TABLE OF CONTENTS.

TABLE OF CONTENTS ------------------------------------------------ 1 CHAPTER 1 (INTRODUCTION) ------------------------------------- 2 CHAPTER 2 (FRAME OF THEORY) -------------------------------- 3-6 CHAPTER 3 (SUMMARY) -------------------------------------------- 7

CHAPTER 1 INTRODUCTION Indonesia is a country where the spread of tropical diseases like dengue fever still high in this country. Dengue fever disease was first discovered in Indonesia in Surabaya in 1968, but gained new virological confirmation in 1972. Asia ranks first in the number of patients with dengue fever each year. This may be caused by the rainfall in Asia is very high, especially in east Asia and south combined with environmental sanitation is not good. WHO estimates more than 500,000 of 50 million cases of dengue fever requiring hospitalization. More than 40% of world population living in endemic areas affected by this disease. Hemoragic Dengue fever is a disease caused by dengue virus belonging to group B arthropod, dengue virus is transmitted through the bite of mosquitoes of the genus Aedes (Aedes aegypti, Aedes albopictus, and Aedes polynesiensis). Many contracted dengue fever in the tropics and subtropics.

CHAPTER 2

FRAME OF THEORY
2.1 Definition Dengue hemoragic fever :
Dengue hemoragic fever is a disease caused by dengue virus

2.2 Epidemiology :
The case of the disease was first discovered in Manila, Philippines in 1953. The case was first reported in Indonesia occurred in Surabaya and Jakarta with a total mortality by 24 people in 1968. Several years later the disease spread to several provinces in Indonesia, with the number of cases as follows: - Year 1996: the number of cases of 45,548 people, with the number of deaths as many as 1234 people. - Year 1998: the number of cases of 72,133 people, with the number of deaths as many as 1414 people (an explosion) - Year 1999: the number of cases of 21,134 people. - Year 2000: the number of cases of 33,443 people. - Year 2001: the number of cases of 45,904 people - Year 2002: the number of cases of 40,377 people. - Year 2003: the number of cases of 50,131 people. - Year 2004: up to 5 March 2004 the number of cases already reached 26,015 people, with total mortality by 389 people.

2.3 Ethiology :
dengue hemoragic fever is caused by infection with dengue virus enters the body through the bite of a mosquito genus Aedes (Aedes aegypti, Aedes albopictus, and Aedes polynesiensis).

2.4 Risk factor :

Banyak jentik nyamuk di rumah nya, tetangga/serumah ada yang terkena dengue hemoragic fever tidak pernah dilakukan pengasapan di rumah nya. keadaan rumah yang kurang terurus,, kurang nya edukasi,

2.5 Clinic picture :

Fever for three days continuously (cyclic fever) fever-free phase (crisis phase) muscle pain hepatomegali (liver enlargement) freckle spots on skin (peteki) anemia

2.6 Patofisiologi :
1.) (Pathophysiology of dengue hemoragic fever causes plasma leakage) Aedes mosquito bites that contain dengue virus viremia (sudden fever, headache, nausea, muscle pain, aches throughout the body, decreased appetite, abdominal pain and red spots on skin) anafilaktosin release substances, histamine, and serotonin, hipertermi if the system activity accompanied kolikrein increased permeability of capillary wall / vascular

so that fluid from the intravascular out into ekstravaskular occur plasma enlargement due to its shortage in the intravascular plasma volume there will be hypovolemia, hypotension, hemokonsentrasi, hipoproteinemia and shock.

2.) (Patofisiologi DHF menyebabkan anemia)

Aedes mosquito bites that contain dengue virus excretion of saliva, which contains anti-coagulant (anti-clotting agents) that facilitate the entry and spread of dengue virus it decreases the blood clotting process if there is bleeding anemia

2.7 Diagnose :
Based on clinical symptoms and physical examination and laboratory examination then we will know his diagnosis of this disease eg only on clinical symptoms of fever was found there three days later continuous physical examination hepatomegaly was found there and on examination found there in his lab thrombocytopenia

2.8 Diagnose deferensial :

typhoid fever hepatitis influenza yellow fever

2.9 handling :
In DHF patients we did five protocol handling Protocol 1: adult protocols without shock Someone who is in his best guess suffer dbd monitored kept in hospital. Protocol 2 : fluid administration in patients with DHF 1500+(20x(BB dalam kg -20) = .. ml Protocol 3 : management of DHF with increased hematocrit> 20% Protocol 4 : management of spontaneous bleeding in adult DHF Protocol 5 : treatment of dengue shock syndrome in adults

2.10 Prognosa
If you've passed the critical phase (phase-free fever), then the prognosis would be good, continue to monitor the patient's condition and fluid intake do not overdo it.

CHAPTER 3 SUMMARY DHF disease is a disease caused by viruses that enter our body through mosquito bites, if we want to be free of this disease we have to clean up mosquito breeding in our homes and kill mosquito larvae in our homes.