Dengue fever (DB) is an acute febrile disease caused by the dengue virus, which

enters the human bloodstream by mosquitoes of the genus Aedes, such as Aedes
aegypti or Aedes albopictus. There are four different types of dengue virus, but
close related, which can cause dengue fever. Dengue virus is a virus of the genus
Flavivirus, family Flaviviridae. Dengue fever are found in tropical and subtropical
regions around the world, especially in the rainy season that clammy. The World
Health Organization (WHO) estimates that each year there are 50-100 million cases
of dengue virus infection in the world.
CAUSE
The main causes of dengue fever is dengue virus, which is a virus of the family
Flaviviridae. There are four types of dengue virus are known to cause dengue fever.
The fourth is the DEN virus-1, DEN-2, DEN-3, and DEN-4. Symptoms of dengue
emerging as someone who has been infected by one of four types of dengue virus
infection by a different dengue virus types. Immune system that has been formed in
the body after the first infection would likely result in the emergence of a more
severe disease symptoms when infected for the second time. A person can be
infected by at least two types of dengue virus during life, but the same type of virus
that can only infect one time due to the body's immune system is formed.
Dengue virus can enter the human body through the bite of the carrier vector, the
mosquito of the genus Aedes such female Aedes aegypti and Aedes albopictus.
Vector Aedes aegypti is the most common cause of this disease. Mosquitoes can
carry the dengue virus after sucking the blood of people who have been infected
with the virus. After the incubation period in the mosquito for 8-10 days, an infected
mosquito can transmit dengue virus to healthy humans bitten. Female mosquitoes
can also spread the dengue virus is brought to the offspring via the egg
(transovarial). Several studies have shown that monkeys can also be infected by
dengue virus, and can also serve as a source of infection for other monkeys when
bitten by a mosquito vector.
The level of risk of contracting dengue fever rose to someone who had antibodies to
dengue virus caused the first infection. In addition, the risk of dengue fever were
also higher in women, a person younger than 12 years, or someone who comes
from the Caucasian race.
Clinical Manifestations
Dengue virus infection can manifest in several outcomes, including common fever,
dengue fever (classic), dengue hemorrhagic fever (hemorrhagic), and dengue shock
syndrome.
Dengue fever (classic)
Dengue fever symptoms that generally vary depending on the age of the patient.
Common symptoms in infants and children is fever and the appearance of the rash.
Whereas in adolescence and adult patients, symptoms that appear are high fever,
severe headache, pain behind the eyes, pain in the joints and bones, nausea and

vomiting, as well as the appearance of a skin rash. Decrease in the number of white
blood cells (leukopenia) and a decrease in blood platelets or platelets
(thrombocytopenia) also often be observed in patients with dengue fever. In some
epidemics, patients also showed bleeding include nosebleeds, bleeding gums,
gastrointestinal bleeding, bloody urine (haematuria), and heavy menstrual bleeding
(menorrhagia).
Dengue hemorrhagic fever (hemorrhagic)
Patients suffering from dengue hemorrhagic fever (DHF) patients typically show
symptoms such as classic dengue plus the four major symptoms, namely high fever,
hemorrhagic phenomena or severe bleeding, which is often accompanied by
enlargement of the heart and blood circulation system failure. The damage to blood
vessels, lymph vessels, bleeding under the skin which makes the emergence of
bluish bruises, thrombocytopenia, and an increase in the number of red blood cells
are also frequently found in patients with DHF. One of the characteristics to
distinguish the severity of dengue hemorrhagic fever at once distinguish it from the
classic is the leakage of blood plasma. Critical phase of dengue was established
after 2-7 days of high fever, the patient experienced a drastic drop in body
temperature. Patients will continue sweating, sleeplessness, and decreased blood
pressure. When therapy with electrolyte done quickly and properly, patients can
recover quickly after experiencing a critical period. But if not, DHF can result in
death.
Dengue Shock Syndrome
Rate shock syndrome is a severe dengue virus infection, in which the patient will
experience most or all of the symptoms that occur in patients with classic dengue
and dengue hemorrhagic fever accompanied by leakage of fluid outside the blood
vessels, severe bleeding, and shock (blood pressure resulting in very low), usually
after 2-7 days of fever. Body is cold, sleeplessness, and abdominal pain are early
signs that were common before the shock. Shock syndrome usually occurs in
children (sometimes occurs in adults) who have dengue infection for the second
time. It is generally very fatal and can result in death, especially in children, if not
handled properly and quickly. Duration of the shock itself is very fast. Patients may
die during the period of 12-24 hours after the shock occurs or can be recovered
quickly when efforts to restore body fluid therapy done right. Within 2-3 days,
patients who have successfully passed the shock will be cured, marked with the
appropriate level of urine output and return of appetite.
DIAGNOSIS
Dengue fever is diagnosed by looking at the symptoms, such as high fever and the
appearance of the rash .. However, because the symptoms of dengue fever is
sometimes difficult to distinguish from malaria, leptospirosis, typhoid fever and then
usually a medical worker or doctor will first check the patient's medical history and
a trip to look for the possibility of patient information being bitten mosquitoes. In

