Running head: dengue

Dengue
Spencer May
Dixie State University

dengue

2
Dengue
Dengue is a very infectious disease that is caused by a virus that is spread by mosquito

bites. It is most common in warm, wet areas of the world. There are four main types of dengue
that are known at this time. The dengue virus cannot be passed from human to human because it
is not contagious and once a mosquito is infected with the virus it will have Dengue for the
remainder of its life. It is also important to know there is no vaccination for Dengue and
preventative measures should be taken to prevent acquiring this infection (Cassetti &Halstead,
2014, p. 316).
History of Disease
The Dengue virus was found to originally come from monkeys from Africa or Southeast
Asia between 100-800 years ago (Halstead, 2007, p. 1647). This disease was pretty restricted
geographically until the outbreak of World War 2, which many Aedes mosquitos travelled across
the world in cargo. Since this war there have been outbreaks of dengue in the Philippines,
Thailand, the Caribbean and Latin America.
Pathophysiology
After the mosquito bite the incubation period usually lasts between 3-14 days with the
average time being 4-7 days. The virus then targets dendritic cells viral replication takes place.
The entry of the virus causes viraemia which causes a fever. This fever can last about 3 days. It
also causes swelling in the endothelial tissue, perivascular edema and mononuclear cell
infiltration with in small blood vessels (Rothman, 2011, p. 535). All of these problems are what
cause several different signs and symptoms.
Signs and Symptoms

dengue

3
Some of the signs and symptoms of Dengue include: a sudden onset of an elevated

temperature or fever, severe headache, pain behind the eyes, severe joint and muscle pain,
fatigue, nausea and vomiting, a skin rash, and mild bleeding. Sometimes this disease is mistaken
for the flu or other infections. Also in mild cases there are no symptoms and these symptoms also
tend to be worse than those who have had the infection before. On rare occasions two types of
complications can occur. One is Dengue Hemorrhagic Fever and which can lead to the other
which is Dengue Shock Syndrome.
Laboratory Results
There are several laboratory tests that can be done to diagnose Dengue. Some of these
laboratory tests that might be done include: Thrombocytopenia, haemoconcentration, and
serologically. The first two are used more for the diagnosis of Dengue hemorrhagic fever or
dengue shock syndrome because it is an advances stage of the disease which causes severe
problems. Serologically a doctor can check the rising titer of neutralizing antibodies to diagnose
if a person has Dengue or has had it in the past.
Imaging orders
The doctor might out in an order for a chest x-ray because pleural effusions could
possibly be present especially on the right side. The doctor may also order an ultrasound of the
lungs.
Plan of Care
The plan of care with someone who has Dengue is mainly done by symptoms and to give
them supportive care. There is no vaccination for Dengue fever and the plan of care changes if
the disease advances to Dengue Hemorrhagic Fever or Dengue Shock Syndrome. With regular
dengue if a person has a fever then offer the person a tepid sponge bath and drugs to reduce their

dengue

fever like Acetaminophen. For nausea and vomiting fluid intake should be increased by giving
them intravenous or oral fluids. If the person complains of diarrhea they should increase their
fluid intake and the person should also be administered electrolyte therapy like ORSA. If there
is a rise in their hematocrit value this shows a large loss of plasma and a possible need for
parenteral therapy. The type of fluids that are typically given are crystalloid and this includes 5%
dextrose in lactated ringers. If a person goes into shock then the management of shock should be
done. The replacement of plasma that is lost is done with an isotonic salt solution which runs at
the rate 10-20 ml/kg. A blood transfusion should be considered in situations of profound or
persistent shock despite decreasing hematocrit values after the first fluid replacement (Wong,
Shakir, Atefi, & AbuBakar. 2015).
Nursing Diagnosis
Some nursing diagnosis that could be used for dengue include: Alteration in body
temperature hypothermia related to disease process. Alteration in nutrition less than body
requirement related to self-induced vomiting. Alteration in comfort related to headache and body
ache. High risk for infection related to inadequate primary defenses.
Medication
It should be noted immediately that medications like aspirin and ibuprofen should not be
taken if a person is suspected of having dengue due to the risk of bleeding. There are no set drugs
that a doctor should order for the treatment of Dengue because there is no cure. The only thing a
doctor can do is treat the symptoms (Girimont. 2010). For pain and fever a doctor would order
acetaminophen (Tylenol) 650 mg every 6 hours for fever or pain. There ae typically no side
effects with this medication. If there are side effects the person should call the doctor
immediately. Should speak to doctor before taking Tylenol if there is liver disease or regular

dengue

use/abuse of alcohol. There is a risk of a drug to drug interaction with Tylenol is the person is
taking isoniazid, busulfan, or select anticoagulants. A doctor should be consulted before taking
Tylenol if these drugs are being used.
Conclusion
Though Dengue is rarely found in the United States of America it is something that
should be watched out for. Many times people travel to areas that do have the disease and are not
symptomatic until they get home from their vacation. Wearing clothes that cover the body,
sleeping with a net around the bed are a few examples of prevention that should be used. Since
there is no vaccination at this time so it is important that people are aware of what Dengue is and
how to prevent getting this virus.

dengue

6
References

Cassetti, M. C., & Halstead, S. B. (2014). Consultation on dengue vaccines: Progress in

understanding protection, 26-28 june 2013, rockville, maryland. Vaccine, 32(26), 311521. doi:http://dx.doi.org/10.1016/j.vaccine.2014.04.017
Halstead, S. B. (2007). Dengue. The Lancet, 370(9599), 1644-52. Retrieved from
http://search.proquest.com/docview/198985437?accountid=27045
Jincy, G. P. (2004). Dengue fever: Diagnosis, prevention & control. Nursing Journal of India,
95(12), 281-4. Retrieved from

http://search.proquest.com/docview/214371192?

accountid=27045
Rothman, A. L. (2011). Immunity to dengue virus: A tale of original antigenic sin and tropical
cytokine storms. Nature Reviews.Immunology, 11(8), 532-43.
doi:http://dx.doi.org/10.1038/nri3014
Wong, L. P., Shakir, S. M., Atefi, N., & AbuBakar, S. (2015). Factors affecting dengue
prevention practices: Nationwide survey of the malaysian public. PLoS One, 10(4)
doi:http://dx.doi.org/10.1371/journal.pone.0122890
Girimont, Trina M.,A.R.N.P., C.O.H.N.-S. (2010). Dengue disease. AAOHN Journal, 58(10),
448. doi:http://dx.doi.org/10.3928/08910162-20100928-03

Excellent. Very thorough, organized and to the point. Very well done.
Melissa Baldwin , May 2 at 5:58am