Post by Abante on Sept 28, 2006 21:58:41 GMT -5
Dengue fever
Dengue fever and dengue hemorrhagic fever (DHF) are acute febrile diseases, found in the tropics, with a geographical spread similar to malaria. Caused by one of four closely related virus serotypes of the genus Flavivirus, family Flaviviridae, each serotype is sufficiently different that there is no cross-protection and epidemics caused by multiple serotypes (hyperendemicity) can occur. Dengue is transmitted to humans by the mosquito Aedes aegypti (rarely Aedes albopictus). The transmitter of the disease is a day biting mosquito which lays eggs in stagnant water.
Dengue virus
Signs and symptoms
Onset of symptoms is abrupt with principal manifestations as:
1. Fever (high grade which may last 2 to 7 days)
2. Generalized body malaise or weakness
3. Headache
4. Muscle pains and/or joint pains
5. Eye pain
6. Abdominal pain
7. Rash (maculopapular or tiny red spots on the skin called petechiae)
There is a predisposition towards bleeding of the nose and gums and in more severe forms, vomiting of blood and passing out of black stools. This constitutes the hemorrhagic type (“H-fever”).
How do we confirm cases of Dengue Fever?
Except under epidemic conditions, the differential diagnosis of Dengue Fever / Dengue Hemorrhagic Fever may be difficult because symptoms are common to a wide gamut of viral bacteria and other infections. Hence, over diagnosis is impossible. Nevertheless, since this is a public health concern of global dimension, clinical recognition cannot be over emphasized. Diagnostic confirmation can be done by Complete Blood Count with Platelet Count Determination (CBC with PC).
Treatment
The mainstay of treatment is supportive therapy. The patient is encouraged to keep up oral intake, especially of oral fluids. If the patient is unable to maintain oral intake, supplementation with intravenous fluids may be necessary to prevent dehydration and significant hemoconcentration. A platelet transfusion is rarely indicated if the platelet level drops significantly or if there is significant bleeding.
How do we prevent Dengue Fever?
1. Check regularly for Aedes aegypti mosquito breeding places such as stagnant water found in flower vases, pots, roof gutters, empty cans, old tires, leaves and stems of plants.
2. Change the water in flower vases at least once a week.
3. Remove indoor flower pots, if possible.
4. Clean roof gutters at least once a month.
5. Turn pails/water containers upside down when not in use.
6. Clean regularly and/or throw away empty cans and old rubber tires.
7. Provide screens in doors and windows. Use mosquito nets when sleeping in mosquito infested areas.
8. Isolate patients suffering from Dengue / H-fever for at least 5 days.
9. Request the field Epidemiology Office of the Department of Health in your area to spray with insecticides all possible breeding places of mosquitoes.
10. Report to your family physician suspected cases of Dengue fever.
Recent outbreaks
2005 dengue outbreak
Country Cases Deaths Date of Information
Cambodia
- 38 Sep.
Costa Rica
19,000 1 7 Sep.
India, (West Bengal)
900 15 Sep.
Indonesia
80,837 1,099 Jan. 2006
Malaysia
32,950 83 1 Nov.
Martinique
6,000 2 26 Sep.
Philippines
21,537 280 2 Oct.
Singapore
12,700 19 22 Oct.
Sri Lanka
3,000 - 16 Sep.
Thailand
31,000 58 Sep.
Vietnam
20,000 28 4 Oct.
Total+ 227,924 1,623 -
+For listed countries only. World Health Organization estimates that there may be 50 million cases of dengue infection worldwide each year.
Recent dengue outbreaks in America:
• Dominican Republic (August - September 2006) 3,000 cases with 30 dead.
Recent dengue outbreaks in South East Asia:
• Philippines (January - August 2006) 13,468 cases with 167 dead.
• Thailand (May 2005) 7200 infected. At least 12 dead.
• Indonesia (2004) 80,000 infected with 800 deaths.
• Malaysia (January 2005), 33,203 cases.
• Singapore (2005), At least 13 deaths, (2004), 9460 cases, (2003), 4788 cases.
• Australia [2006] 15 March 2006, 2 Confirmed Cases at Gordon Vale, Cairns, Queensland.
