Dengue cases in Mumbai have reportedly risen by 28% since last year, raising concerns about the growing risk of mosquito-borne infections. Health experts also warn that many patients may continue to experience fatigue, weakness, and low energy levels for weeks even after the fever and other symptoms have subsided. Doctors say that while the disappearance of fever may indicate that the acute phase of the illness is improving, it does not always mean the body has fully recovered. The city's warm and humid weather, combined with rainfall and stagnant water, creates favourable conditions for Aedes mosquitoes, which transmit dengue. These mosquitoes can breed in flowerpots, discarded containers, tyres, coolers, construction sites and other water-holding areas around homes and buildings. As the risk increases, in conversation with NDTV Lifeline, doctors are urging Mumbaikars to take mosquito-control measures seriously and remain alert to symptoms. They also caution patients against returning to normal activity too quickly after dengue or malaria.
Why Are Dengue Cases Rising In Mumbai?
Dengue is spread through the bite of infected Aedes mosquitoes. These mosquitoes commonly breed in small collections of stagnant water, including water stored in household containers, plant trays, buckets, coolers and discarded tyres. Mumbai's humid climate and periods of heavy rainfall can increase the number of mosquito breeding sites. Rainwater may collect in open containers, construction materials, rooftop spaces, drains and poorly maintained surroundings. "Currently, there is a worrisome surge in dengue cases across Mumbai. Dengue cases are surging in Mumbai because the city's warm, humid weather creates favourable conditions for Aedes mosquitoes, which spread dengue," says Dr Nimitt Nagda, Internal Medicine Expert, Zynova Shalby Hospital Mumbai. The risk is not limited to a particular age group. Children, adults, pregnant women and senior citizens can all develop dengue after being bitten by an infected mosquito. People living in areas with poor waste disposal, water stagnation or inadequate mosquito protection may face greater exposure.
Why Does Weakness Continue After Dengue Or Malaria?
One of the most important points patients should understand is that fever going away does not necessarily mean that the body has completely recovered. "One thing I often tell my patients is that the fever going away does not necessarily mean that the body has completely recovered. This is particularly true with dengue and malaria. Patients may be afebrile and their reports may be improving, but still feel remarkably weak for several days or sometimes a few weeks," says Dr Vimal J. Pahuja, MD (Internal Medicine), Metabolic Physician & Diabetologist, Dr LH Hiranandani Hospital. Dengue and malaria are different infections, but both can cause significant systemic illness.
"In dengue, there is an intense inflammatory response, and we commonly see a fall in white blood cells and platelets. In more significant disease, there can also be fluid shifts, dehydration and involvement of organs such as the liver," explains Dr Pahuja. Malaria, on the other hand, infects red blood cells. The destruction of these cells, inflammation and anaemia in some patients can contribute significantly to fatigue and weakness.
Therefore, even after the fever settles, the body may still be in a recovery and rebuilding phase. Appetite may remain poor, sleep may have been disturbed, physical activity may have reduced and some muscle strength and conditioning may have been lost.
What Symptoms Can Patients Experience After The Fever Is Gone?
During the acute illness, people may experience:
- High fever
- Chills
- Severe body ache
- Headache
- Loss of appetite
- Muscle and joint pain
- Sweating
- Profound weakness
Dengue may cause significant muscle and joint pain, while malaria can produce episodes of fever with chills and sweating. However, not every patient develops textbook symptoms. After the fever disappears, some patients continue to experience:
- Tiredness after walking a short distance
- Heaviness in the legs
- Poor stamina
- Reduced concentration
- Dizziness
- Weakness during routine activities
- Difficulty returning to work or exercise
"After the fever has disappeared, the most common complaint I hear is: 'Doctor, my reports are better, but I still don't feel like myself.' They may feel tired after walking a short distance, have heaviness in the legs, poor stamina, reduced concentration, dizziness or simply lack the energy to get through a normal working day," says Dr Pahuja.
Why Can The Weakness Feel So Severe?
