A REVIEW ON HERBAL DRUGS OR HOMEMADE MEDICINE CAN BE USED TO TREAT DENGUE

2. INTRODUCTION
 Dengue is self-limited , systemic viral infection transmitted between humans by mosquito.
 It is a mosquito-borne viral disease that has rapidly spread in recent years.
 It is severe flu-like illness and sometimes causing a potentially lethal complication called severe
dengue.
 Transmitted by the bites of Aedes aegypti mosquito infected with four dengue virus (DENV1-4)
(genus flavivirus , family Flaviviridae.

3. THE GLOBAL BURDEN OF DENGUE
 The global burden of dengue is large ; an estimated 50 million infections per year occur across
approximately 100 countries.
 The primary vector , the urban-adapated Aedes aegypti mosquito , has become widely distributed across
tropical and subtropical latitudes.
 It emerged from Africa during the slaves trade in 15th through 19th centuries , spread into Asia .
 According to the survey of the WHO dengue has affected 40% of the global population.
 However, dengue epidemic has extended many new countries and amplified significantly in the already
affected areas.

5. PATHOPHYSIOLOGY
 After a person is bitten , the virus incubation period varies between 3 and 14 days , after which the person may
experience early symptoms such as fever , headache , rash , nausea , joint and musculoskeletal pain.
 This classic DF records temperatures between 39 and 40oc and usually lasts 5-7 days.
 During this period , the virus may get into the peripheral bloodstream and , if left untreated, can damage blood
vessels and lymph nodes resulting in DHF with symptoms such as bleeding from nose , gums or under the skin.
 Dengue viruses exist in two environments : the urban or endemic setting, where humans and mosquitoes are the
only known hosts , and forested areas , where transmission of mosquito-borne viruses occurs between non
human primates and rarely from these primates to humans.

7.  There are currently no specific treatments for dengue fever .
 Only standard treatment for management of fever is given, i.e. nursing care, fluid balance , electrolytes and
blood clotting parameters.
 Patients with dengue fever will be treated symptomatically , for example. Sponging , acetaminophen, bed
rest and oral rehydration therapy, and if sign of dehydration or bleeding occur the patients are usually
hospitalized.
 If vaccine were produced for only one or two serotypes, the other serotype would increase the risk of more
serious illness.
 Ribavirin has shown significant in vivo activity against RNA viruses; it exhibited only very weak activity
against Flaviviruses.
 A possible strategy in the treatment of dengue is to use chimeric tetravalent vaccines that show high
neutralizing antibody against all dengue serotypes.

9.  In endemic areas, most patients with DF are either asymptomatic or present with mild febrile illness.
 The illness ranges from asymptomatic infection, through undifferentiated fever and benign DF to severe
haemorrhagic fever with or without shock syndrome.
 Children often experience symptoms similar to those of the common cold and gastroenteritis (vomiting and
diarrhoea) and generally have less severe symptoms than adults, but more susceptible to the severe
complications.
 The characteristics symptoms of dengue are sudden-onset fever, headache (typically located behind the eyes),
muscle , joint pains and rashes.
 Some petechiae (small red spots that do not disappear when the skin is pressed, which are caused by broken
capillaries ) can appear at this point as well as mild bleeding from mucous membranes of the mouth and nose.

11.  Febrile phase
 The initial phase is typically characterized by high temperature (>38.50c) accompanied by
headache, vomiting, myalgia, and joint pain.
 Mild haemorrhagic manifestation such as petechiae and bruising, particularly at
venepuncture sites, and palpable liver.
 This phase lasts for 3 to 7 days, after which most patients recover without complications.

12.  Initially, physiological compensatory mechanisms are up-regulated in an attempt to maintain
adequate circulation to critical organs, resulting in narrowing of the pulse pressure when loss of
plasma volume becomes critical.
 If the pulse pressure narrows to 20 mm Hg or less, accompanied by signs of peripheral vascular
collapse dengue shock syndrome is diagnosed and urgent, although careful, resuscitation is
required.
 This phase between 4 to 7 days of the illness.

