Unani Perspective regarding Dengue Fever (Humma-e- Danaj)
Introduction and Aetiology
Dengue fever is a mosquito-borne disease caused by any one of the four closely related dengue viruses (DENV-1, 2, 3, and 4). Because it is caused by one of four serotypes of virus, it is possible to get dengue fever repeatedly. However, an attack of dengue produces immunity for a lifetime to that particular serotype to which the patient was exposed.
Dengue virus is transmitted from one person to another by a bite from the Aedes aegypti mosquito. Only female Aedes mosquito transmits the dengue virus. This mosquitocan bite at any time but is mainly a daytime biter, both inside and outside homes and it is most active in the hours after sunrise and before sunset. Other species of mosquito like Aedes albopictus can also transmit the virus.
It is a disease caused by family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen glands and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles. The first epidemic of clinical dengue like illness was recorded in Madras, India. It now has become endemic throughout tropical Asia (India) since 1967, after that the term dengue haemorrhagic fever and dengue shock syndrome have come into general use.
Dengue goes by other names like Onyong Nyang Fever, West Nile Fever, Break Bone Fever, Abul Rakab, Humma-e- saaliba or Dandy Fever. Victims of dengue often have contortions due to the intense joint and muscle pain, hence described with the name of break bone fever.
According to the U.S. Centres for Disease Control and Prevention (CDC), there are an estimated 100 million cases of dengue fever with several hundred thousand cases of dengue haemorrhagic fever requiring hospitalization each year. Nearly 40% of the world's population lives in an area endemic with dengue.
Aedes aegypti mosquito breeds inside and outside the home in artificial containers containing water. It usually breeds in clean, stagnant water easily found in our homes. Damage caused by dengue is more dangerous than swine flu; therefore the awareness and knowledge of precautionary measures is very important. The life-cycle ofAedes aegypti averages seven days.
Unani Concept of Dengue Fever
In Unani literature, there is as such no direct description of Dengue fever, although all types of fever in general are discussed in detail. Most probably this disease is “Humma Damwi Ufooni”, where ufoonat is found in blood (khilt-e-dam) and produce rashes on skin (surkh daane). Sheikh Bu Ali Sina says, there are abnormal changes in fluids and humours because of infectious material (madah afna’h), which disrupt the qualities and normal activities of the fluids and humours. Humours (Akhlat) are infected sometimes both intravascularly (dakhil-e-urooq) and extravascularly (kharij-e-urooq). But in this case, intravascular (dakhil-e- Urooq) infection is found because of the vector Aedes aegypti, which bites and transmit the disease as blood borne disease.
Dengue (pronounced DENG-gay) strikes people having poor immunity. Because it is caused by one of the four serotypes of virus, it is possible to get dengue fever with any one of the strain.
It is also mentioned in "Tibbi Nabavi (PBUH)". It is nothing but the treatment suggested or practised by Prophet Mohammad (PBUH). It mentions complete cure of all diseases, including Dengue. Therefore, instead of just depending upon the modern medicine, people should look for treatment in "Tibbi Nabavi (PBUH)". Although, the treatment could be offered by a select group of Unani physicians only.
Signs and Symptoms of Dengue Fever
It is an acute illness of sudden onset with general symptoms such as severe headache, fever for 3 to 7 days, exhaustion, severe muscle and joint pain, loss of appetite, vomiting and diarrhoea, skin rash, bleeding usually from the nose and gums and swollen glands and rash. Dengue Triad: Usually the presence of fever, rash, and headache (and other pains) are peculiar characteristic features of dengue. Other features are severe discomfort behind the eyes, and red palms and soles.
Preventive Measures of Dengue Virus Spread
How can dengue fever be prevented is most important as it is highly contagious and may prove fatal. The transmission of the virus to mosquitoes must be interrupted to prevent the disease. For this, patients are required to be kept under cover of mosquito nets, until the second bout of fever is over and they are no longer contagious.
