November 2026

Introduction Every year, when the rains arrive and water collects in pots, tyres, coconut shells and roadside drains across the delta districts, fever cases rise. Most of these fevers are mild, but dengue is the one that can turn dangerous quickly, often just when the patient seems to be getting better. Knowing the symptoms, understanding what a platelet report does and does not tell you, and recognising the signs that mean it is time to go to hospital can make a real difference for your family. What is dengue fever? Dengue is a viral infection spread by the bite of an infected Aedes mosquito. These mosquitoes typically bite during the daytime and breed in clean, stagnant water. Dengue does not spread directly from one person to another. Many people have a mild illness or none at all, while some develop a more serious form that needs close medical monitoring. Dengue fever symptoms Dengue usually begins suddenly with a high fever. Along with the fever, people commonly have: Severe headache, especially behind the eyes Pain in the muscles, joints and bones, which is why dengue is sometimes called “breakbone fever” Nausea and vomiting Skin rash Marked tiredness and loss of appetite Mild bleeding from the nose or gums in some people Many other illnesses, including viral fevers, typhoid, malaria and leptospirosis, can look similar in the early days. This is why symptoms alone cannot confirm dengue, and why a doctor’s assessment and the right tests matter. The course of the illness: why the days after the fever matter Dengue is best understood as an illness that moves through stages. The fever stage. High fever, body pain and headache dominate. Most patients who are drinking well and have no warning signs can be cared for at home under medical advice. The critical stage. This is the part many families do not expect. Around the time the fever begins to settle, some patients become worse instead of better. Fluid can leak out of the blood vessels, the blood may become thicker, and platelets can fall. This is when warning signs tend to appear. The recovery stage. The body gradually reabsorbs the leaked fluid, appetite returns and energy improves. A rash and itching may appear, and tiredness can linger for some time after the fever is gone. How long does it take to recover from dengue? There is no fixed timeline. Fever usually lasts for several days, and most people with uncomplicated dengue recover over the following period. Weakness and fatigue can continue for a good while afterwards, particularly in adults. Recovery is slower if the illness becomes severe, or if the person has other conditions such as diabetes, kidney disease or heart disease. Your doctor will guide you on when it is safe to return to school or work. Dengue tests: NS1 and other blood tests Several tests may be used, and the right choice depends on how many days you have been ill. NS1 antigen test: This detects a protein from the virus and is most useful in the early days of fever. Antibody tests (IgM and IgG): These become more useful later in the illness, as the body starts producing antibodies. Complete blood count: This shows platelet levels and helps doctors see whether the blood is getting thicker (haematocrit). Doctors often repeat it to watch the trend. Other tests: Liver and kidney tests, or an ultrasound of the abdomen, may be advised if there is pain, breathlessness or a concern about fluid collection. A negative result very early in the illness does not always rule out dengue, so your doctor may repeat or combine tests. Dengue platelet count: what it really means Platelets are blood cells that help the blood clot. In dengue, the platelet count commonly falls, and families understandably become anxious when they see a low number on the report. However: A low platelet count by itself does not decide whether you need admission. Doctors look at the whole picture: your symptoms, how well you are drinking fluids, your blood pressure and pulse, urine output, and the blood thickness (haematocrit). The direction of the trend matters. A count that keeps dropping, especially together with warning signs, is more concerning than a low but stable reading. Many patients with a low count do well with rest, fluids and monitoring. Platelet transfusion is not routine for every low report. It is considered by doctors in specific situations, such as significant bleeding. A recovering patient’s platelet count usually rises on its own as the illness settles. Please avoid chasing the number on your own. Do not demand platelet transfusion or take unprescribed “platelet-boosting” products. The safest approach is to follow your treating doctor’s plan and attend every repeat blood test. When to get admitted: warning signs you should never ignore Go to a hospital without delay if a person with fever or recent dengue has any of the following, especially as the fever begins to settle: Severe or persistent stomach pain, or tenderness in the upper abdomen Repeated vomiting, or inability to keep fluids down Bleeding from the gums or nose, blood in vomit, or black or bloody stools Unusual drowsiness, irritability, restlessness or confusion Cold, clammy or pale skin, or very cold hands and feet Very little urine, or none for many hours Fast breathing or difficulty breathing Extreme weakness, or fainting on standing Doctors may also advise admission, even without obvious warning signs, for people who face higher risk or cannot be safely monitored at home. This includes infants and young children, pregnant women, older adults, and people with diabetes, kidney disease, heart disease or other serious long-term conditions. Living far from a hospital, or having no adult who can watch the patient closely, can also be a reason for admission. If you notice any warning sign, do not wait for the next day’s appointment or the next blood report. Go to the nearest emergency department. How dengue is treated in hospital There is no specific antiviral medicine for