DENGUE FEVER

PRESENTATION DONE BY

DR.THANOOJA. S.H
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DENGUE: De!"e is ca"se# $% &'e $i&e o(

a i(ec&e# Ae#es ae!%)&i mos*"i&o.
Ae#es is a #a% $i&e+ i.e. i& $i&es #"+i! &'e
#a% &ime.Aedes aegypti is also ,ow as
TIGER mos*"i&o #"e &o )+esece o( w'i&e
s&+i)es o i&s wi!s a# le!s. T'ese
mos*"i&oes "s"all% $+ee# i clea wa&e+
collec&ios i co&aie+s- &a,s- #is)osa$le
.", ma&e+ial s"c' as #isca+#e# $"c,e&s
"&esils &%+es (lowe+ )o&s e&c. All s"c'
co&aie+s s'o"l# $e em)&ie# +e!"la+l%-
a&leas& oce a wee, &o s&o) $+ee#i! o(
&'ese mos*"i&os. De!"e ca )+ese& as /
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A)Dengue Fever:
Signs and Symptoms of Dengue Fever:

A$+")& ose& o( 'i!' (e1e+

Se1e+e (+o&al 'ea#ac'e

Pai $e'i# &'e e%es w'ic' wo+ses wi&' e%e

mo1eme&

2"scle a# .oi& )ais

3oss o( sese o( &as&e a# a))e&i&e

2easles4li,e +as' o1e+ c'es& a# "))e+ lim$s

Na"sea a# 1omi&i!
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B)Signs and Symptoms of Dengue Haemorrhagi
Fever !DHF)" Dengue Sho# Syndrome !DSS)

S%m)&oms simila+ &o #e!"e (e1e+

Se1e+eco&i"o"s s&omac' )ais

S,i$ecomes)ale- col# o+ clamm%

Blee#i! (+omose- mo"&' 7 !"ms a# s,i

+as'es

F+e*"e& 1omi&i! wi&' o+ wi&'o"& $loo#

Slee)iess a# +es&lessess

Pa&ie& (eels &'i+s&% a# mo"&' $ecomes #+%

Ra)i# wea, )"lse

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2.5-3 billion people are at risk.

Aedes aegypti is the primary epidemic vector

Urban disease, but becoming rural.

Estimated 50-00 million cases o! dengue !ever annually.

500,000 "#$ cases re%uire hospitali&ation, each year o!

'hich (0) are children less than 5 years o! age.

*ortality average 5) o! "#$ cases.

Epidemics are cyclical.

