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    Dengue Fever

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    Nadia Farah
    Dengue is a mosquito-borne viral infection found in tropical and subtropical regions. It is transmitted by the Aedes aegypti mosquito. There are four types of dengue viruses that cause the disease. Symptoms range from a mild fever to severe dengue hemorrhagic fever. Diagnosis involves blood tests to detect antibodies or the virus. There is no vaccine or specific treatment, so care involves fluid replacement and symptom relief. Prevention focuses on eliminating mosquito breeding sites and reducing exposure to bites. While dengue can occasionally be fatal, most cases resolve without long-term issues if properly managed.

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    Dengue Fever

    Uploaded by

    Nadia Farah
    85 views52 pages
    Dengue is a mosquito-borne viral infection found in tropical and subtropical regions. It is transmitted by the Aedes aegypti mosquito. There are four types of dengue viruses that cause the disease. Symptoms range from a mild fever to severe dengue hemorrhagic fever. Diagnosis involves blood tests to detect antibodies or the virus. There is no vaccine or specific treatment, so care involves fluid replacement and symptom relief. Prevention focuses on eliminating mosquito breeding sites and reducing exposure to bites. While dengue can occasionally be fatal, most cases resolve without long-term issues if properly managed.

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    Dengue is a mosquito-borne viral infection found in tropical and subtropical regions. It is transmitted by the Aedes aegypti mosquito. There are four types of dengue viruses that cause the disease. Symptoms range from a mild fever to severe dengue hemorrhagic fever. Diagnosis involves blood tests to detect antibodies or the virus. There is no vaccine or specific treatment, so care involves fluid replacement and symptom relief. Prevention focuses on eliminating mosquito breeding sites and reducing exposure to bites. While dengue can occasionally be fatal, most cases resolve without long-term issues if properly managed.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    85 views52 pages

    Dengue Fever

    Uploaded by

    Nadia Farah
    Dengue is a mosquito-borne viral infection found in tropical and subtropical regions. It is transmitted by the Aedes aegypti mosquito. There are four types of dengue viruses that cause the disease. Symptoms range from a mild fever to severe dengue hemorrhagic fever. Diagnosis involves blood tests to detect antibodies or the virus. There is no vaccine or specific treatment, so care involves fluid replacement and symptom relief. Prevention focuses on eliminating mosquito breeding sites and reducing exposure to bites. While dengue can occasionally be fatal, most cases resolve without long-term issues if properly managed.

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    © All Rights Reserved
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    DEFINITION
    Dengue is a
    mosquito-borne
    infection found in
    tropical and sub-
    tropical regions
    around the world.
    General facts about DENGUE
    It is nicknamed break- bone fever
    About 50 -100 million infections world wide
    every year.
    Dengue fever is passed by infected female
    AEDES AEGYPTI mosquitoes.
    Dengue is caused by flaviviruses.
    Epidemiology
    In India first outbreak of
    dengue was recorded in 1812

    A double peak hemorrhagic


    fever epidemic occurred in
    India for the first time in
    Calcutta between July 1963 &
    March 1964

    In New Delhi, outbreaks of


    dengue fever reported in 1967
    `
    Dengue Virus

    • Flavivirus are spherical and 40- 60 mm


    in diameter.
    • RNA virus
    • Enveloped
    • Three structural polypeptides two are
    glycosylated
    • Replication in cytoplasm
    Dengue Virus
    • Most potent vector having epidemic
    potential is A. aegypti
    • Other species are
    Aedis albopictus,
    A. Stegomyia,
    A. Ploynesiensis,
    A. Scutellaris and
    A. Finalaya
    In India A. tigris
    How do Aedes mosquito transmitted
    disease
    TRANSMISSION CYCLE OF
    DENGUE
    TRANSMISSION CYCLE OF
    DENGUE
    Few common and favoured
    breeding places/sites of
    A. aegypti
    Risk factors
    • Age – common in all groups but in southeast Asia children are
    more affected.
    • Pre existing anti dengue antibody
    Previous infection
    Maternal antibody
    • Higher risk in secondary infections
    • Higher risk with two or more serotype circulating
    simultaneously
    • Host genetics ; race (white may be great risk than black )
    • Virus strain : certain genetic strain virus causes dengue in
    primary infection
    Causes of dengue
    Causes of dengue fever
    Dengue (DF) is caused by one of four closely
    related, but antigenically distinct, virus
    serotypes (DEN-1, DEN-2, DEN-3, and DEN-
    4), of the genus Flavivirus.