To prevent the spread of dengue fever, one must first prevent the breeding of its vector, the Aedes aegyptimosquito. The Aedes aegypti mosquito is easily identifiable by the distinctive black and white stripes on its body.
Dengue Fever is a disease caused by dengue viruses which are transmitted to people by infected Aedes aegypti mosquito.
Aedes aegypti becomes infected when it bites a person who happens to be carrier of the dengue virus and after about 8 to 12 days can transmit the virus while biting a healthy person.
Aedes aegypti can lay eggs in small containers such as tree holes, bamboo ends, cans, discarded tyres, and rock pools holding small amount of water.
The most effective way to prevent Dengue Fever is to stop Aedes aegypti, the carrier of the virus. This can be achieved by eliminating the breeding grounds for the mosquito by means of good environmental hygienic practices.
The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue. In nations plagued by dengue fever, people are urged to empty stagnant water from old tires, trash cans, and flower pots. Government initiatives to decrease mosquitoes also help to keep the disease in check, but are not enough.
There is currently no vaccine available for dengue fever.
Some Useful Tips
Personal protection and the environmental management of mosquitoes are important in preventing illness. If one is living or travelling in tropical areas where dengue fever is common, these tips may help reduce risk of mosquito bites. Some useful and easy steps are:
Management in Unani Medicine
Here every measure is applied to control the symptoms, restrict the complications and enhance the platelets count. Dengue being a fatal disease and not having any specific treatment is a challenge for medical fraternity and health department. As vaccines for Dengue is not available only supportive treatment (treatment of symptoms), controlling fever, therapy for pain (to avoid aspirin and other non-steroidal anti-inflammatory medications because they may increase the risk for haemorrhage and also steroids should not be used). Reminding the patients to drink more fluids/ juices, especially when they have high fever. Avoid eating solid foods until the fever is gone.
Principles of Treatment (Usool-e-Ilaj)
Antipyretics (Dafa’e Humma)
· Qurs Humma 2 tab BD / Qurs Tabasheer kafoori 2tab BD or Joshanda Malaria /21 adad BD.
Use of fluids and juices (Barid Mashroobaat wa sayyal Aghzia)
· Maa-al- shaeer, Sharbat Neelofer, Sharbat Banafsha, SharbatAaloo, each 2 tola Aabe kahoo, Aabe Anaar, Aabe Seb, AabeBahi, Arq- e- Mako, Arq-e-Kasni each 4 tola.
Haemostyptic Drugs (Habis-e-dam advia)
· Qurs Habis 2tab BD+ Sharbat Injabar 2 tola BD
Blood Purifiers (Moaddelat wa Musaffiyat-e- Dam)
· Sharbat Unnab 2 tola BD or Majoon Ushba 6gm after meal
General Tonics (Muqawwiyat-e- A'am)
· Khameera Gaojaban Anbari, Khameera Marwareed, Khameera Sandal each 6 gm BD
Haematogenic Drugs (Muwallid dam advia):
· Qurs Damvi 2 tab, Qurs Sadaf 2 tab, Sharbat Faulad 2 tola orSharbat Anarain 2 tola after meal, or Kushta Khabsul Hadeed4 chawal.
Precautionary Measures and Unani Homemade Remedie
Several Unani homemade remedies are easily available in the kitchen, garden and market that could easily cure Dengue patients. Try home remedies for one or two days only. Always visit doctor and consult regarding any need of hospitalisation?
Some single Unani drugs have potential to treat Dengue are, Afsanteen, Sheerah Tukhm Khurfa10 gm in normal water, Sharbat-e- Deenar 40 ml two times daily, Qurs-e-Tabasheer with sharbat-e-Buzoori, Sharbat-e- Tamar hindi 40 ml with Arq-e- Gao Zaban 100 ml two times, Habb-e- Shifa 2 tab two times etc. However, these medicines should be taken only when prescribed by a Unani physician.
Note: Drugs should be taken under the advice of the qualified Unani physician. The patients are required to follow strict Unani regimen for optimum results.