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DENGU
DHF
DSS
CHIKUNGUNYA
LEPTOSPIROSIS
E
4 Serotype of the dengue virus Alphavirus
Spirochete
bacteriaETIOLOGY (DEN 1,2,3 &4)
genus- family
genus leptospira
of togaviridea
Rodents(rats),
dogs,
livestock, wild animals
Aedes
female Aedes Aegypty use the Aegypty
catdirect
& and
VECTORS
Aedes
blood for laying of eggs.
exposer to infected
Albopictus
urine/contaminated
soil &water
3-7
Days Last about 5-14 days
INCUBATI
ON
4-7 Days ( range 3-14 days)
(range
1-12 and within a range of
PERIODS
days)
2-30 days
Anicteric
leptospirosis
{ systemic with
Sudden onset of high fever
aseptic
(biphasic), retro-orbital or frontal
meningitis}
headache, myalgia& arthralgia, Sudden onset
-90% cases
anorexia, abdominal discomfort, of high fever
Icteric
nausea, vomiting
(>39
),
C
leptospirosis
Febrile phase- last 2-7 days severe
Sign &
(weils
ds)
Critical phase- > 3 days arthralgia and
Symptom
{overwhelming
with degree of plasma myalgia,
ds-vascular
leakage, last about 24-48 inconstant
collapse.
skin rash.
hrs.
Thrombocytopen
Recovery
phaseia, hemorrhage,
reabsorption
of
hepatic & renal
extravascular fluid.
dysfunction}

10%
cases
[severe form]

HFMD
Human
enterovirusesPicornaviridea
Coxsackie
viruses
A16(
common)
&
Enteroviruses
17
( severe form)

Fever usually >39 C

longer than 3 days, 4
stages.
Stage 1- oral
ulcers
&
vesicular rash
Stage 2- CNS
involvement
Stage
3cardiopulmonar
y
failure,
pulmonary
edema
or
hemorrhage
Stage
4convalescence.

5.

Fever

++

6.

Tournique
t/hess
test

++

7.

Maculopa
pular
rash

8.

Confluent
rash

hepatom
egaly

9.

1
0.

1
1.

+++

+++

+++

+++

++

+++

++

-/+

++++

++
(pulse
volume is
small,
narrowes
shock
+
pulse
pressure
with cold
extremiti
es)
Investigat h/o
fever Abdomi Pulse
ion
with living nal
pressure
in endemic pain,
<20mmH
area, rash, nausea g,
resp
aches and ,
rate >24,
pain,
vomitin evidence
leukopenia
g,
of plasma
diarrhe leak,

Arthralgia
is Severe
myalgia
the
key localized
to
calf
clinical
muscle
with
features
for conjunctival
dx.(persist for congestion/subconjunc
month
to tival hemorrhage with
years)
or w/o jaundice or
oliguria.
Consider

Oral
ulcers
and
vesicular
rash
appearing
on
the
hands, feet, knees
and/or
buttocks;,
herpangina including
oral ulceration over
anterior
tonsillar

a,
HCT>4
Capillary
5(M)
refill >2
>40(F),
sec.
low plt
count.

1
2.

1
3.

1
4.

pillars,
the
soft
history of contact with
palate,
buccal
contaminated water.
mucosa or uvula.
Lethargy
and
weakness,
refusing
feed & passing less
urine, rapid breath,
vomitting, drowsiness
or
irritably,
fits
(Meningitis,
encephalitis
and
neurogenic
pulmonary edema.)
enterovirus inf.

Abdominal
pain/tenderness,
persistent vomiting, clinical fluid
accumulation, mucosal bleed,
restlessness/lethargy,
liver
enlargement >2cm, lab(increase
HCT,rapid decrease in platelet.

Anicteric leptospirosis
associated
with
pulmonary
haemorrhage & Weils
ds (meningitis, kidney
failure & jaundice)

Lab

RT-PCR (+ day
1-8), Ig M (+
RT-PCR (+ day >5),Ig G & Ig M (+
day
4day 4-10)
>8),PRNT (+
day >8)

Microscopic
agglutination
test
-MAT (gold standard),
Blood serology, swab
Ig M (+ day 5-10),
for viral culture, CSF
rapid test kit for
leptospira, CSF (1st
phase)

treatmen
t

Acetaminophe
n
Adequate
(Paracetamol)
bed rest & Compensated&dec - antipyretic &
fluid intake, ompensated shock NSAID
paracetamo therapy
(ibuprofen)l.
relieve
the
arthritic
component.

Antibiotic(essential)Penicillin/
doxycyclin/tetracyclin/
ampicillin/amoxicillin.

Warning
Sign

Self-limited ds.
Proper
hygiene
control,