denguee presentation
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By: Dr Syed Zia Hussain
Registrar General Medicine
PIMS Islamabad
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What is dengue fever?
Dengue Fever is an illness caused byinfection with a virus transmitted by the
Aedesmosquito.
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What is Dengue?
Is an acute fever producing infectious disease
Mostly found in the tropics It is also known as Dengue fever , breakbone fever or
Dengue hemorrhagic fever
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Characteristics of theAedes MosquitoOne distinct physicalfeature black and whitestripes on its body and legs.
Bites during the day.
Lays its eggs in clean,
stagnant water.
Close-up of an Aedes mosquito
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Causative agent of DengueDengue is cause by a RNA virus
This virus is a member of the viral family
Flaviviridae.
Dengue virus
Bauman, R., (2006). Microbiology disease by systems. San Francisco , CA: Pearson Benjamin CummingPublishers
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Transmission of DengueA mosquito is the biological vector
This mosquito is the obligate intermediate host forsome viruses
Aedes albopictus/aegypti are generally associated withthe spread of dengue fever
Biting around the ankles and knees close to theground in the daytime.
Only female mosquitoes will bite; mostly in thedaytime
Akram, W., (n.d.). Aedes as a vector of Dengue: a possible threat to our lives. Khwarzimig Science Society.University of Agriculture, Faisalabad. Retrieved April 19, 2010 fromhttp://www.khwarzimic.org/takveen/dengue_kss.pdf
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Aedes albopictus The Asian tiger mosquito was found in Florida at a tire
dump site near Jacksonville
The species has spread rapidly throughout the easternstates, including all Floridas 67 counties
Aedes albopictus is a vector for many viruses includingdengue fever and Eastern equine encephalitis virus
Currently this mosquito is established in 866 countiesin 26 states
Rios, L., Maruniak, J.E. (2008). Asian tiger mosquito. University of Florida Institute of Foodand Agricultural Sciences . Retrieved April 19, 2010 fromhttp://www.entemdept.ufl.edu/creatures/aqutic/asian_tiger.htm
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Aedes albopictus
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Common breeding sites Dengue cases usually increase during the rainy season
The spread of the mosquito is attributed to poor
environmental sanitationWhen it rains the water gets stored in any place such as
discarded tires, broken bottles, and even shoes
Other examples are soda cans, birdbaths, rain gutters,
toys, pool covers, tree stumps, and garbage cans.Illinois Environmental Protection Agency, (2007).Mosquito-Borne illnesses prevention
techniques. Retrieved April 22, 2010 from http://www.epa.st.il.us /land/tires/mosquito-borne-illness.html
http://www.epa.st.il.us/http://www.epa.st.il.us/ -
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Do the 10-Minute Mozzie Wipe-out everyday.
Remove water from flowerpot plates onalternate days.
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10-Minute Mozzie
Wipe-Out Exercise
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Do the 10-Minute Mozzie Wipe-out everyday.
Change water in vases on alternate days.
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Do the 10-Minute Mozzie Wipe-out everyday.
Turn over all pails and waterstorage containers.
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Do the 10-Minute Mozzie Wipe-out everyday.
Cover bamboo pole holderswhen not in use.
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Do the 10-Minute Mozzie Wipe-out everyday.
Clear blockages and put Bti insecticide in roofgutters monthly.
d
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Unwanted items
Do not litter. Rubbish such as cupsand bottles can collect rain waterand breed mosquitoes.
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Aedes aegyptilife cycle
2-7 days
>4 days 2 days
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Signs and Symptoms of Dengue
Fever High fever, up to 105 F (40.6 C)
A rash over most of your body, can subside after a couple of days and then
reappear
Sever headache, backache or both Pain behind your eyes
Severe joint and muscle pain (breakbone fever)
Nausea and vomiting
Signs and symptoms usually begin about four to seven days after being
bitten byA. aegypti.
