥 Seek hospitalization immediately if any of these symptoms appear.

🏠 Home Management for Mild Dengue Cases

• Take adequate rest
• Stay well-hydrated (ORS, water, juices)
• Eat a nutritious, protein-rich diet
• Avoid aspirin or NSAIDs (use paracetamol for fever instead)
• Monitor symptoms regularly

If symptoms worsen, consult a doctor immediately.

🧪 Recommended Diagnostic Tests for Dengue Fever

✅ 1. Complete Blood Count (CBC)

• Monitors platelet and WBC count routinely
• Platelets often drop below normal (150,000–400,000 cells/mcL)
• Can be done any time during infection

CBC is a key tool but not sufficient alone for Dengue diagnosis. But routine CBC checkup will help to understand the degree of severity of disease.

✅ 2. Dengue NS1 Antigen Test

• Detects NS1 protein in blood
• Most accurate in the first 0–5 days and can give results up to 7th day of fever
• Early detection is crucial to prevent complications
• This is one of the most reliable and economical method can be accessed at low resource setting health institutions like pharmacies, clinics, and health posts.

Dengue NS1 Antigen test kits

✅ 3. Dengue RT-PCR Test

• Detects viral RNA (genetic material)
• Highly sensitive and specific
• Best done during the first week of illness
• It is relatively expensive, takes highly sophisticated equipment and high skilled human resources to run the test.

✅ 4. Dengue IgM Antibody Test

• Detects IgM antibodies which develop after 4–5 days
• Useful if symptoms persist beyond 5 days
• Confirms recent or current infection but not a confirmatory test

Dengue IgM kits

✅ 5. Dengue IgG Antibody Test

• Detects IgG antibodies indicating past infection
• This test is not a confirmatory test, and can’t diagnose the test with just IgG antibodies results.
• Useful for long-term detection (even after 14 days)

IgG may remain in the body for months or even years

Related readings

1. Dengue NS1 vs NS1 IgG/IgM combo Tests: Which One Should Nepal Choose for Faster Diagnosis?
2. Dengue Diagnosis in Nepal: Comparing NS1, IgG/IgM, Combo Kits, PCR, and ELISA Tests
3. Top 5 Reasons to Use Dengue NS1 Kits for Accurate Diagnosis During Nepal’s Monsoon Outbreaks
4. Why Dengue NS1 Rapid Test Is the Best Diagnostic Tool for Early Detection in Nepal

🧠 Takeaway

Dengue can be prevented, diagnosed early, and managed effectively with the right information. Do not ignore symptoms like high fever or body pain — especially during monsoon months.

✨ Prevention Tip:

Use mosquito nets, repellents, wear full sleeves, and eliminate stagnant water around your home.

Reference:

1. https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue

2. World Health organization, Dengue Global situation, https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498

Edited and Reviewed by

Dr Prabhat Adhikari , MD ( Internal Medicine with specialization in Infectious Disease and Critical care)