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$% &'inia' manifestations of DF" DHF
:liical mai(es&a&ios 1a+% (+om
"#i((e+e&ia&e# (e1e+ &o(lo+i#'emo++'a!e a#
s'oc,. T'e cliical )+ese&a&ios #e)e# o
a!e-imm"e s&a&"s o( &'e 'os& a# &'e 1i+"s
s&+ai. U#e+ &'e )+o!+am &'e(ollowi! ;HO
+ecomme#e# case #e(ii&ios a+e (ollowe#/
Dengue Fever : &'inia' desription
A ac"&e (e$+ile illess o( 04< #a%s #"+a&io
wi&' &wo o+ mo+e o( &'e (ollowi!
mai(es&a&ios/
Hea#ac'e- +e&+oo+$i&al)ai- m%al!ia- a+&'+al!ia-
+as'- 'aemo++'a!icmai(es&a&ios.
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&riteria for Dengue Hemorrhagi Fever and Dengue Sho# Syndrome
Dengue Hemorrhagi Fever : A )+o$a$le o+ co(i+me# case o( #e!"e
a#
'emo++'a!ic &e#ecies e1i#ece# $% one or more of the fo''o(ing
4 Posi&i1e &o"+i*"e& &es&
4 Pe&ec'iae- ecc'%moses o+ )"+)"+a
4 Blee#i! (+om m"cosa- !as&+oi&es&ial &+ac&- i.ec&io si&es o+ o&'e+
si&es
4 Haema&emesis o+ malea
And &'+om$oc%&o)eia >?1@@ @@@ cells )e+ c"mmA
And e1i#ece o( )lasma lea,a!e #"e &o ic+ease# 1asc"la+ )e+mea$ili&%-
mai(es&e# $% one or more of the fo''o(ing :
4 A +ise i a1e+a!e 'aema&oc+i& (o+ a!e a# seB CD 0@E
4 A mo+e &'a 0@E #+o) i 'aema&oc+i& (ollowi! 1ol"me +e)laceme&
&+ea&me& com)a+e# &o $aselie
4 Si!s o( )lasma lea,a!e >)le"+al e(("sio- asci&is- '%)o)+o&eiaemiaA
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Dengue Sho# Syndrome :
All &'e a$o1e c+i&e+ia (o+ DHF )l"s e1i#ece o( ci+c"la&o+% (ail"+e mai(es&e# $%
+a)i# a# wea, )"lse a# a++ow )"lse )+ess"+e >?F0@ mm H!A o+ '%)o&esio
(o+ a!e a# col# a# clamm% s,i a# +es&lessess
&ase 'assifiation
Suspeted: A case com)a&i$le wi&' &'e cliical #esc+i)&io
)ro*a*'e: A case com)a&i$le wi&' &'e cliical #esc+i)&io wi&' one or more
o(
&'e (ollowi!/
4 S"))o+&i1e se+olo!% >+eci)+ocal 'aema!!l"&ia&io 4 i'i$i&io &i&+e-
com)a+a$le I!G E3ISA &i&+e o+ )osi&i1e I!2 a&i$o#% &es& i la&e ac"&e o+
co1alesce&4)'ase se+"m s)ecimesA
4 Occ"++ece a& same loca&io a# &ime as o&'e+ co(i+me# cases o( #e!"e
(e1e+
&onfirmed: A case com)a&i$le wi&' &'e cliical #esc+i)&io &'a& is la$o+a&o+%
co(i+me#
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DFD
DHF
G+a#e S%m)&omsD si!s 3a$o+a&o+% Fi#i!s
DF Fe1e+ wi&' &wo o+ mo+e o(
(ollowi!
- Hea#ac'e
- Re&+o4o+$i&al )ai
- 2%al!ia
- A+&'+a!ia
3e"co)eia-
&'+om$oc%&o)eia
a# e1i#ece o( loss o(
)lasma
DHF I A$o1e si!s- s%m)&oms )l"s
)osi&i1e &o"+i*"e& &es&-
e1i#ece o(
)lasma lea,a!e
T'+om$oc%&o)eia/ Pla&ele&
co"& less &'a
1@@@@@Dc".mm.
Haema&oc+i& +ise 0@E o+
mo+e
DHF II A$o1e si!s a# s%m)&oms
)l"s
some e1i#ece o(
s)o&aeo"s
$lee#i! i s,i o+ o&'e+
o+!as
>$lac, &a++% s&ools- e)is&aBis-
$lee#i! (+om !"ms- e&cA
a#
a$#omial )ai
T'+om$oc%&o)eia )la&ele&
co"&
less &'a 1@@-@@@Dc"mm
Haem&oc+i& +ise 0@E o+
mo+e
+a*'e , Grading the severity of Dengue infetion:
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DHF III A$o1e si!s a# s%m)&oms
)l"s
ci+c"la&i! (ail"+e >wea,
+a)i# )"lse-
)"lse )+ess"+e FD?0@ mm
H! o+
'i!' #ias&olic )+ess"+e-
'%)o&esio
wi&' &'e )+esece o( col#
clamm%
s,i a# +es&lessessA
T'+om$oc%&o)eia/
Pla&ele&
co"& less &'a
1@@-@@@Dc"mm
Haema&oc+i& +ise mo+e
&'a 0@E
DHF IV P+o(o"# s'oc, wi&'
"#e&ec&a$le
$loo# )+ess"+e o+ )"lse
T'+om$oc%&o)eia/
Pla&ele&
co"& less &'a
1@@-@@@Dc"mm
Haema&oc+i& +ise mo+e
&'a 0@E
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-a*oratory riteria for diagnosis
.ne or more of the fo''o(ing:

Isola&io o( &'e #e!"e 1i+"s (+om se+"m- )lasma-

le"coc%&es o+ a"&o)s% sam)les

Demos&+a&io o( a (o"+(ol# o+ !+ea&e+ c'a!e i

+eci)+ocal I!G o+ I!2a&i$o#% &i&+es &o oe o+ mo+e
#e!"e 1i+"s a&i!e i )ai+e# se+"m sam)les.

Demos&+a&io o( #e!"e 1i+"s a&i!e i a"&o)s%

&iss"e $% imm"o'is&oc'emis&+% o+
imm"o(lo+escece o+ i se+"m sam)les $% E3ISA.

