In trying to stem the spread of Covid-19, we should not forget the battle against the equally dangerous dengue, writes Meera Murugesan
WE live in a time when any sign of a fever is worrying.
Do I have Covid-19? It's the first thought that comes to mind should we or our family members develop fever and body ache, symptoms which may also be due to other medical conditions.
Dengue, for example, which is a yearly struggle for Malaysia, is also on the rise now and one of its most visible signs is high fever.
In the midst of the Covid-19 pandemic, it's equally important not to lose sight of our battle against dengue, which can also be deadly.
Health director-general Datuk Dr Noor Hisham Abdullah pointed out that Malaysia is seeing an upward trend in dengue cases, with an average increase of eight per cent each week.
A total of 88 dengue fatalities were recorded from Jan 1 to June 13. Up to June 15, 50,988 dengue cases were recorded nationwide.
IMU Healthcare's consultant family physician, Associate Professor Dr Verna Lee Kar Mun says people with fever and body ache need to see a doctor immediately for further investigation.
Doctors cannot tell whether someone has Covid-19 or dengue just by their history of fever and body ache.
Dr Lee says in dengue, besides high grade fever and muscle and joint pains, there will also be headache with pain around the eyes but an absence of cough, sore throat and breathing difficulty.
"Covid-19 is a disease of the respiratory system and dengue is a systemic febrile disease that may or may not have respiratory symptoms."
While the coronavirus commonly enters our body via the nose, mouth and eyes, the dengue virus enters our body via our blood after a bite by a female aedes mosquito that carries the virus.
TWO DANGEROUS CONDITIONS
The World Health Organisation has stated that there is no evidence that Covid-19 can be transmitted by mosquitoes, unlike dengue.
But given the pandemic, more patients with fever (patients who actually have dengue) are now seeking treatment earlier at primary care clinics because of concerns over Covid-19.
"Nevertheless, I believe some patients may try to avoid doctors and hospitals due to the fear of Covid-19, and may present late at hospitals with complications of dengue. The mortality rate will eventually tell us if this is the case," says Dr Lee.
Patients with dengue should seek help early, she adds. All private and government clinics in Malaysia have the rapid dengue antigen diagnostic test. The test is highly sensitive and specific for dengue if performed from day 1 to day 3 of fever.
Once confirmed, doctors will give appropriate advice on follow-up and education about warning signs of severe dengue.
"Adhere to the advice and be sensitive to your body. Please go back to the doctor if you develop any one of the warning signs."
International Medical University's infectious diseases consultant and associate dean of academic affairs, Professor Dr James Koh Kwee Choy says the symptoms of dengue and Covid-19 are virtually indistinguishable from each other in the early stages.
Fever, body aches and diarrhoea are present in both conditions. However, in Covid-19, some patients develop cough, breathlessness and in rare instances, the loss of the sense of smell which is not typical of dengue.
"To make a diagnosis based on symptoms alone would be unwise. A definite diagnosis can be made by appropriate blood tests. If anyone has these symptoms, he or she should seek medical attention immediately," says Dr Koh.
DIFFERENT STRATEGIES
The strategy for preventing Covid-19 (such as physical distancing, wearing mask and hand hygiene) is not the same as the strategy against dengue (such as clearing of breeding sites for aedes mosquitoes, the use of insect repellent, avoiding mosquito bites and wearing protective clothing).
"Because the Covid-19 pandemic has taken a grip throughout the world and the prominence given to Covid-19 in the news and social media, people's attention is focused just on Covid-19, to a point that other common conditions prevalent in our country are neglected or forgotten. We are already seeing rising cases of dengue in the country."
Patients with symptoms suggestive of dengue should seek medical help as soon as possible, stresses Dr Koh.
However, bearing in mind that Covid-19 is still a concern in our country, these patients should also maintain social and physical distancing, wear a mask and ensure good hand hygiene when seeking medical attention.
SIGNS OF DENGUE
* High fever — up to 40-41 dg C, from day one till day 5 or 6
* Pain around the eyes
* Muscle and joint pains
* Rashes
* Upper abdominal pain
* Nausea, vomiting, diarrhoea
* Bleeding of the skin and gums