Mild dengue fever rarely causes death, it is usually self-limiting
Mayo clinic, (2010). Dengue fever symptoms. Retrieved April 19, 2010 from
http://www.mayoclinic.com/health/dengue_fever/DS01028/DSECTION=symptoms
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Signs and Symptoms of Dengue
Hemorrhagic fever (DHF) A more severe form of dengue that begins the same way as
dengue fever but become worse after several days
Significant damage to your blood and lymph vessels
A decrease in the number of blood cells that help yourblood clot (platelets)
Bleeding from nose and mouth
Bleeding under the skin, which gives the appearance ofbruising
DeathMayo clinic, (2010). Dengue fever symptoms. Retrieved April 19, 2010 from
http://www.mayoclinic.com/health/dengue_fever/DS01028/DSECTION=symptoms
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Signs and Symptoms of Dengue
Shock Syndrome (DSS) The most severe form of the disease
It may start with the signs and symptoms of mild dengue plus
Severe abdominal pain
Frequent vomiting
Disorientation
Fluid (plasma) leakage from blood vessels
Heavy bleeding
A sudden drop in blood pressure (shock)
DeathMayo clinic, (2010). Dengue fever symptoms. Retrieved April 19, 2010 fromhttp://www.mayoclinic.com/health/dengue_fever/DS01028/DSECTION=symptoms
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Why does different clinical manifestations
of Dengue exists? There are four different types (serotypes) of the dengue
virus
These are DEN-1, DEN-2, DEN-3 and DEN-4
Recovery from infection by one provides lifelong immunityagainst that virus, confers only partial and transientprotection against subsequent infection by the other three
viruses
There is evidence that sequential infection increases therisk of developing dengue hemorrhagic fever
World Health Organization, (2009). Dengue and dengue haemorrhagic fever. Retrieved April 19,2010 fromhttp://www.who.int/mediacentre/factsheet/fs117/en/
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Diagnosis for Dengue Travel history and symptom profile
Detection of antibodies against the virus
Complete blood count
Chemistry panel
Liver function test
Occult blood in stool
DIC panel
Price, D.D., Wilson, S.R., (2009). Dengue fever: differential diagnoses andworkout. Medscape. Retrieved April 19, 2010 fromhttp://emedicine.medscape.com/article/781961-diagnosis
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Treatment for Dengue No specific therapeutic agents exist for dengue
infections
Bed rest and hydration therapy
Fever control with acetaminophen. Narcotics may be
necessary if headaches are very severeAspirin should be avoid because of anticoagulant
properties, children should avoid aspirin when a viralinfection is suspected
Monitoring of signs and symptoms for warning signsof DHF or DSS
Price, D.D., Wilson, S.R., (2009). Dengue fever: differential diagnoses and workout. Medscape. RetrievedApril 19, 2010 from http://emedicine.medscape.com/article/781961-diagnosis
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Preventive Measure for Travelers No vaccine or drugs are available for the prevention of dengue
Preventive measure should be taken to avoid the bite of the mosquito
Well screen accommodations or air conditioning
Use of insecticide indoors Apply insect repellent to skin and clothing. The most effective are
the ones with DEET
Empty , clean or cover any standing water that can be a mosquito-breeding site
Center for Disease Control and Prevention, (2009). Other infectious disease related to travel,dengue fever (DF) and dengue hemorrhagic fever (DHF). Retrieved April 19, 2010 fromhttp://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-5/dengue-fever-dengue-hemorrhagic-fever.aspx
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Incidence of Dengue Fever Global incidence of dengue has grown dramatically
2500 million people- two fifths of the worlds population-are now at risk from dengue
WHO estimates 50 million to 100 million cases of dengueinfection worldwide every year
In 1998,there were 616,000 cases of dengue in the Americasof which 11,000 cases were DHF
In 2007, there were more than 890,000 reported cases ofdengue in the Americas, of which 26000 were DHF
World Health Organization, (2009) Dengue and dengue haemorrhagic fever. RetrievedApril 19, 2010 from http://www.who.int/mediacentre/factsheets/fs117/en/
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More StatisticsAn estimated 500,000 people with DHF require
hospitalization each year, a large proportion arechildren, about 2.5% of these die
DHF fatality rates can exceed 20% without propertreatment
World Health Organization, (2009) Dengue and dengue haemorrhagic fever. RetrievedApril 19, 2010 from http://www.who.int/mediacentre/factsheets/fs117/en/
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Final word of advice The times of higher risk of being bitten by the female
mosquito is 2 to 3 hours after daybreak and 3 to 4hours before nightfall
The mosquito can feed indoors as well as outdoors
Precautions as mention before should be takenespecially at peak biting activity time
The risk of exposure may be lower in modern, air-conditioned hotels with well-kept grounds
Gubler, D., (1998). Dengue and dengue hemorrhagic fever . Clinical Microbiology Reviews,July 1998, p.480-496. Retrieved April 24, 2010 fromhttp:/www.cmr.asm.org/cgi/repreint/11/3/480
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Thank you for your time
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