

 The disease
 Epidemiology
 Monitoring and evaluation
 Information resources

Disease surveillance
Effective surveillance of dengue cases is essential:

 To detect outbreaks in order to initiate timely and effective control measures;

 Monitor the trends of incidence including temporal and geographic distribution of cases;
 To monitor number of severe dengue cases and deaths;
 To assess and confirm possibility of outbreaks based on serological evidence;
 To monitor the impact of control interventions.

Epidemiological surveillance requires the report on the following indicators

 Suspected (clinical) cases of dengue and severe dengue;

 Confirmed (laboratory-tested) cases of dengue and severe dengue;
 Circulating serotypes (DEN-1,-2,-3 or -4);
 Number of deaths from dengue or severe dengue;
 Number of deaths among severe dengue cases, suspected or confirmed.

The effective prevention and control of epidemic dengue requires an active laboratory-based
disease surveillance programme (using serological and virological diagnosis) that can provide
early warning of impending epidemic transmission. However, for early detection of suspected
cases, routine monitoring of fever cases in sentinel sites should be considered.

Vector surveillance
Surveillance on Ae. aegypti density is important in determining factors related to dengue
transmission, in order to prioritize areas and seasons for vector control. Selection of appropriate
surveillance strategies are based upon outcome/objective, also taking into consideration time,
resources, and infestation levels.

Additionally, vector surveillance is required to sustain the control measures and detect any
increase in vector density.

The most used indicators for vector surveillance are:

Larval surveys:

House index (HI): percentage of houses infested with larvae and/or pupae.
Container index (CI): percentage of water-holding containers infested with larvae or pupae.

Breteau index (BI): number of positive containers per 100 houses inspected.

Pupae surveys:

Pupa index (PI): number of pupae per 100 houses inspected.

Adult surveys:

Estimating adult population density using ovitraps, sticky traps, human landing collections or
any similar traps

Dengue Fever
In this Article

 Symptoms of Dengue Fever

 Diagnosing Dengue Fever
 Treatment for Dengue Fever
 Preventing Dengue Fever

Dengue (pronounced DENgee) fever is a painful, debilitating mosquito-borne disease caused by

any one of four closely related dengue viruses. These viruses are related to the viruses that cause
West Nile infection and yellow fever.

An estimated 390 million dengue infections occur worldwide each year, with about 96 million
resulting in illness. Most cases occur in tropical areas of the world, with the greatest risk
occurring in:

 The Indian subcontinent

 Southeast Asia
 Southern China
 Taiwan
 The Pacific Islands
 The Caribbean (except Cuba and the Cayman Islands)
 Mexico
 Africa
 Central and South America (except Chile, Paraguay, and Argentina)
Most cases in the United States occur in people who contracted the infection while traveling
abroad. But the risk is increasing for people living along the Texas-Mexico border and in other
parts of the southern United States. In 2009, an outbreak of dengue fever was identified in Key
West, Fla.

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Dengue Fever
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Dengue fever is transmitted by the bite of an Aedes mosquito infected with a dengue virus. The
mosquito becomes infected when it bites a person with dengue virus in their blood. It can’t be
spread directly from one person to another person.

Symptoms of Dengue Fever

Symptoms, which usually begin four to six days after infection and last for up to 10 days, may
include

 Sudden, high fever

 Severe headaches
 Pain behind the eyes
 Severe joint and muscle pain
 Fatigue
 Nausea
 Vomiting
 Skin rash, which appears two to five days after the onset of fever
 Mild bleeding (such a nose bleed, bleeding gums, or easy bruising)

Sometimes, symptoms are mild and can be mistaken for those of the flu or another viral
infection. Younger children and people who have never had the infection before tend to have
milder cases than older children and adults. However, serious problems can develop. These
include dengue hemorrhagic fever, a rare complication characterized by high fever, damage to
lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and failure
of the circulatory system. The symptoms may progress to massive bleeding, shock, and death.
This is called dengue shock syndrome (DSS).

People with weakened immune systems as well as those with a second or subsequent dengue
infection are believed to be at greater risk for developing dengue hemorrhagic fever.