Understanding Dengue’s Attack on the Body
Dengue is a viral infection transmitted by mosquitoes that causes high fever, severe headache, and intense muscle and joint pain. Crucially, the virus also attacks the blood. It causes a condition called thrombocytopenia, which is a sharp drop in the number
of platelets. Platelets are the tiny cells in your blood responsible for forming clots and stopping bleeding. The dengue virus both suppresses the production of new platelets in the bone marrow and tricks the immune system into destroying existing ones. This leaves the body highly vulnerable and compromises its natural ability to control even minor bleeding.
The Red Flag: Why NSAIDs Are Dangerous
Non-steroidal anti-inflammatory drugs, or NSAIDs, are among the most common over-the-counter medications used for pain and fever. This category includes widely used drugs such as ibuprofen (found in brands like Brufen), aspirin, and diclofenac. While effective for many ailments, these drugs are strictly advised against during a dengue infection by health authorities, including the World Health Organization and Indian national guidelines. Taking them can significantly increase the risk of severe complications. Even some combination cold and flu remedies contain hidden NSAIDs, so it is vital to read labels carefully.
The Double Threat of NSAIDs in Dengue
The danger of NSAIDs in dengue comes from a two-pronged attack. First, these drugs interfere with the function of the remaining platelets in the bloodstream. By inhibiting enzymes that help platelets clump together, NSAIDs cripple the body's already weakened clotting ability. Second, NSAIDs are known to irritate the lining of the stomach and intestines, which can cause gastric bleeding. In a healthy person, this might be a minor issue. But for a dengue patient with a low platelet count and impaired clotting, this irritation can lead to severe, life-threatening internal haemorrhage. This combined effect turns a manageable symptom into a medical emergency.
The Safe Alternative: Paracetamol
The only recommended over-the-counter medication for managing fever and pain during a dengue infection is paracetamol, also known as acetaminophen. Unlike NSAIDs, paracetamol reduces fever and alleviates pain without interfering with platelet function or increasing the risk of bleeding. However, it must be used with caution. The dengue virus can put stress on the liver, and an overdose of paracetamol can cause severe liver damage. It is crucial to stick to the recommended dosage and consult a doctor, especially when managing the illness in children.
Recognising Haemorrhage Warning Signs
The critical phase of dengue often begins just as the fever starts to subside. This is when the risk of bleeding is highest. It is vital for patients and their families to watch for the warning signs of severe dengue or internal haemorrhage. These include severe abdominal pain, persistent vomiting (sometimes with blood), bleeding from the gums or nose, black or tarry stools, and extreme fatigue or restlessness. If any of these symptoms appear, it is a medical emergency, and you should seek immediate hospital care.
