DENGUE FEVER

A Written Report
In Partial Requirement for Clinical Duty (General Ward)

Prepared By:
SATINA, MICHA MAE R.`
SORRONDA, VJ YIESHA C.
SUMAGANG, JOHN LINO R.
BSN2 BLOCK B

Submitted to:
JOANNA J. ALBAÑO
Clinical Instructor

2ND Semester A.Y 2023 - 2024

 INTRODUCTION
Dengue fever is a viral illness transmitted by mosquitoes, primarily the Aedes aegypti species. It
is prevalent in tropical and subtropical regions, posing a significant public health concern due to
its increasing incidence and potential for severe complications. Dengue fever typically presents
with symptoms such as sudden onset of fever, severe headache, muscle and joint pain, rash, and
mild bleeding manifestations. While most cases resolve on their own, some individuals may
develop severe dengue, which can be life-threatening if not promptly diagnosed and treated.
Prevention efforts focus on mosquito control measures and personal protective measures, as
there is currently no specific antiviral treatment for dengue fever.

DEFINITION
The dengue virus, which is the primary cause of dengue, is contracted by humans from the bite
of an infected Aedes mosquito, especially Aedes aegypti. Worldwide, tropical and subtropical
regions are home to a large population of these mosquitoes, particularly in urban and semi-urban
areas.

From asymptomatic or mild illness to severe dengue that may be fatal, dengue infection can
cause a wide range of clinical manifestations. The illness usually manifests as a sudden onset of
fever, intense headache, rash, pain in the muscles and joints, and mild bleeding symptoms like
petechiae or easy bruising. While supportive care is all that is needed for the majority of dengue
fever cases to resolve on their own, severe dengue fever can lead to complications like severe
bleeding, plasma leakage, and organ impairment.

RISK FACTORS
You run a higher chance of getting dengue fever, or a more serious case of the illness, if you:

 You visit or reside in tropical regions. Living in tropical and subtropical regions raises your
chance of contracting the dengue fever virus.
 You've previously had dengue fever. If you contract the dengue fever virus again, your chances
of experiencing severe symptoms are increased.
 Urbanization, particularly unplanned urbanization, is linked to the spread of dengue through a
number of social and environmental factors, including human mobility, population density, and
access to dependable water sources and water storage practices.
 Since exposure to dengue is strongly correlated with behaviors like storing water, caring for
plants, and protecting oneself from mosquito bites, community risks from the disease also
depend on the knowledge, attitudes, and practices of a population regarding dengue. The
resilience of a community is significantly increased by regular vector surveillance and control
activities that involve the community.

ETIOLOGY
One of the four dengue viruses is the cause of dengue fever. The dengue virus can enter your
bloodstream and multiply when it is bitten by an infected mosquito. You may become ill as a
result of the virus itself and the reaction of your immune system.

The blood clotting components that give your blood vessels shape and support can be destroyed
by the virus. This can cause internal bleeding by causing your blood to leak out of your vessels,
along with some chemicals produced by your immune system. The potentially fatal symptoms of
severe dengue follow from this.
 SIGNS AND SYMPTOMS

Most people with dengue have mild or no

symptoms and will get better in 1–2 weeks. Rarely, dengue can be severe and lead to death.

If symptoms occur, they usually begin 4–10 days after infection and last for 2–7 days. Symptoms
may include:

 high fever (40°C/104°F)

 severe headache
 pain behind the eyes
 muscle and joint pains
 nausea
 vomiting
 swollen glands
 rash.

Individuals who are infected for the second time are at greater risk of severe dengue.

Severe dengue symptoms often come after the fever has gone away:

 severe abdominal pain

 persistent vomiting
 rapid breathing
 bleeding gums or nose
 fatigue
 restlessness
 blood in vomit or stool
 being very thirsty
 pale and cold skin
 feeling weak.

People with these severe symptoms should get care right away. After recovery, people who have
had dengue may feel tired for several weeks.

TRANSMISSION

Transmission through the mosquito bite

Humans contract the dengue virus when bitten by female infected mosquitoes, most commonly
the Aedes aegypti mosquito. Although they can also serve as vectors, other Aedes species
typically have a greater role than Aedes aegypti. However, a spike in the local dengue
transmission of the tiger mosquito, Aedes albopictus, has been observed in Europe in 2023.

The virus replicates in the midgut of the mosquito after feeding on an infected person and then
spreads to secondary tissues, such as the salivary glands. The extrinsic incubation period (EIP) is
the amount of time that passes between a virus's ingestion and its actual transmission to a new
host. When the outside temperature is between 25 and 28°C, the EIP takes about 8 to 12 days.
Changes in the duration of extrinsic incubation are not just

Human-to-mosquito transmission

People who are virulently infected with the dengue virus can infect mosquitoes. This can include
a person with a dengue infection who is exhibiting symptoms, a person who is pre-symptomatic
and has not yet developed any symptoms, and a person who is asymptomatic and does not
exhibit any symptoms. Transmission from humans to mosquitoes can happen up to two days
before or after an individual exhibits symptoms of the illness.

