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TUGAS ENDNOTE

PROGRAM B KEPERAWATAN 2017

Nama : Nurhamidah

NIM : 1711165822

Judul : Dengue high fever (DHF)


DENGUE FEVER

Dengue virus (DEN) is a small single-stranded RNA virus comprising four distinct
serotypes (DEN-1 to -4). These closely related serotypes of the dengue virus belong to the genus
Flavivirus, family Flaviviridae. The various serotypes of the dengue virus are transmitted to
humans through the bites of infected Aedes mosquitoes, principally Ae. aegypti. Ae. Aegypti
has been found as far north as 45 degress N, but such invasions have occurred during warmer
months and the mosquitoes have not survived the winters (WHO, 2009).
Mostly in artificial containers closely associated with human dwellings and often indoors.
Studies suggest that most female Ae. Aegypti may spend their lifetime in or around the houses
where they emerge as adults. This means that people, rather than mosquitoes, rapidly move the
virus within and between communities (WHO, 2009).
Dengue infection is generally considered to be a paediatric disease but is currently a
growing problem in adults throughout the tropics. Furthermore, dengue infection can be more
severe in adults in whom early recognition of dengue infection, bleeding tendencies and signs of
circulatory collapse would reduce mortality (Tantawichien, 2012). The most common bleeding
manifestations are petechiae and other symptoms (epistaxis, gum bleeding, hematemesis,
melena, hypermenorrhea, hemoglobinuria) which help in identifying early suspected dengue but
are often missed by doctors/nurses in busy out-patient or primary care units. Tourniquet test is a
simple tool that helps in the early diagnosis of dengue infection (Kalayanarooj, 2011).
Around the time of defervescence, when the temperature drops to 37.5–38oC or less and
remains below this level, usually on days 3–7 of illness, an increase in capillary permeability in
parallel with increasing haematocrit levels may occur.This marks the beginning of the critical
phase. The period of clinically significant plasma leakage usually lasts 24–48 hours (Clark,
2005). Those who deteriorate will manifest with warning signs. This is called dengue with
warning signs, Cases of dengue with warning signs will probably recover with early intravenous
rehydration. Some cases will deteriorate to severe dengue (WHO, 2009)
Patients in critical phase of DHF required a higher volume of fluids from the 3rd day of
fever and again on 5th to 7th day of fever (Kularatne, Weerakoon, Munasinghe, Ralapanawa, &
Pathirage, 2015). The early diagnosis of dengue fever and timely institution of supportive fluid
management is essential to prevent morbidity and mortality (Yudhishdran, Navinan, Ratnatilaka,
& Jeyalakshmy, 2014).
REFERENCE LIST

Clark. (2005). ECONOMIC IMPACT OF DENGUE FEVER/DENGUE HEMORRHAGIC FEVER IN THAILAND AT


THE FAMILY AND POPULATION LEVELS. Am. J. Trop. Med. Hyg., 72(6),, 786-791.
Kalayanarooj, S. (2011). Clinical Manifestations and Management of Dengue/DHF/DSS. Trop Med Health,
39(4 Suppl), 83-87. doi: 10.2149/tmh.2011-S10
Kularatne, S. A., Weerakoon, K. G., Munasinghe, R., Ralapanawa, U. K., & Pathirage, M. (2015). Trends of
fluid requirement in dengue fever and dengue haemorrhagic fever: a single centre experience in
Sri Lanka. BMC Res Notes, 8, 130. doi: 10.1186/s13104-015-1085-0
Tantawichien, T. (2012). Dengue fever and dengue haemorrhagic fever in adolescents and adults.
Paediatr Int Child Health, 32 Suppl 1, 22-27. doi: 10.1179/2046904712Z.00000000049
WHO. (2009). DENGUE GUIDELINES FOR DIAGNOSIS, TREATMENT, PREVENTION AND CONTROL NEW
EDITION

Yudhishdran, J., Navinan, R., Ratnatilaka, A., & Jeyalakshmy, S. (2014). Dengue haemorrhagic fever
presenting with cholestatic hepatitis: two case reports and a review of literature. BMC Res
Notes, 7, 568. doi: 10.1186/1756-0500-7-568

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