Dengue Symptoms, Platelet Count and Treatment: A Complete Guide for Indian Families

Every monsoon, dengue fills hospital beds across India. Most people recover at home with rest and fluids, but a small number develop severe dengue, which can be life-threatening. Knowing the warning signs saves lives.

What causes dengue?

Dengue is a viral infection spread by the Aedes mosquito, which breeds in clean standing water (coolers, flower pots, tyres, water tanks) and bites mostly during the day.

Common symptoms

Symptoms usually start 4–10 days after a mosquito bite:

• Sudden high fever (often 102–104°F)
• Severe headache and pain behind the eyes
• Body ache and joint pain
• Nausea or vomiting
• Rash appearing a few days into the illness

Warning signs: go to hospital immediately

The most dangerous phase often comes around days 3–7, when the fever starts coming down. Go to hospital if you notice:

• Severe or persistent abdominal pain
• Vomiting that does not stop
• Bleeding from gums or nose, blood in vomit or stool
• Feeling restless, drowsy or confused
• Cold, clammy hands and feet
• Passing very little urine

Which test confirms dengue?

• NS1 antigen works best in the first 5 days of fever.
• IgM antibody becomes positive after about day 5.
• A complete blood count tracks platelets and haematocrit.

See our dengue test guide.

Platelet count in dengue: what the numbers mean

A normal platelet count is about 1.5–4.5 lakh per microlitre. In dengue it often falls, sometimes sharply, and then recovers on its own. A low count alone is not a reason for a platelet transfusion: doctors usually consider it only when the count is extremely low (around 10,000) or there is significant bleeding. Rising haematocrit with falling platelets is a more important danger sign, which is why doctors repeat the CBC daily.

Treatment at home

There is no specific antiviral for dengue. Treatment focuses on:

1. Fluids: water, ORS (e.g. Electral), coconut water, soups and juices.
2. Fever control with paracetamol only, such as Dolo 650 or Crocin, at the dose your doctor advises.
3. Rest, and a daily CBC as advised.

Do not take ibuprofen, diclofenac, aspirin or mefenamic acid (e.g. Brufen, Combiflam, Voveran, Disprin, Meftal) in dengue, as they increase bleeding risk.

What about papaya leaf juice and giloy?

Some small studies suggest papaya leaf extract may help platelet counts, but the evidence is limited. Traditional remedies such as giloy should never replace fluids and medical monitoring, and giloy has been linked to liver injury in some people.

Prevention

• Empty and scrub coolers, pots and containers every week
• Use mosquito repellent and nets, and wear full sleeves during the day
• Fit mesh on windows

When to see a doctor

See a general physician for any fever lasting more than 2 days during monsoon, and go to hospital immediately for any warning sign.

The three phases of dengue

1. Febrile phase (days 1–3): high fever, body ache and headache. Drink plenty of fluids and rest.
2. Critical phase (around days 3–7): the fever settles, but fluid can leak from blood vessels. This is when platelets often fall and when warning signs appear. Close monitoring is essential even though the person may feel a little better.
3. Recovery phase: appetite returns, platelets rise and a fine itchy rash may appear. Tiredness can last for weeks.

How much fluid?

Adults should drink enough to pass urine every 4–6 hours, usually around 2.5–3 litres a day unless your doctor advises otherwise. For children, offer small, frequent sips of ORS and other fluids. Reduced urine, dry lips and drowsiness are signs of dehydration that need urgent care.

Who is at higher risk of severe dengue?

• Infants and older adults
• Pregnant women
• People with diabetes, high blood pressure, heart or kidney disease
• People who have had dengue before (a second infection with a different type can be more severe)

These groups should be seen by a doctor early and may be admitted for monitoring.

Dengue, malaria or typhoid?

All three cause fever in the monsoon. Dengue typically causes severe body ache and pain behind the eyes; malaria often causes fever with chills and shivering; and typhoid causes fever that rises gradually over several days. Only tests can tell them apart, so do not self-treat with antibiotics or antimalarials.

Food during dengue

Eat light, easily digestible food such as khichdi, dal, soups, fruits and curd. Avoid alcohol. There is no special "platelet-raising diet" proven to replace fluids and monitoring.

Recovery and going back to work

Most people recover in 1–2 weeks. Return to work or school once you have had no fever for at least 48 hours without medicine and your doctor confirms your counts are recovering. Avoid strenuous exercise for a few weeks.