Demam Berdarah Dengue

Dr Achmadi Eko Sugiri

RSUD Ade Muh Djoen
Sintang
 DENGUE FEVER

• ACUTE FEVER
• CASE FATALITY RATES (CFR)
0,79 % (WHO-SEARO, 2009)
• SYSTEMIC AND DYNAMIC
DISEASE
• SEVERE AND NON SEVERE
MANIFESTATION
• RELATIVE SIMPLE
MANAGEMENT
Dengue virus

• Is an arbovirus
• Genus Flavovirus
• Family Flaviridae
• Transmitted by mosquitoes (Aedes Aegypti & Aedes
Albopictus)
• Composed of single-stranded RNA
• Has 4 serotypes (DEN-1, 2, 3, 4)
• Human is the main host
Dengue Viruses

• Each serotype provides specific lifetime immunity, and

short-term cross-immunity
• All serotypes can cause severe and fatal disease
• Genetic variation within serotypes
• Some genetic variants within each serotype appear to be
more virulent or have greater epidemic potential
Transmission of Dengue Virus
by Aedes aegypti

Mosquito feeds / Mosquito refeeds /

acquires virus transmits virus

Extrinsic Intrinsic
incubation incubation
period period
Viremia Viremia
0 5 8 12 16 20 24 28
Days
Illness Illness
Human #1 Human #2
Replication and Transmission
of Dengue Virus (Part 1)
1. Virus transmitted 1
to human in mosquito
saliva
2
2. Virus replicates 4
in target organs

3. Virus infects white

3
blood cells and
lymphatic tissues

4. Virus released and

circulates in blood
Replication and Transmission
of Dengue Virus (Part 2)
5. Second mosquito 6
ingests virus with blood

6. Virus replicates
in mosquito midgut
and other organs, 7
infects salivary
glands
5
7. Virus replicates
in salivary glands
Aedes aegypti
• Dengue transmitted by infected female mosquito
• Primarily a daytime feeder
• Lives in and around human habitation
• Lays eggs and produces larvae preferentially in artificial
containers
Aedes aegypti Breeding Sites
Areas at Risk of Dengue transmission
CLINICAL SPECTRUM OF DENGUE INFECTION
DENGUE AND CLINICAL SEVERITY
THE COURSE OF DENGUE ILLNESS
DENGUE FEVER SEVERITY
SEVERE DENGUE

• A number of criteria may be used to decide when to transfer a patient to a

highdependency unit.
• These include:
• – early presentation with shock (on days 2 or 3 of illness);
• – severe plasma leakage and/or shock;
• – undetectable pulse and blood pressure;
• – severe bleeding;
• – fluid overload;
• – organ impairment (such as hepatic damage, cardiomyopathy, encephalopathy,
• encephalitis and other unusual complications).
H0USE HOLD WATER CONTAINERS ARE POTENCYAL
MOSQUITOES BREEDING SITE
EFFECTIVE DENGUE TRANSMISION

3M :
1.MENGURAS
2.MENUTUP
3.MENGUBUR