Authors
P Baburaja, S Vasudevanb
a Department of Medicine, Jubilee Mission Medical College Thrissur
b Department of Urology, Medical College, Trivandrum; Kerala Medical Journal
Abstract
Introduction: Kerala experiences recurrent monsoon fevers, with dengue emerging as a significant public health threat due to its severe manifestations and the lack of specific antiviral treatments or vaccines.
Clinical Presentation and Management: The 2017 monsoon season saw a major dengue epidemic, accounting for nearly 70% of febrile illnesses. Typical presentations included a 2-7 day fever, myalgia, headache, orbital pain, often accompanied by thrombocytopenia, leucopenia, monocytosis, and hepatitis. Severe dengue involved shock syndrome, hemorrhage, and organ dysfunction. Management guidelines focused on antipyretics, maintaining fluid balance with IV crystalloids, and judicious platelet transfusions for severe thrombocytopenia.
Public Health Challenges and Strategies: The high volume of cases and associated mortality prompted calls for standardized management protocols. The Indian Medical Association’s “Strategies for Fever Control” document aimed to guide members on fever management, resource allocation, public participation, and source reduction. Trend analysis (2013-2015) revealed new public health challenges in Kerala, including increasing migrant populations, urbanization, waste disposal issues, and the re-emergence or increase of diseases like scrub typhus, leptospirosis, malaria, and dengue.
Prevention: Control of the *Aedes aegypti* vector is crucial, involving the elimination of larval habitats, use of repellents, and mosquito nets. Prevention efforts face obstacles such as non-degradable waste, insecticide resistance, urban poverty, and difficulties in mobilizing public participation. While live attenuated dengue vaccines are in advanced stages of development, continuous monitoring of insecticide resistance is vital as dengue rapidly becomes a major public health concern.