• China September 2006, 70 cases since June in Guangzhou,Guangdong.
Dengue fever and dengue hemorrhagic fever (DHF) are acute febrile diseases, found in the tropics, with a geographical spread similar to malaria. Caused by one of four closely related virus serotypes of the genus Flavivirus, family Flaviviridae, each serotype is sufficiently different that there is no cross-protection and epidemics caused by multiple serotypes (hyperendemicity) can occur. Dengue is transmitted to humans by the mosquito Aedes aegypti (rarely Aedes albopictus). The transmitter of the disease is a day biting mosquito which lays eggs in stagnant water.
Dengue virus
Signs and symptoms
Onset of symptoms is abrupt with principal manifestations as:
1. Fever (high grade which may last 2 to 7 days)
2. Generalized body malaise or weakness
3. Headache
4. Muscle pains and/or joint pains
5. Eye pain
6. Abdominal pain
7. Rash (maculopapular or tiny red spots on the skin called petechiae)
There is a predisposition towards bleeding of the nose and gums and in more severe forms, vomiting of blood and passing out of black stools. This constitutes the hemorrhagic type (“H-fever”).
How do we confirm cases of Dengue Fever?
Except under epidemic conditions, the differential diagnosis of Dengue Fever / Dengue Hemorrhagic Fever may be difficult because symptoms are common to a wide gamut of viral bacteria and other infections. Hence, over diagnosis is impossible. Nevertheless, since this is a public health concern of global dimension, clinical recognition cannot be over emphasized. Diagnostic confirmation can be done by Complete Blood Count with Platelet Count Determination (CBC with PC).
Treatment
The mainstay of treatment is supportive therapy. The patient is encouraged to keep up oral intake, especially of oral fluids. If the patient is unable to maintain oral intake, supplementation with intravenous fluids may be necessary to prevent dehydration and significant hemoconcentration. A platelet transfusion is rarely indicated if the platelet level drops significantly or if there is significant bleeding.
How do we prevent Dengue Fever?
1. Check regularly for Aedes aegypti mosquito breeding places such as stagnant water found in flower vases, pots, roof gutters, empty cans, old tires, leaves and stems of plants.
2. Change the water in flower vases at least once a week.
3. Remove indoor flower pots, if possible.
4. Clean roof gutters at least once a month.
5. Turn pails/water containers upside down when not in use.
6. Clean regularly and/or throw away empty cans and old rubber tires.
7. Provide screens in doors and windows. Use mosquito nets when sleeping in mosquito infested areas.
8. Isolate patients suffering from Dengue / H-fever for at least 5 days.
9. Request the field Epidemiology Office of the Department of Health in your area to spray with insecticides all possible breeding places of mosquitoes.
10. Report to your family physician suspected cases of Dengue fever.
Recent outbreaks
2005 dengue outbreak
Country Cases Deaths Date of Information
Cambodia
- 38 Sep.
Costa Rica
19,000 1 7 Sep.
India, (West Bengal)
900 15 Sep.
Indonesia
80,837 1,099 Jan. 2006
Malaysia
32,950 83 1 Nov.
Martinique
6,000 2 26 Sep.
Philippines
21,537 280 2 Oct.
Singapore
12,700 19 22 Oct.
Sri Lanka
3,000 - 16 Sep.
Thailand
31,000 58 Sep.
Vietnam
20,000 28 4 Oct.
Total+ 227,924 1,623 -
+For listed countries only. World Health Organization estimates that there may be 50 million cases of dengue infection worldwide each year.
Recent dengue outbreaks in America:
• Dominican Republic (August - September 2006) 3,000 cases with 30 dead.
Recent dengue outbreaks in South East Asia:
• Philippines (January - August 2006) 13,468 cases with 167 dead.
• Thailand (May 2005) 7200 infected. At least 12 dead.
• Indonesia (2004) 80,000 infected with 800 deaths.
• Malaysia (January 2005), 33,203 cases.
• Singapore (2005), At least 13 deaths, (2004), 9460 cases, (2003), 4788 cases.
• Australia [2006] 15 March 2006, 2 Confirmed Cases at Gordon Vale, Cairns, Queensland.
• China September 2006, 70 cases since June in Guangzhou,Guangdong.
