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Dengue

Background  Most rapidly spreading mosquito-borne viral disease in the world .

family Flaviviridae  4 antigenic types (DEN-1 to -4) . Transmitted by Aedes aegypti  Single stranded RNA virus Etiology  Genus Flavivirus.

5 billion people live in dengue endemic countries  132.046 dengue cases in the Philippines (2012)  701 fatalities (2012) .Epidemiology  50 million dengue infections annually  2.

1st Dengue Virus Infection Pathogenesis Production of Antibodies Control of Clinical Signs and Symptoms .

2nd Dengue Virus Infection Pathogenesis Non-neutralizing. cross reactive antibodies bind to epitopes on surface of heterologous infecting virus Dengue virus immune complexes attach to macrophage Fc receptors .

increase in TNF. IL2 . IFN-Y.Signal suppression of innate immunity Pathogenesis Enhanced viral production Activation of complement system.

Immune mediators attack endothelial cells Pathogenesis Increased vascular permeability CAPILLARY DAMAGE .

Course of Dengue .

Case Classification .

 Incubation Period: 1-7 days  Biphasic fever (1-5 days) Clinical Manifestations  Frontal or retro-orbital pain  Myalgia / arthralgia  Rash  Lymphadenopathy .

Complications .

Prognosis  Dengue has excellent prognosis  Death has occurred in 40-50% of patients with shock  Survival directly related to early and intense supportive treatment .

aegypti . repellants Body clothing Screening of houses Destroy breeding sites for A.Prevention  Avoid mosquito bites     Use insecticides.