DENGUE FEVER

Definition:

Dengue fever is an infection with a virus that is transmitted by an Aedes Aegypti

mosquito. It is an acute viral disease characterized by sudden onset of fever for 3-5
days, with intense headache, joint and muscle pain, pain behind the eyes, nausea,
gastrointestinal disturbances and rash. Minor bleeding, such as gum and nose bleeding, may
occur at any time during the febrile phase. Children usually have a milder disease than
adults. The incubation period is 3 to 14 days.

Characteristic of the mosquito:

 Day biting – normally catches us unaware

 Loves / lives in fresh water in homes
 Lays eggs preferentially in jars, discarded containers, coconut shells, old
tires etc.
 Year round breeding
 Tropical regions like our mother India are its favorite zones.
 It is an urban mosquito

Manifestation of dengue virus infection:

ASYMPTOMATIC Undifferentiated
dengue fever Without hemorrhagic

SYMPTOMATIC Dengue fever

With unusual hemorrhagic

No shock
Dengue
hemorrhagic fever

DSS
Cause of dengue fever

Dengue fever is caused by infection with one of four different viruses known as
DEN-1, DEN-2, DEN-3 and DEN-4. All four viruses are capable of causing the
complications of dengue haemorrhagic fever and dengue shock syndrome.

Infection with one type gives you lifelong immunity to that particular dengue virus.
However, the infection does not offer immunity to the other three types, so it is
possible to contract dengue fever again. A person who has had dengue fever once is
at increased risk of dengue haemorrhagic fever or dengue shock syndrome if they
get infected again.

Symptoms of dengue fever

The typical signs and symptoms of uncomplicated dengue fever may include:

 High temperature within one week of infection

 Severe headache
 Pain behind the eyes
 Joint and muscle aches
 Metallic taste in the mouth
 Appetite loss
 Abdominal pain
 Nausea and vomiting
 Diarrhoea
 Generally feeling unwell (malaise)
 Skin rash that appears about four days after the onset of fever
 Depression.
Symptoms of dengue haemorrhagic fever

Babies and young children are at increased risk of this complication. Signs and
symptoms may include:

All the above symptoms of uncomplicated dengue fever

 Bleeding under the skin, which causes purple bruises

 Bleeding from the nose or gums
 Liver problems
 Heart problems.

Symptoms of dengue shock syndrome

All the above symptoms of uncomplicated dengue fever and dengue haemorrhagic
fever:

 Severe bleeding
 Extremely low blood pressure caused by blood loss (shock)
 Coma
 Death.
 Most infected areas of the world

Dengue fever is common throughout tropical and subtropical areas of:

 Africa
 The Caribbean
 Central America
 Central Pacific
 China
 India
 The Middle East
 South America
 Southeast Asia
 The South Pacific.
 Dengue fever in Australia

How it is spread?

Dengue fever is not transmitted (spread) from person to person. Only infected
mosquitoes transmit dengue fever. It is thought that the mosquito contracts the
virus when it bites an infected person. The mosquito is then infective for the rest
of its life and can spread the virus every time it bites someone.

At least three different kinds of mosquito in Australia are suspected to be dengue

carriers: Ae aegypti, Ae scutellaris and Ae katherinensis. These mosquitoes are
found in northern Queensland, the Northern Territory and northern Western
Australia.

Diagnosis of dengue fever

See a doctor immediately if you think you may have dengue fever. Early diagnosis is
important to reduce the risk of complications and avoid further spread of the
virus.

Your doctor will ask about your medical history including any travel, and will do a
physical examination. They may order a blood test.

There are two types of blood tests that can be used to diagnose dengue fever:

 Nucleic acid testing requires one blood test.

 Antibody testing requires two blood tests, three weeks apart.

Other tests:

 Routine blood test

 Tests to check the clotting process
 Special tests to identify the Dengue or its foot marks in our blood
 Urine to check protein leak
Treatment for dengue fever

There is no specific treatment for dengue fever. Medical care aims to manage the
symptoms and reduce the risk of complications while the person recovers. Most
cases of uncomplicated dengue fever resolve within two weeks or so. During this
time, your doctor may advise:

 Bed rest
 Plenty of fluids
 Drugs to reduce fever such as paracetamol (do not take aspirin because of
its blood-thinning properties).
 Hospital admission is usually required if the person develops dengue
haemorrhagic fever or dengue shock syndrome. Treatment for these
complications may include intravenous fluids and replacement of lost
electrolytes.

 Avoid mosquito bites

 Protect yourself against mosquito bites when in dengue-prone areas.
Suggestions include:
 Avoid outdoor activity, particularly around dusk and dawn when mosquitoes
are most active.
 Wear socks, long pants and long-sleeved shirts when outdoors.
 Wear mosquito repellent that contains the active constituents DEET (N,N-
Diethyl-m-toluamide) or picaridin. Reapply regularly and make sure you follow
directions for safe use on the label.
 Apply a product, such as permethrin, to your clothes or bedding.
 Use a bed net.
 Stay in air-conditioned accommodation with flyscreens on the windows.