ISLAMABAD: The National Institute of Health (NIH) has asked healthcare authorities to further strengthen and improve the level of preparedness in prevention and control of dengue virus. According to an NIH official, keeping in view the past seasonal trends and continuous increase in the number of suspected dengue patients, it was imperative to be vigilant about the situation and take certain steps to limit further transmission. He said that an advisory had already been issued to the departments to raise awareness among the general public about dengue and to take steps to stop the disease. “Dengue fever is marked by the rapid onset of high fever, headache, retro-orbital pain, diffuse body pain both muscle and bone, weakness, vomiting, sore throat, altered taste sensation, and a centrifugal maculopapular rash, among other manifestations,” he said. He added the severity of the pain led to the term break-bone fever to describe dengue. Sequential infections with different serotypes increase the risk for dengue haemorrhagic fever and dengue shock syndrome. He said that warning signs included severe abdominal pain, persistent vomiting, marked change in temperature from fever to hypothermia, haemorrhagic manifestations, change in mental states, like irritability, confusion or obtundation and thrombocytopenia. He said that early signs of shock included restlessness, cold clammy skin, rapid weak pulse, and narrowing of the pulse pressure like systolic and diastolic blood pressure. Patients with dengue fever should be advised to return to the hospital if they develop any of these signs, he added. He said that there was no specific treatment for the disease. “It is important for the attending physicians to exclude other treatable diagnoses,” he said. He said that patients with dengue fever should be cautioned to maintain their intake of oral fluid to avoid dehydration. “The most important measure to assist the patient with dengue fever is to carefully evaluate them for impending complications, such as early evidence of dengue hemorrhagic fever,” he said. Published in Daily Times, September 5th 2017.