As the ongoing dengue outbreaks in southern Taiwan persist, several deaths have been reported. According to studies, dehydration is the main cause of complications and death among patients. Therefore, maintaining proper fluid balance is important and supportive care with fluid replacement is the mainstay of treatment for dengue fever.

Initial symptoms of dengue fever include fever, headache, and muscle and joint pains. Some patients experience loss of appetite. Other common symptoms include nausea, vomiting and diarrhea. All of the abovementioned symptoms can easily cause dehydration in patients. Dengue is usually a self-limited illness and most dengue patients recover on their own after adequate rest and adequate fluid intake. However, some patients, especially those who had been previously infected with other type of dengue virus, elderly patients and those with chronic conditions such as diabetes, who have become infected with the currently circulating dengue virus type 2 are at increased risk for developing complications. Although the exact cause of severe dengue is yet to be fully understood, most studies have shown leakage of plasma from the blood vessels leads to shock and subsequent complications, which is the main cause of severe cases and death.

The course of dengue infection is divided into three phases: febrile, critical, and recovery. Depletion of fluid from the circulation and plasma leakage usually happen when fever is about to resolve, which is approximately 3 to 7 days after disease onset. If proper care has been administer and the patient has not developed other complications, such phenomenon typically lasts 1 to 2 days. The disease then proceeds to the recovery phase. As a result, it is important to provide adequate fluid to the patient during the critical phase to ensure proper fluid balance. Doctors can determine whether a patient requires hospital admission and advise patients to take plenty of fluids after returning home. Patients are also urged to pay attention to the signs of developing severe dengue such as persistent vomiting, severe abdominal pain, rapid breathing, bleeding, cold sweaty skin or cold hands and feet, and change of consciousness, which will require immediate hospital admission.

Taiwan CDC warns against folk remedy such as drinking red guava juice or homeopathy use and reminds the public that there is no specific medicine or vaccine to treat dengue fever. In addition, Taiwan CDC urges the public to seek immediate medical attention when suspected of dengue infection and when dengue fever is diagnosed, please follow the doctor’s instructions in completing the treatment, drink plenty of fluids to avoid dehydration, and rest at home as much as possible. For more information, please visit the Taiwan CDC’s website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922 (or 0800-001922).