DENGUE FEVER and

DENGUE HEMORRHAGIC FEVER

DENGUE FEVER
the

most common and most important mosquito-borne viral disease in the world found in both tropical and subtropical regions transmitted by aedes aegypti

Aedes Aegypti

primarily a daytime feeder lays eggs and produces larvae preferentially in artificial containers highly urbanized

DENGUE VIRUS
An arbovirus. Dengue is transmitted though mosquito bites Causes dengue fever and dengue hemorrhagic fever Has four serotypes (den 1, den 2, den3, den4) All serotypes can cause severe and fatal disease All serotypes are immunologically related but do not provide crossprotective immunity against each other

Dengue in the Philippines

Quick Facts:
Affects all regions in the Philippines, especially those which are highly populated Region X (Mindanao) NCR, Region VII (Cebu) with the highest number of cases 28% increase in Dengue cases during the period of Jan to Sep 05 vs Jan to Sep 04 Ages of people with Dengue range from 1 to 95 yrs old with a median of 10 years old; 43% belong to 1-9 yr age group and 52% of dengue cases are males 26 81% of Dengue cases are unreported

SOURCES: www.doh.gov.ph/nec/dengue/dusept2005.pdf www.bayanihan.org/html/article.php/20060926152921347

REPLICATION AND TRANSMISSION

OF DENGUE VIRUS

Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases

REPLICATION AND TRANSMISSION

OF DENGUE VIRUS

Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases

CLINICAL CHARACTERISTICS
of DENGUE FEVER
Fever

Headache
Muscle

and joint pain Nausea and vomiting Rash Hemorrhagic manifestation

PETECHIAE

Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases

DIAGNOSIS
Clinical

Fever - blood pressure - evidence of bleeding in skin or other sites - hydration status - evidence of increase vascular permeability (effusions, ascites) - (+) torniquet test

evaluation in Dengue

POSITIVE TORNIQUET TEST

Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases

CLINICAL CASE DEFINITION

DENGUE HEMORRHAGIC FEVER

4 necessary criteria Fever or recent history of acute fever Hemorrhagic manifestation Low platelet count - 100,000/mm3 or less Objective evidence of leaky capillaries

Pleural Effusion

Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases

HEMORRHAGIC MANIFESTATIONS
OF DENGUE HEMORRHGIC FEVER Skin hemorrhages - purpura, petechia, ecchymoses Gingival bleeding Nasal bleeding Gastrointestinal bleeding - hematemesis, melena, hematochezia Hematuria Increase menstrual flow

DANGER SIGNS OF DHF

Abdominal

sustained Persistent vomiting Abrupt change from fever to hypothermia with sweating & prostration Restless or somnolence

pain intense &

4 GRADES OF DHF
Grade 1 - fever & non specific constitutional s & sx - positive torniquet test Grade 2 - grade 1 + spontaneous bleeding Grade 3 - signs of circulatory failure Grade 4 - profound shock

LABORATORY TEST
Clinical

laboratory tests CBC liver function tests Chest X-ray Urinalysis

VIRUS ISOLATION
CELL CULTURE

Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases

VIRUS ISOLATION
CELL CULTURE

Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases

VIRUS-ISOLATION
MOSQUITO-INOCULATION

Centers for Disease Control and Prevention Division of Vector-Borne Infectious Disease

Treatment
Fluids

Rest
Antipyretics

avoid aspirin/NSAID Monitor blood pressure, hct, platelet count, PT, PTT and level of consciousness May need transfusion

Dengue

Undifferentiated fever

Classical Dengue Fever

Dengue Hemorrhagic Fever

NATIONAL EPIDEMIOLOGY CENTER

NATIONAL EPIDEMIOLOGY CENTER

4S 1)Search and Destroy, mosquito breeding places 2)Self protection measures 3)Seek early treatment 4)Say NO to fogging

NATIONAL EPIDEMIOLOGY CENTER

They Hide, We Seek

NATIONAL EPIDEMIOLOGY CENTER

Thou Shalt Protect

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Mistakes to Avoid

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