addition to getting a higher accuracy of diagnosis is generally performed various

laboratory tests. Several tests are usually performed serologic studies to determine
the presence or absence of antibodies to dengue virus in the patient's body,
calculate the titer of antibodies to dengue virus, and complete blood cell count (red
blood cells, white blood cells, and platelets). In addition, other laboratory tests that
can be done is a hemagglutination inhibition assay, ELISA assay, and reverse
transcriptase polymerase chain reaction for the detection of antigens, antibodies, or
nucleic acids specific for dengue virus. These tests can take several days.
Prevention
Until now, there is no vaccine or antiviral drugs for this disease. The most effective
measures to reduce the epidemic of dengue is by controlling where and whenever
possible avoid mosquito vector of dengue viruses. Mosquito control can be done by
using some appropriate method, namely:
Environment
Prevention of dengue fever can be done by controlling the mosquito vector, among
others, with the tub drain / water storage at least once a week, replacing / drain
vase and place the bird drink once a week, tightly closed water reservoirs, buried
cans, used batteries and used tires around the house, and home improvement
design.
Biological
Biologically, the vector mosquitoes carrying dengue virus can be controlled with the
use of fish-eating larvae and bacteria.
Chemical
Fumigation (fogging) can kill adult mosquitoes, while giving abate powder in water
shelters can kill mosquito larva. Moreover, it can also be used larvicides.
Additionally because Aedes mosquitoes active during the day a few precautions that
can be done is to use compounds containing DEET mosquito repellent, pikaridin, or
oil of lemon eucalyptus, and use clothing to protect the body covered from mosquito
bites when being active outside the home. In addition, immediately seek treatment
when symptoms appear dengue fever before they become more severe.
Treatment
Until now there is no specific cure for dengue fever patients. Many people who
recover from the disease within a period of 2 weeks. A common treatment measures
in patients with dengue fever is less severe body fluids (through drink or electrolyte)
to prevent dehydration from fever and vomiting, consumption of medicines
containing acetaminophen (eg tilenol) to relieve pain and reduce fever and lots of
rest. Aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen and
naproxen sodium can actually increase the risk pendarahan.Bagi patients with more
severe dengue, it is advised to be hospitalized in the hospital, and the infusion of
electrolytes to replace body fluids and blood transfusion due to bleeding occurs.
Someone who is hit by dengue fever also exposed to mosquito bites should be
prevented, because it feared could transmit dengue virus to others who are healthy.

Epidemiology
Dengue fever is a disease believed to be existing in the old world. Track record of
the disease with similar symptoms have been found in the medical encyclopedia of
China dated 992 years. In line with global developments in the field of shipping and
sea freight industry in the 18th and 19th century, the port cities grew rapidly and
creating a suitable environment for the growth of the mosquito vector for dengue
fever. Mosquitoes and viruses that play a role in the disease continues to spread to
new areas and has led to many worldwide epidemic. One of the most dengue
epidemic first occurred in the regions of Southeast Asia.
The first official report on patients infected with dengue-like illness occurred in
1779.
There are no vaccines or antiviral drugs for dengue fever dengue virus making it
one of the disease is very serious attention globally.