Dengue Fever

An acute infectious disease manifested initially with fever that caused by the Flavi virus
and the first confirmed Dengue epidemic was reported from Philippines in 1953-1954.

Transmission

Aedes aegypti or the common household mosquito are the

transmitter of the disease, is a day-biting mosquito which lays
eggs in clear and stagnant water found in flower vases, cans,
rain barrels, old rubber tires, etc. The adult mosquitoes rest in
dark places of the house.

Mosquito Bite

Diagnosis

Tests may include the following blood tests:

• Antibody tests—to see if your body is producing substances that fight the dengue
fever viruses
• Reverse transcriptase polymerase chain reaction test (RT-PCR)—to determine the
presence and quantity of virus present in the bloodstream
• 20 or more petechiae that form within a 2.5-cm diameter circle by tourniquet test
Signs and Symptoms

Signs and Symptoms

First 4 days: febrile or invasive stage

- Sudden onset of high fever

- Abdominal pain
- Joint & muscle pain
- Headache
- Vomiting
- Conjunctival infection / pain behind the eyes
- Epistaxis
- Loss of appetite and Weakness

4th – 7th days: toxic or hemorrhagic stage

- Lowering of temperature
- Skin rashes - maculopapular rash or red tiny spots on the skin called petechiae
- Severe abdominal pain
- Vomiting
- Hematemesis and melena
- Unstable BP

7th – 10th day: convalescent or recovery stage

- Generalized flushing with intervening areas of blanching appetite regained and blood
pressure already stable.
Management: no medications available that can provide a cure. Treatment addresses the
symptoms and it also attempts to avoid potential complications.

Dengue fever:

• Symptomatic and supportive treatment.

• Bed rest during acute febrile illness.
• Avoidance of antipyretics or aspirin because of gastritis and bleeding.
Paracetamol may be given.
• Analgesics / mild sedation for pain such as headache.
• For vomiting and sweating, oral fluids and electrolytes must be supplemented
• IV fluids if necessary.
• Monitoring of patient is required till he becomes afebrile, has normal platelet
count and normal hematocrit.
• Prevention of DHF by early recognition of plasma leakage by frequent estimation
of hematocrit (> 20% in normal values) and platelet count < 50,000/mm3 would
cause Dengue Hemorrhagic Fever.
• Check for low BP and for Narrow pulse pressure (< 20 mm Hg)

Prevention and Control

• Cover water drums and water pails at all times to prevent mosquitoes from
breeding.
• Replace water in flower vases once a week.
• Clean all water containers once a week. Scrub the sides well to remove eggs of
mosquitoes sticking to the sides.
• Clean gutters of leaves and debris so that rain water will not collect as breeding
places of mosquitoes.
• Old tires used as roof support should be punctured or cut to avoid accumulation of
water.
• Collect and dispose all unusable tin cans, jars, bottles and other items that can
collect and hold water.
• Insect repellents, screen the window and bed mosquito net
• Wear long-sleeved shirts and pants. Also wear socks and shoes, and apply insect
repellents on your skin and your clothing whenever going out in infected area.