Maternal transmission

High viremia and fever in the patient are positively correlated with the risk of mosquito
infection; on the other hand, high levels of DENV-specific antibodies are correlated with a lower
risk of mosquito infection. Although viremia can linger up to 12 days, most cases last between 4
and 5 days. Mosquito vectors are the main means by which the dengue virus spreads among
humans. Nonetheless, there is proof that maternal transmission—transmission from a pregnant
woman to her fetus—may occur. Vertical transmission rates, however, seem to be low, and the
timing of the dengue infection during pregnancy appears to be associated with the risk of vertical
transmission. In cases where a pregnant mother contracts dengue, her unborn child may
experience preterm birth, low birthweight, and developmental distress.

Other transmission modes

Rare cases of transmission via blood products, organ donation and transfusions have been
recorded. Similarly, transovarial transmission of the virus within mosquitoes have also been
recorded.

LATEST STATISTICS

Dengue remains a serious health concern in the Philippines. The first recorded epidemic in
Southeast Asia occurred in Manila in 1954, and more epidemics followed in 1966, 1983, and
1998. During morbidity week 48 in 2023 (26 November to 2 December), 2607 new dengue cases
were reported, a 41% decrease compared with the same period in 2022 (4415 cases). As of 2
December 2023, a total of 195 603 dengue cases have been reported. The number of cases is
23% lower compared with the same period in 2022 (252 700 cases). From 1 January to 2
December 2023, there have been 657 deaths (case fatality rate, 0.34%), compared with 894
deaths (0.35%) reported in the same period in 2022.

TREATMENT
 There
is no specific treatment for dengue. The focus
is on treating pain symptoms. Most cases of
dengue fever can be treated at home with pain medicine. Acetaminophen (paracetamol) is often
used to control pain. Non-steroidal anti-inflammatory drugs like ibuprofen and aspirin are
avoided as they can increase the risk of bleeding.

For people with severe dengue, hospitalization is often needed. If you get dengue, it’s important
to:

1. rest
2. drink plenty of liquids
3. use acetaminophen (paracetamol) for pain
4. avoid non-steroidal anti-inflammatory drugs, like ibuprofen and aspirin
5. watch for severe symptoms and contact your doctor as soon as possible if you notice any.

DIAGNOSING AND LABORATORY TEST

Doctors can diagnose dengue infection with a blood test to check for the virus or antibodies to it.
If you become sick after traveling to a tropical area, let your doctor know. This will allow your
doctor to evaluate the possibility that your symptoms were caused by a dengue infection. For
patients presenting during the first week after fever onset, diagnostic testing should include a test
for dengue virus (rRT-PCR or NS1) and IgM. For patients presenting >1 week after fever onset,
IgM detection is most useful, although NS1 has been reported positive up to 12 days after fever
onset.

PREVENTION

The mosquitoes that spread dengue are active during the day. Lower the risk of getting dengue
by protecting yourself from mosquito bites by using:

1. clothes that cover as much of your body as possible

2. mosquito nets if sleeping during the day, ideally nets sprayed with insect repellent
3. window screens
4. mosquito repellents (containing DEET, Picaridin or IR3535)
5. coils and vaporizers.

Mosquito breeding can be prevented by:

1. preventing mosquitoes from accessing egg-laying habitats by environmental management

and modification
2. disposing of solid waste properly and removing artificial man-made habitats that can hold
water
3. covering, emptying and cleaning domestic water storage containers on a weekly basis
4. applying appropriate insecticides to outdoor water storage containers.

HEALTH TEACHING

Dengue fever, a viral infection spread by mosquitoes, poses a significant health risk in many
parts of the world. The disease can cause severe flu-like symptoms and complications, but by
taking proactive steps, you can reduce your risk of infection. Prevention revolves around
eliminating mosquito breeding sites and practicing personal protection measures. Key Points:
1. Mosquito Breeding Prevention: Remove standing water around your home, keep containers
covered, and maintain clean gutters to eliminate breeding grounds.
2. Personal Protection: Use insect repellents, wear long clothing, and use mosquito nets while
sleeping to prevent mosquito bites.
3. Recognize Symptoms: Be aware of symptoms like high fever, headache, joint pain, and rash,
and seek medical care promptly if they occur.
4. Treatment and Care: There's no specific treatment for dengue, so focus on symptom relief,
hydration, and rest.

Severe cases may require hospitalization for monitoring and supportive care. By staying
informed and adopting preventive measures, you can safeguard yourself and your community
against dengue fever. Together, we can combat this mosquito-borne illness and ensure a
healthier future for everyone.

REFERENCES

Mayo Clinic. (2022, October 5). Dengue fever - Symptoms and causes. Mayo Clinic.

https://www.mayoclinic.org/diseases-conditions/dengue-fever/symptoms-causes/syc-

20353078
World Health Organization. (2023). Dengue and severe dengue. World Health Organization.

https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue

Cordero, D. A. (2024). Initiatives and challenges of dengue incidence in the Philippines. The Journal of Infectious Diseases

(Online. University of Chicago Press)/the Journal of Infectious Diseases. https://doi.org/10.1093/infdis/jiae082

Dengue Diagnosis | CDC. (2019, June 13). Centers for Disease Control and Prevention. https://www.cdc.gov/dengue/healthcare-

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