Advice for Dengue patients who are on home based care temporarily

• Even if you are positive(+) for dengue NS1 antigen test you may not need immediate hospitalization.

• Negative NS1 test does not exclude dengue illness.

• Home care should be always guided by a qualified doctor.

• Hospital admissions will be determined by platelet count of the latest full blood count (FBC).

Make sure to follow the instructions given below in order to ensure smooth home based care during early part of the illness

1. Physical Rest

Physical rest is highly recommended.

Staying at home without exerting yourself is ideal.

2. Fever control

• Use Paracetamol only.

• Do not use NSAIDs such as Ibuprofen, Diclofenac,Mefenamic acid, Celecoxib etc.

• Do not use steroids such as Prednisolone, Dexamethasone etc.

• Follow your doctor’s instructions on the dose of Paracetamol and fever control.

• Use tepid sponging to bring down the fever in between the Paracetamol dosing. Soak a clean towel in moderately warm water, then squeeze the excess water away and wipe the body to reduce fever.

3. When and how often should the Full Blood Count (FBC) be repeated?

• Do the FBC in 8-12 hour intervals as recommended by your doctor.

• Do not delay showing the report to your doctor (at least within 2 hours) to get medical advice.

• If the platelet count has reached a low value nearing 130,000/mm3, see your doctor immediately.

• When you see the doctor, bring all your blood investigation reports done during this fever episode.

4. Food

• If you have appetite take a soft light diet.

• Avoid taking red or brown colour food or drinks. This may mimic blood stained stools or vomitus.

5. Fluids

• Fluids should include not only water but certain electrolyte solutions such as fruit juice, white rice kanji, “Jeewani”, king coconut etc.

• Drink enough fluids to maintain a normal urine output. Please follow the instructions below to calculate the required fluid amount.

• If the body weight is between 30 to 50 kilograms, take fluids double the weight in milliliters (ml) per hour.

• If the weight is below 30kg or above 50 kg, change the fluid intake as shown below :

• If there is any doubt on how much fluids to drink please ask your doctor.

• You may use a properly calibrated cup to measure the fluid intake.

6. Urine Output

• Ensure adequate amount of fluids are taken to produce a urine volume per hour in milliliter (ml) equal to your body weight in kilograms to prevent dehydration.

• Ensure urine measurement at least every four hourly to calculate the output

• Passing urine slightly more than the above expected amount is not a problem.

• If the urine output is less than the expected amount, you should consume more fluids to maintain the above urine output.

• If the patient is feeling thirsty, taking additional fluids up to 3-4 times per day is allowed until the thirst subsides.

• But if thirst continues, consult your doctor as soon as possible.

Record all your fluid intake and the amount of urine you passed with the time and show your doctor.

You may use the following format :

Warning signs to seek immediate medical advice

• Continued vomiting and diarrhea (which can result in dehydration)

• Lethargy/restlessness

• Bleeding from any site

• Severe headache

• Severe abdominal pain

If you feel any additional discomfort, please seek medical advice.

Unlike in other conditions, settling of fever is not a sign of recovery in Dengue. Complications may arise as the fever settles.