DENGUE

Dr Abrar Umar www.abrarumar.com

DENGUE
Arthropod borne viral infection in humans Caused by flavivirus genus,four different antigenic varieties of dengue virus are recognised all transmitted by day time biting by aedes aegypti Humans are indective during the first three days of illness Mosquitoes become infective about 2 weeks after feeding on an infected and remain so for the rest of their lives individual Immunity after illness is partial

INCUBATION PERIOD 5-6 days following the mosquito bite CLINICAL FEATURES A symptomatic and mild infections are common There are two recognised clinical forms

 Abrupt onset of fever malaise .headache facial flushing retro bulbar or severe backacheprominent symptoms Lymphadenopathy petechiae on the soft palate and skin rashes may occurerashes are transient appearon limbs and then spread to the trunk Fever subsides after 3-4 days ,temperature turns to normal for a couple of days and then then fever eturns with features mentioned before but milder This biphasic or saddleback pattern Severe fatigue and feeling of of being unwell and depression for several weeksself limiting disease

A-CLASSICAL DENGUE FEVER break bone fever

B-dengue hemorrhagic fever

Believed to be result of two or more sequential infections with with different dengue serotypes---disease of children Symptoms of upper respiratory infection high fever accompanied by facial flushing and headache abrupt onset of shock and haemorrhage into skin and ear ,epistaxix,hematemesis and melaena- Dengue shock syndrome

DIAGNOSIS Isolation of dengue virus by tissue culture in sera obtained during the first few days of illness ELISA---rising antibody titres PREVENTION travelers to use impregnated nets AND topical repellents Adult mosquitoes should be destroyed by sprays and breeding siteds shud be eradicated

 Keep flower pots dry Cover body and arms especially at sunrise and sunset Mosquito repellent lotion on uncovered body parts Wash water containers daily and keep them covered No effective vaccine has been made

TRAEATMENT Symptomatic and supportive Antipyretics and sponging for for temperature Shockvigorous volume replacement -----immediate replacement of plasma volume by 5% dextrose saline Persistant shock ----blood transfusion