 Hello everybody, I am Dr. Akshaya Kelebi. I am a consultant physician at Padiman Hospital. We are in the peak of monsoons and seeing a lot of rainbow cases. So today, let's talk on rainbow fever. It's an infection which is caused by the virus called denu virus which is transmitted from the bite of a mosquito carrying the denu virus. Symptoms can happen anytime between 4 to 7 days after the bite from a mosquito carrying the denu virus. And the symptoms can be different for different people. It can vary from mild to severe symptoms. Most common what we see is a fever headache, the tropical pain, pain behind the eyes. They can have severe body pain, fat pain. Some people can have sore throat or cold. And few people can present with pain or vomiting or motions. There are few people who can present the severe symptoms of denu. Like they can have severe headache, ulcerative insomnia, sudden loss of consciousness. There could be seizures, things what we call in layman term. Some people can have severe abdomen pain. They can present with a different abdomen. When in few weeks, we see reading manifestations from different sites. Like reading from the lungs. They can have reading at different sites. They can have reading from the, you know, in the schools. They can have black stools. Women can have PDB reading in between the cycles. But the severe symptoms we see in only 0.5 to less than 5% of the patients. Here we need to understand the denu, the natural history of the denu in less. It usually has three phases. One is the acute febrile phase, which is followed by critical phase and then color-set phase. In acute febrile phase, it can last in between two to seven days. And as the people abuse, the critical phase setting, which can last about 48 to 72 hours. This is where we see, you know, the complications that happen in denu. Like it could be fall in platelets. The BP can go down. Like a systemic involvement can happen in this phase. And this is followed by the convulsant recovery phase, where the patients can continue to have symptoms, you know, lingering symptoms like body fatigue or going for few days to deep weeks. Diagnosis of denu depends on, you know, the type of the system description and the time the test is taken. The sensitivity and specificity of a test depends on the timing and the day of illness. For example, the denu PCR test usually detects denu as early as first to three days of illness. Between three to three to six a day, denu, LSDN, ELISA please them to detect the denu. And beyond six days to up to at some second weeks, we can do denu, IT, and ELISA. So the test to diagnose denu depends on the day of illness, when the test is taken and the physician's description. There is no specific anti-viral against the denu virus. All the treatment is newly symptomatic and supportive. Like most of the people who have mild symptoms, we treat it with a simple task of all adequate hydration, good rest, and supportive treatment. And people who are hospitalized, even if they give IV-2, IV-2, IV-5, and symptomatic supportive care. The patients are transfused when the patients come for less than 10,000 or if the patient has a major viewing issues. No, the denu is not transfused. There is a human-to-human direct transmission. Yes, but it can happen if a mosquito fights an infected human being and the virus replicates in the mosquito. It takes around 8 to 10 days for the virus to replicate in the mosquito. And then this is called external intubation period. And this mosquito carries the denu virus. If it bites a healthy human being, then the person can be infected with denu. So there is a no direct human-to-human transmission by touching or holding hands. But yes, it can be transmitted through the mosquito bites. We can prevent denu by, of course, preventing from getting bitten by the mosquito carry the denu virus. And we have to take all the measures to keep ourselves fully covered with the clothings, wearing the food shirts and, you know, good pants, and taking care of trying to clear all the water-clothed areas around us because these water-clothed areas are the fertile ground for breeding of mosquitoes. And also, we should make sure that we use the mosquito repellents, nets, screens, and avoid getting bitten by the mosquito. Hence, they can be prevented. But if you get infected, don't worry. You can contact your physician. They are always there to help you guide you. And always remember that all negative patients who are infected may not require denution and all patients don't require daily transmission. Thank you.