denguee presentation

8/2/2019 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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Change water in vases on alternate days.


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Turn over all pails and waterstorage containers.


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Cover bamboo pole holderswhen not in use.

h


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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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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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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

denguee presentation

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