De&ec&io o( 1i+al !eomic se*"eces i a"&o)s%

&iss"e- se+"m o+ :SF sam)les $% )ol%me+ase c'ai
+eac&io >P:RA.
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&% /anagement of DHF Grade 0 and 00
A% )e+so w'o 'as #e!"e (e1e+ wi&' &'+om$oc%&o)eia a#
'aemococe&+a&io a# )+ese&s wi&' a$#omial )ai- $lac,
&a++%s&ools-
e)is&aBis- $lee#i! (+om &'e !"ms a# i(ec&io e&c ee#s &o $e
'os)i&aliIe#. All &'ese )a&ie&s s'o"l# $e o$se+1e# (o+ si!s o(
s'oc,.
T'e c+i&ical )e+io# (o+ #e1elo)me& o( s'oc, is &+asi&io (+om
(e$+ile &o
a$(e+ile )'ase o( illess- w'ic' "s"all% occ"+s a(&e+ &'i+# #a% o(
illess. A
+ise o( 'ameococe&+a&io i#ica&es ee# (o+ IV (l"i# &'e+a)%. I(
#es)i&e
o( &'e &+ea&me&- &'e )a&ie&s #e1elo) (all i BP- "+ie o"&)"& o+
o&'e+
(ea&"+es o( s'oc,- &'e maa!eme& (o+ G+a#e IIIDIV DHFDDSS
s'o"l# $e
is&i&"&e#.
O+al +e'%#+a&io s'o"l# $e !i1e alo! wi&' a&i)%+e&ics li,e
Pa+ace&amol
s)o!i!- e&c. as #esc+i$e# a$o1e. T'e #e&aile# &+ea&me& (o+
)a&ie&swi&' DHF G+a#e I a# II is !i1e i :'a+& 1.
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D% /anagement of DHF Grade 000"01
:ommo si!s o( com)lica&ios a+e o$se+1e# #"+i! &'e a(e$+ile )'ase o(
DHF. Imme#ia&el% a(&e+ 'os)i&aliIa&io- &'e 'aema&oc+i&- )la&ele& co"& a#
1i&al si!s s'o"l# $e eBamie# &o assess &'e )a&ie&.s co#i&io a#
i&+a1eo"s (l"i# &'e+a)% s'o"l# $e s&a+&e#. T'e )a&ie& +e*"i+es +e!"la+
a# s"s&aie# moi&o+i!. I( &'e )a&ie& 'as al+ea#% +ecei1e# a$o"& 1@@@
ml o( i&+a1eo"s (l"i#- i& s'o"l# $e c'a!e# &o colloi#al sol"&io )+e(e+a$l%
DeB&+a o+ i( 'aema&oc+i& is #ec+easi!- (+es' w'ole $loo# &+as("sio
1@mlD,!D#ose s'o"l# $e !i1e.
Howe1e+- i case o( )e+sis&e& s'oc, w'e- a(&e+ ii&ial (l"i# +e)laceme&
a# +es"sci&a&io wi&' )lasma o+ )lasma eB)a#e+s- &'e 'aema&oc+i&
co&i"es &o #eclie- i&e+al $lee#i! s'o"l# $e s"s)ec&e#. I& ma% $e
#i((ic"l& &o +eco!iIe a# es&ima&e &'e #e!+ee o( i&e+al $loo# loss i &'e
)+esece o( 'aemococe&+a&io. I& is &'"s +ecomme#e# &o !i1e (+es'
w'ole $loo# i small 1ol"mes o( 1@mlD,! (o+ all )a&ie&s i s'oc, as a
+o"&ie )+eca"&io. OB%!e s'o"l# $e !i1e &o all )a&ie&s i s'oc,. T'e
#e&aile# !+a)'ical )+ese&a&io o( &'e &+ea&me& (o+ )a&ie&s wi&' DHF
G+a#es III a# IV is !i1e i :'a+& 0.
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I#ica&ios o( )la&ele& &+as("sio

I !ee+al &'e+e is o ee# &o !i1e )la&ele&s

e1e a& ? 0@@@@Dc"mm

J P+o)'%lac&ic )la&ele& &+as("sio ma% $e

!i1e a& le1el o( ?1@@@@Dc"mm i

a$sece o( $lee#i! mai(es&a&ios

J P+olo!e# s'oc,K wi&' coa!"lo)a&'% a#

a$o+mal coa!"lo!+am

J I case o( S%s&emic massi1e $lee#i!-

)la&ele& &+as("sio ma% $e ee#e# i

a##i&io &o +e# cell &+as("sio

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E% &riteria for disharge of patients

J A$sece o( (e1e+ (o+ a& leas& 08 'o"+s wi&'o"& &'e

"se o( a&i4(e1e+

&'e+a)%

J Re&"+ o( a))e&i&e

1@

J Visi$le cliical im)+o1eme&

J Goo# "+ie o"&)"&

J 2iim"m o( 5 #a%s a(&e+ +eco1e+% (+om s'oc,

J No +es)i+a&o+% #is&+ess (+om )le"+al e(("sio o+

asci&is

J Pla&ele& co"& C 9@ @@@D c"mm

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+HAN2 3.U
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