INCIDENCE

• Philippines ranks 4th in the list of Association of Southeast Asian Nations (ASEAN) member-countries tormented by dengue

• The Philippines recorded 144.55 dengue cases per 100,000 population last year, up from 58.94 in 2009, according to DOH data.

Philippine DENGUE updates as of Jan. 1 to Sept. 4• Total Number of Cases last year - - - 36,887• Total Number of Cases this year - - - 77,012 (48% higher

than last year)• Total Number of Death last year - - - 383• Total Number of Death this year - - - 534 (72% higher

than last year)• DOE- Total Number of Death (School Children) this year

- - - 118 (out of 534)• Source: http://topnews.co.uk/213000-philippines-dengue-death-toll-touches-534

Dengue is a virus which is carried by an infected Female Aedes Mosquito

After 24 – 48 hours mating with the male aedes mosquito, the female seeks out blood for egg production.

The Cycle of Dengue infections in the environment involves only 3 elements.

MAN

MOSQUITOVIRUS

Absence of any of these implies non-occurrence of the disease.

Transfer of the virus from a sick person to a healthy person requires only the bite of an infected female Aedes mosquito.

In the Philippines, only two species of mosquitoes are known to transmit Dengue.

, the primary vector of the disease and an important factor in epidemics,

, the secondary vector & believed to be responsible for maintaining the virus in the environment.

ADULT(Fem. Ave. 30 days)(Male ave. 20 days)

EGGS(Ave. 2-3 days)

LARVA or KITI-KITI (Ave. 6-8 days)

PUPA (1 day)

Eggs are laid in water or in moist places. Embryonic development is completed within 48 hours if the environmental conditions are favourable, i.e. warm and humid. Due to their protective covering, Aedes eggs can resist desiccation for up to a period of about one year.

A female Aedes mosquito lays eggs 3 to 4 times in its lifetime. About 60 to 100 eggs are laid per hatch.

A female Aedes mosquito lays eggs 3 to 4 times in its lifetime. About 60 to 100 eggs are laid per hatch.

• The larva, which is feeding stage of the mosquito, depends much on the aquatic nutrient for its food. This stage last for 6-8 days on the optimum but may extend to several days depending upon the environmental conditions.

• Through the shape of the Comb scale (comb teeth) on the eight segment of the abdomen.

The highly mobile pupa has only a duration of one to two days. This is the immediate phase from which the adult form of the mosquito emerges.

The breeding places of Aedes aegypti are almost always exclusively confined to artificial containers seen commonly in close association with man. These are usually found indoor and contain water generally considered clean, clear, and unpolluted. In very rare instances however, they may be found breeding in polluted water sources but may not be able to survive the hostile water conditions.

1. Flower vases2. Water jug/jars3. Concrete water tanks4. Discarded vehicle tires5. Ant traps6. Metal drums7. Water barrels8. Tin cans and even soft drinks cap9. Any other containers which can accumulated

water up to 7 days.

Unlike Aedes Aegytpti, Aedes albopictus prefers to breed outdoor, in natural containers. It is not ordinary however, to see them in some indoor containers. Examples of their preferred sites are the following:1. Tree holders2. Bamboo stumps3. Coconut shells and husks4. Flower axils (Bromeliad)5. Ground rock/holes

Generally, Aedes mosquitos are “daybiters” with two peaks of biting time:

a.) at dawn, just after sunrise (6:00am – 8:00am)b.) at dusk, just before sunset (4:00pm -6:00pm)Only female mosquitoes can bite because of the requirement of blood for ovipositions or egg production; males do not bite.

As a domestic mosquito, Aedes aegypti prefers rest in cool, dark corners of the house. Commonly, they are found in closets (where clothes are hung), under beds, tables and chairs.

Aedes albopictus adults usually rest outdoors in clearings and vegetations.

Aedes mosquitoes do not fly great distances. Their average flight range is only 50 meters. The farthest distance (flight distance) they could reach is only within 200-400 meters radius from their breeding places.

A. Dengue FeverB. Dengue Hemorrhagic Fever(DHF)C. Dengue Shock Syndrome(DSS)

Probable: an acute febrile illness with 2 or more of the following manifestations:

any two or more of the constitutional signs and symptoms like pain behind the eye, headache, muscle pain, joint pain, nausea, vomiting, loss of appetite, body weakness.

• Fever or history of acute fever of 2-7 days duration• Any 2 or more of the constitutional signs and

symptoms like loss of appetite, body weakness, headache, muscle pain, joint pains, nausea, vomiting.

• Hemorrhagic tendencies which can be any one of the following:

- positive tourniquet test -facial flush

- gum bleeding, nose bleeding, easy bruising- abdominal pain which signals internal bleeding- bleeding from the stomach or from the intestine as manifested by blood in vomitus or black colored stools

(platelet count ≤ 100,000 cells)

DO NOT TAKE ASPIRIN if it is suspected dengue case.

. rapid and weak pulse. capillary refill of > 3 seconds. narrow pulse pressure. Cold clammy skin and restlessness with or without difficulty of breathing

. restlessness

Any of these signs and symptoms should make a health worker suspect a Dengue case, either Dengue Fever or Dengue Hemorrhagic Fever.

REFER IMMEDIATELY TO A PHYSICIAN OR DIRECTLY TO THE HOSPITAL Request for Laboratory examination if laboratory

facility is available.1.) complete blood count with differential count2.) platelet count3.) hematocrit

Signs and Symptoms Treatment

Fever Paracetamol

DON’T GIVE ASPIRIN

Increase fluid intake-ORS can be given if available

Headache, joint pain & muscle pain and pain behind the eyes

Paracetamol can help relieve pain

Anorexia, vomiting and/or abdominal pain

Give oral fluid-ORS and/or fruit juiceORS like ORESOL can be given as in moderate dehydration at 75ml/KgBW in 4-6 hours or up to 2-3 liters in adults. Continue ORS until patient improves

• Remove accumulated water from artificial and dish container, drainer of refrigerator/aircon

• Clean and scrub the inside and outside surfaces of water containers

• Ask an elder to clean house and school gutters• Cover all drums, pails and other water containers

How to prevent and control Dengue?at home, in school and in the community

• Put your trash in garbage can• Report to barangay officials or an elder any

vacant lot with possible breeding sites of dengue carrier mosquito

• Cooperate in cleanliness campaign or clean-up drive in your community

• Change water from flower vases once a week

BE AN ANTI-DENGUE ADVOCATE,DISSEMINATE

INFORMATION ON DENGUE

The Department of Health is not recommending to use fogging as solution to prevent and reduce dengue cases. However, using of fogging is too much expensive.

• Conduct cases investigation• Conduct Larva surveillance to determine the

presence of the vector• Conduct Information Education Campaign in

Schools, Puroks and Barangays.• Promote environmental sanitation practices

particularly the 4 o’clock habit

EPIDEMIOLOGY GROUP 7