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Dengue Care at Home: Warning Signs, Fluids and Platelet Checks

Dengue is a viral fever spread by the bite of the Aedes mosquito. During and after the monsoon, rainwater and stored water collect in coolers, pots and containers around Indian homes, and this mosquito breeds in them. Most people with dengue have a mild illness and recover in a week or two. A few become seriously ill, often just as the fever seems to be getting better. Anyone with a fever that could be dengue should see a doctor.

Common Symptoms of Dengue

Symptoms usually start 4 to 10 days after the mosquito bite and last 2 to 7 days:

• Sudden high fever
• Severe headache, often at the front of the head
• Pain behind the eyes that gets worse when the eyes move
• Muscle and joint pain
• Loss of appetite and taste, nausea and vomiting
• A rash, often on the chest and arms

Malaria, chikungunya and typhoid can look similar, so the doctor will need blood tests.

Who Can Be Cared for at Home, and Who Needs Hospital

India’s national dengue guidelines (NCVBDC) say that mild dengue, with no warning signs, may be managed without admission, with follow-up visits and blood tests as the doctor advises. A patient with any warning sign should be treated in hospital.

Some people are at higher risk of severe dengue. The doctor may advise hospital care for them even if they seem well:

• Babies and young children, adults over 65, and pregnant women
• People with diabetes, high blood pressure, heart, lung, kidney or liver disease, or obesity
• People with a stomach ulcer, thalassaemia or other blood disorders
• People who take blood thinners, aspirin, long-term painkillers or steroids
• Anyone who has had dengue before

Fluids and Rest

• Offer fluids often through the day: ORS, coconut water, fruit juice, water and other fluids the patient can take.
• Avoid fizzy (carbonated) drinks.
• Let the patient rest in bed as much as possible.
• If the patient has heart or kidney disease, ask the doctor how much fluid is right, because too much can also cause problems.

Keep a simple notebook: how much the patient drinks, when they last passed urine, the temperature and any new symptom, to show the doctor.

Fever and Pain: Only as the Doctor Advises

• The doctor may advise paracetamol for fever and pain, and will tell you how much and how often.
• Do not give aspirin, ibuprofen or similar painkillers (NSAIDs). WHO and NCVBDC advise avoiding them, as they can increase the risk of bleeding.
• Sponging the forehead, armpits, arms and legs with lukewarm water can help bring the temperature down.
• If the patient already takes aspirin, a blood thinner or a painkiller every day, tell the doctor straight away. Do not stop or change any medicine on your own.

Platelet Count and Other Blood Tests

The doctor may order a dengue test (NS1 antigen early in the illness, or an antibody test from around the fifth day) and a complete blood count (CBC). The CBC shows the platelet count and the haematocrit, which tells the doctor how concentrated the blood is.

• The doctor decides how often to repeat the CBC. Tests may be needed more often during the critical days.
• A falling platelet count can mean the illness is getting worse. A rising haematocrit can be an early sign that fluid is leaking from the blood vessels.
• The platelet count alone does not tell you whether the patient will bleed. The doctor reads it with the haematocrit and how the patient is.
• Platelet transfusion is not routinely needed. The doctor decides, mainly when there is bleeding.

With a blood test at home, the sample is collected at home and the report comes on WhatsApp and email.

The Critical Phase: When the Fever Comes Down

Families often relax when the fever goes away, but this is the time to watch most closely. The critical phase usually begins between the third and seventh day of illness, as the fever comes down, and lasts about 24 to 48 hours. Warning signs usually appear in this period, and the patient can get worse within a few hours.

Warning Signs: Go to Hospital Straight Away

• Severe belly pain, or vomiting again and again
• Bleeding from the nose or gums, new red spots on the skin, or heavy periods
• Vomiting blood, black stools, or red urine
• Very tired, drowsy, restless or irritable, or a sudden change in behaviour
• Unable to drink, passing very little urine, or no urine for 12 hours
• Feeling dizzy or faint, fast breathing, or pale, cold, clammy skin
• A sudden drop in temperature with the patient looking unwell

When to Call 112

Call 112 straight away if the patient is struggling to breathe, faints, is very drowsy or hard to wake, is confused, has a fit (seizure), is bleeding heavily, or has cold, clammy skin with a weak pulse. Severe dengue is a medical emergency. See what to do in a medical emergency at home.

Preventing Mosquito Bites and Breeding at Home

Mosquitoes that bite a dengue patient, mainly in the first week of illness, can pick up the virus and infect other family members. So protect the patient and the whole household:

• Let the patient rest under a mosquito net, day and night. The dengue mosquito bites in the daytime.
• Use mosquito repellent creams, liquids, coils or mats, as the label says.
• Wear full-sleeved shirts and full-length trousers or salwar.
• Once a week, empty, scrub and dry coolers, buckets, flower vases, plant saucers and the fridge drip tray. Aedes eggs can survive without water for more than a year.
• Keep water tanks, drums and pots covered. Clear terraces and balconies of old tyres, tins and bottles that hold rainwater.
• Use screens on windows and doors.

How OSVI Healthcare Helps with Dengue Care at Home

• Doctor visit at home: a doctor visits at home, day or night, to examine the patient, prescribe and follow up. Online consultation is also available.
• Blood tests at home: CBC, platelet count and other tests the doctor orders, through home sample collection.
• Nursing care: background-verified nurses on hourly, 12-hour or 24-hour shifts can help the patient drink enough, keep temperature and urine records, and watch for warning signs.
• Medicines: prescribed medicines can be delivered at home.

Our care team is available 24×7, with one care manager as your point of contact. If a warning sign appears, do not wait for a home visit: go to hospital or call 112.

Frequently Asked Questions

Can dengue be treated at home?

There is no specific medicine for dengue. Mild dengue without warning signs can often be cared for at home with fluids, rest and fever care as the doctor advises, plus check-ups and blood tests. Patients with warning signs need hospital care.

How often should the platelet count be checked?

The doctor decides, based on the day of illness and how the patient is. Home sample collection makes repeat tests easier.

Can a person get dengue more than once?

Yes. There are four types of dengue virus, and a second infection carries a higher risk of severe dengue. Tell the doctor if the patient has had dengue before.

This article is provided for general information and does not constitute medical advice, diagnosis or treatment. Every patient’s situation is different, so please consult a qualified doctor for guidance specific to you. In a medical emergency, call 112.