DENGUE

Breakbone fever Hemorrhagic Fever Dandy Fever Thrombocytopenic Purpura

Is an acute febrile disease caused by infection with one of the serotypes of dengue virus, which is transmitted by mosquito genus aedes. Dengue (pronounced DENG-gay) can affect anyone but tends to be more severe in people with compromised immune systems. Because it is caused by one of four serotypes of virus, it is possible to get dengue fever multiple times.

However, an attack of dengue produces immunity for a lifetime to that particular serotype to which the patient was exposed. Dengue fever is common, in at least 100 countries in Asia, the Pacific, the Americas, Africa, and the Caribbean. Thailand, Vietnam, Singapore, and Malaysia have all reported an increase in cases.

Flaviviruses 1,2,3,4 , a family of Togaviridae, are small viruses that contain single-stranded RNA Arboviruses group B

a. aedes eagypti is a day biting mosquito (they appear 2 hours after sunrise and 2 hours before sunset). b. it breeds in areas of stagnant water. c. it has limited, low flying movement. d. it has a fine white dots at the base of the wings and white bands on the legs.

Aedes Albopictus may contribute to the transmission of the virus in rural areas.

Other contributory mosquitoes: a. Aedes Polynensis b. Aedes Scutellaris Simplex

The incubation period is 3 to 14 days; commonly 7 to 10 days.

Patients are usually infective to the mosquito from a day before the febrile period to the end of it. The mosquito becomes infective from day 8 to 12 after the blood meal and remain infective throughout its life.

Infected Persons the virus is present in the blood of the patients during the acute phase of the disease and will become a reservoir of the virus, sucked by mosquitoes, which may then transmit the disease. Standing water any stagnant water in the household and its premises are usual breeding places of these mosquito.

AGE dengue fever may occur at any age, but it is common among children and peaks between 4 to 9 years old. SEX both sexes can be affected. SEASON it is more frequent during the rainy season. LOCATION dengue fever is more prevalent in urban communities.

High Fever for 2 to 7 days Body Weakness Muscle pain Loss of appetite Presence of rashes Abdominal pain and vomiting Bleeding of the nose and gums

GRADE I there is fever accompanied with non specific constitutional symptoms and the only hemorrhagic manifestation is positive in the torniquet test. GRADE II all signs of grade 1, plus spontaneous bleeding from the nose, gums, ang GIT are present.

GRADE III there is the presence of circulatory failure, as manifested by a weak pulse, hypotension, cold and clammy skin, and restless. GRADE IV there is profound shock and undetectable blood pressure and pulse.

Febrile Convulsion Severe dehydration Nosebleeding / epistaxis Gastrointestinal Bleeding

No specific treatment for dengue fever exists. Your doctor may recommend that you drink plenty of fluids to avoid dehydration from vomiting and high fever. Acetaminophen (Tylenol, others) can alleviate pain and reduce fever. Avoid pain relievers that can increase bleeding complications such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium

If you have severe dengue fever, you may need: Supportive care in a hospital Intravenous (IV) fluid and electrolyte replacement Blood pressure monitoring Transfusion to replace blood loss

Patient should be kept in a mosquito-free environment to avoid further transmission of infection. Keep patient at rest during bleeding episodes. Vital signs must be promptly monitored. In case of nose bleeding, keep the patients trunk elevated; apply ice bag to the bridge of nose and to the forehead.

Observe for signs of shock, such as slow pulse, cold, clummy skin, prostration, and fall of blood pressure. Restore blood volume by putting the patient in trendelenburg position to provide greater blood volume to the head part. Patient with dengue is not infectious; therefore, isolation is not required.

Health education Early detection and treatment of cases will not worsen the victims condition. Treat mosquito nets with insecticides. House spraying is advised. Avoid hanging too many clothes inside the house.

Eliminate victors by: a. changing water and scrubbing sides of flower vases once a week, b. destroying the breeding places of mosquito by cleaning the surroundings, c. keeping the water containers covered.