Post-dengue or post-malaria weakness usually does not have one single cause. It is often the result of several factors occurring together. These may include the body's inflammatory response, several days of fever, poor food intake, dehydration, disturbed sleep and prolonged inactivity. In malaria, red blood cell destruction and anaemia may add to the problem. In dengue, inflammation, fluid shifts and changes in blood counts can contribute to a longer recovery. "A person who has spent a week eating poorly and hardly moving cannot expect the body to immediately return to its pre-illness performance simply because the temperature is normal today," says Dr Pahuja.
This is why recovery should be treated as a gradual process rather than an on-off switch. Fever disappearing is an important milestone, but it is not always the final stage of recovery.
What Happens To Blood Cells During Dengue And Malaria?
Dengue commonly causes leucopenia, or a reduction in white blood cells, along with thrombocytopenia, or a fall in platelet count. Platelets are important for blood clotting, but their number should not be interpreted in isolation. Doctors also assess the patient's hydration, bleeding symptoms, overall condition and the trend in blood reports. "Patients should not panic over a single laboratory value. The clinical picture and the trend in the reports matter much more," says Dr Pahuja.
Malaria primarily affects red blood cells. Their destruction can result in anaemia, which may lead to tiredness, breathlessness on exertion and reduced exercise capacity. Platelet counts can also fall in malaria. Patients should therefore follow their doctor's advice regarding repeat blood tests and should not attempt to interpret platelet or other blood-count results without considering their symptoms and overall clinical condition.
When Should Post-Dengue Weakness Be Evaluated?
Mild fatigue can continue for days or sometimes weeks after dengue or malaria. However, symptoms should not be ignored if they are severe, worsening or interfering significantly with daily life. Medical evaluation is important if the patient develops:
- Persistent or returning fever
- Severe abdominal pain
- Repeated vomiting
- Bleeding from the gums or nose
- Blood in vomit, urine or stool
- Breathlessness
- Chest discomfort
- Fainting or severe dizziness
- Reduced urination
- Confusion or unusual drowsiness
- Worsening weakness despite treatment
Patients recovering from dengue should also avoid self-medication, particularly with medicines that may increase bleeding risk. Fever medicines should be taken only according to medical advice.
How Can Mumbaikars Prevent Dengue?
Dr Nagda recommends taking practical steps to prevent mosquito breeding and reduce mosquito bites. "Make sure to clear all the stagnant water in buckets, flowerpots, trays, coolers, tyres or containers. Empty and clean the water-holding containers, pots and cans twice a week. Keep the tanks properly covered with the lid," he says. Other preventive measures include:
- Wear full-sleeved clothing.
- Use mosquito repellents as advised by a doctor.
- Install window screens where appropriate.
- Use mosquito nets, particularly for children and vulnerable individuals.
- Keep doors and windows closed or screened when mosquitoes are active.
- Dispose of waste properly.
- Keep surroundings clean.
- Check construction sites, terraces and balconies for stagnant water.
- Do not allow water to collect in plant trays or discarded containers.
Dengue mosquitoes can bite during the daytime as well as at other times, so mosquito protection should not be limited only to the evening.
What Should You Do If Dengue Is Suspected?
Symptoms such as high fever, severe headache, body aches, rash, nausea or vomiting should be reported to a doctor, particularly during a local surge in cases. "If dengue is confirmed, follow the doctor's guidelines. Avoid self-medication for symptoms like fever or body rash," says Dr Nagda. Adequate hydration, rest, medical monitoring and appropriate testing may be recommended depending on the patient's symptoms and risk factors. People should not rely only on the improvement of fever to decide whether they are fit to resume strenuous exercise, long working hours or physically demanding activities.
Dengue cases can rise when warm, humid weather and rainfall create more breeding sites for Aedes mosquitoes. Stagnant water around homes, buildings, construction areas and public spaces can increase the risk of transmission. At the same time, recovery from dengue or malaria may continue well after the fever has disappeared. Inflammation, dehydration, poor nutrition, sleep disruption, reduced activity and blood-cell changes can all contribute to prolonged weakness.
Mumbaikars should remove stagnant water, use mosquito protection and seek medical advice for suspicious symptoms. Patients recovering from dengue or malaria should return to normal activity gradually and seek urgent care if they develop bleeding, breathlessness, severe abdominal pain, persistent vomiting, confusion or worsening weakness.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.