    Infection with one of these serotypes provides


    immunity to only that serotype for life,
    Physiology of dengue
    Thrombocytopenia
    SYMPTOMS
    Dengue fever is a
    severe, flu-like
    illness that affects
    infants, young
    children and adults,
    but seldom causes
    death.
    Four dengue clinical stages
    Clinical stages of dengue

    Classic Dengue
    Dengue
    Undifferentiate shock
    d fever dengue hemorrhagic
    syndrome
    fever fever (DHF)
    (DSS)
    Manifestations of the dengue syndrome

    Dengue virus
    Infection

    Asymptomatic Symptomatic

    Undifferentiated Dengue Fever Dengue Hemorrhagic Fever


    fever (plasma leakage)

    No h'rage Unusual DHF I & II DSS


    hemorrhage
    Undifferentiated fever
    • Most common presentation
    • Silent transmission
    • Incubation period of 3-14 days
    • Sudden onset of fever
    • Severe headache (retro orbital)
    Undifferentiated fever
    • Myalgias and arthalgias
    (Break bone fever)
    • Nausea and vomiting
    • Rash may be present at different
    stages of illness
    - Maculpapular
    - Petechial
    - Erthematous
    • Hemorrhagic manifestation
    Dengue hemorrhagic fever
    • Develops 3rd – 7th day of illness

    • Rapid onset of plasma leakage , altered hemostasis,


    damage to the liver resulting in severe fluid losses and
    bleeding

    • Skin hemorrhage

    • Gingival & nasal bleeding, hematuria

    • GI bleeding- haetemesis, melena, haematochezia


    Dengue hemorrhagic fever
    • Plasma leakage due to increase capillary
    permeability ; manifest as hemoconcentration

    • Pleural effusion & ascites

    • Bleeding due to capillary fragility

    • Liver damage manifest as increase in level of


    liver enzymes, low albumin level, deranged
    parameters (PT, PTT)
    How to diagnose dengue
    ??
    Physical Examination may reveal the following:
     Low BP
     A weak, rapid pulse
     Rash
     Red eyes
     Red throat
     Swollen glands
     Enlarged liver (hepatomegaly)
    Investigations
     Hematocrit
     Platelet count
     Electrolytes
     Coagulation studies
     Liver enzymes
     Blood gases
    Investigations
     Torniquet test (causes petechiae below the
    torniquet)
     X -ray of the chest (may demonstrate pleural
    effusion)
     Serologic studies (demonstrate antibodies to
    Dengue viruses)
     Serum studies from samples taken during acute
    illness and convalescence (High in titer to
    Dengue
    antigen)
    How to do a Tourniquet test
    • Tourniquet test is performed by inflating a blood
    pressure cuff to a point mid-way between the
    systolic and diastolic pressures for five minutes.

    • A test is considered positive when 10 or more


    petechiae per 2.5 cm2 (1 inch) are observed.

    • In DHF, the test usually gives a definite positive


    result (i.e. >20 petechiae).
    Characteristic findings in dengue fever are
    as follows:
    • Thrombocytopenia (platelet count < 100 x
    109/L

    • Leukopenia

    • Mild to moderate elevation of aspartate


    aminotransferase and alanine aminotransferase
    values (liver enzymes)
    In patients with dengue hemorrhagic fever, the
    following may be present:
    • Increased hematocrit level secondary to
    plasma extravasation and/or third-space fluid
    loss
    • Hypoproteinemia
    • Prolonged prothrombin time (PT)
    • Prolonged activated partial thromboplastin
    time(APTT)
    • Decreased fibrinogen
    Shock
    Encephalopathy
    Residual brain damage
    Seizures
    Liver damage
    TREATMENT

    For severe dengue, medical care


    by physicians and nurses experienced
    with the effects and progression of the
    disease can save lives.
    TREATMENT
    Maintenance of the patient's
    body fluid volume is critical to
    severe dengue care.
    TREATMENT
    • No Anti viral therapy available

    • Symptomatic management in Majority of cases

    • Dengue Hemorrhagic fever to be treated with


    suitable fluid replacement

    • No Vaccine available, difficult in view of four


    serotypes.
    Recognition of the disease

    Isolation of patient (screening or


    sleeping under the mosquito net)

    Epidemiological investigation

    Case finding and reporting

    Health Education
    1. Eliminate the vector by:
     Changing water and scrubbing sides of lower
    vases once a week.
     Destroy breeding places of mosquito by cleaning
    surroundings
     Proper disposal of rubber tires, empty bottles and
    cans.
     Keep water containers covered.
    2. Avoid too many hanging clothes inside the
    house.
    3. Residual spraying with insecticides
    Seek Early
    Treatment
    PREVENTION

    Stop- all that you’re doing!


    Look-for the breeding sites
    Habit and destroy these!
    Listen-for the government
    advisories
    Is Dengue a Fatal Disease ?
    Yes,….. But don’t press the
    panic button!
    It can be controlled and
    treated if handled properly.
    Keep
    in
    mind
    Your queries please

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