13.  The altered vascular permeability is short-lived, reverting spontaneously to a normal level
after approximately 48 to 72 hours .
 It id concurrent with rapid improvement in the patients symptoms.
 This phase resolves with desquamation over a period of 1 to 2 weeks.

15.  Acetaminophen is recommended for treatment of pain and fever .
 Patients with dengue haemorrhagic fever or dengue shock syndrome may require
intravenous volume replacement.
 Tablet Caricam
 Tablet Caripill
 Capsule Orplat
 Tablet Ceeprox-500
 Tablet levoprin

16. HERBAL DRUGS USED IN DENGUE

17.  Biological source : Carica papaya
 Family : Caricaceae
 Uses : Aid digestion, prevent constipation and colon .papain also helpful in
 healing and preventing stomach ulcers.
 Constituents : Papin , ascorbic acid, flavonoids, chyamopapain, cyanogenic glucoside.

19.  Biological source : Actinidia deliciosa
 Family : Actinidiaceae
 Uses : Increase platelet count , antioxidant , good source of fiber , asthma etc.
 Constituents : Vit. C and E , serotonin and potassium, lutein , zeaxanthin.

21.  Biological source : Trigonella foenum-graecum
 Family : Fabaceae
 Uses : Improves digestive problems, cholesterol level, promotes milk flow in
breastfeeding.
 Constituent : Proteins , amino acid , flavonoids , saponins , coumarin , lipids,
 vitamins , alkaloids such as trigonelline.

23.  Biological source : Hydrastis candensis
 Family : Ranunculaceae
 Uses : Common cold , upper respiratory tract infection , stuffy
nose, high fever , diarrhoea, constipation.
 Constituents : Isoquinoline alkaloids such as berberine, canadine, hydrastine.

25.  Biological source : Tinospora cordifolia
 Family : Menispermaceae
 Uses : Helps to boost immunity , remove toxins, urinary tract infections.
 Constituents : Columbin , tinosporaside , palmatine, berberine, choline.

27.  Biological source : Piper longum
 Family : Piperaceae
 Uses : Carminative, tonic to the liver, stomachic, abortifiacient, night blindness.
 Constituents : Volatile oil , resin , alkaloids , terpenoid, piperlon gumine.

29.  Biological source : Mimosa scabrella
 Family : Fabaceae
 Uses : Paper production, honey production, wood suitable for firewood etc.
 Constituent : Alkaloids tryptamine, N,N-dimethyltryptamine,N-methyltetracarboline.

31.  Eupatorium perfoliatum (Bonset)
 Boesenbergia rotunda (Temu kunci)
 Kaempferia parviflora
 Carica papaya
 Solanum villosum
 Combretum collinum
 Azadirecta indica and pongamia glabra
 Nyctanthes arbortistis, catharanthus roseus, Eupatorium odoratum.
 Acalypha alnifolia
 Delonix elata
HERBAL FORMULATIONS FOR DENGUE

32. Investigation about dengue have relevance because it is the fastest spreading vector-borne viral
disease, and it is endemic in over 100 countries. It is reported that 40 % of the world’s population live in
areas at risk for dengue (WHO,2016). It is communicable disease transmitted by Aedes mosquito , mainly
in last years. The relevance of the medicinal plants in the management of disease reveals the importance
of the investigations about their effects in DENV.

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 Prakash Deep , Vivek Srivastava,Shikar Verma . Journal of pharmaceutical Science Review and Research, 49(2),:Current
preservatives of medicinal plants having Anti-dengue potential March-April 2018; Article No.19,pages;91-96.
 Chawla Pooja,Yadav Amrita, Chawla Viney:On clinical implications and treatment of Dengue. Asian pacific J. of
Tropical Medicine (2014) 169-178.
 Nusrat Hossain’, Palanirajan Vijayaraj Kumar’, Yeong Siew Wei: Dengue and drawbacks of marketed Carica papaya
leaves supplements, J . of Green pharmacy.Jan-Mar 2016 (sup).10 (1) /572.