PREVENTION AND

CONTROL OF
DENGUE HEMORRHAGIC
FEVER
Presented by:
Miko Krisha I. Aller
Reena Caitlin S. Bangalando
Objectives:
At the end of the discussion, the learners shall:
 Explain through their own words the what Dengue
Hemorrhagic Fever is.
 Identify and recognize signs and symptoms, as well as the risk
factors and provide timely interventions.
 Identify and recognize signs and symptoms, as well as the risk
factors and provide timely interventions.
 Recognize the ways to eliminate infection and improve in the
prevention and control of Dengue Hemorrhagic Fever (DHF).
What is Dengue Hemorrhagic Fever?
Dengue fever is an acute febrile disease caused by infection with
one of the stereotypes of dengue virus. It was first reported in
1953.
In 1958, hemorrhagic fever became a notifiable disease in the
country and was later reclassified as Dengue Hemorrhagic Fever.
Both dengue and DHF affect persons of all ages, but whereas
dengue attack rates are either uniform across age groups or in
some studies increase with age, most DHF cases occur among
children younger than 15 years of age.
 Vector
Dengue is a mosquito-
borne disease caused
by genus Aedes. The
Aedes egypti mosquito
is the primary vector of
dengue. The virus is
transmitted to humans
through the bites of
female mosquitos
(infected).
Mode of Transmission
The virus is transmitted to humans through the bites of infected
female mosquitos. After virus incubation of about 4-10 days, an
infected mosquito (female) is capable of transmitting the virus for
the rest of its life.
The virus is deposited in the skin by the vector, within a few days
viremia occurs, lasting until the 5th day or the symptoms to be
visible.
Causes
A.DEN – 1 VIRUS (Undifferentiated Fever)
Undifferentiated fever can mimic any number of other
acute illnesses with fever–it does not meet case
definition criteria for dengue fever. It is difficult to
diagnose based on physical examination and routine
tests alone. Unless a specific dengue diagnostic test is
performed, the diagnosis remains unknown.
B. DEN – 2 VIRUS (Classic Dengue Fever)
Classic dengue fever or “break bone fever” is the most
common and less severe form of the virus. It is
characterized by acute onset of high fever that usually
lasts between 3-5 days prior to the bite from the
infected mosquito.
C. DEN – 3 VIRUS (Classic Dengue Fever)
Dengue shock syndrome (DSS) is a syndrome due to the
dengue virus that tends to affects children under the
age of 10, causing abdominal pain, hemorrhage
(bleeding) and circulatory collapse (shock). It is a most
severe form of the viral illness.
D. DEN – 4 VIRUS (Dengue Shock
Syndrome)
Dengue hemorrhagic fever can occur when someone is
bitten by a mosquito or exposed to blood infected with
the dengue virus (infected mosquitos being the most
common causes).
Classification
Phases:
1.) Febrile Phase
Fever lasts about 2-7 days. Its hallmark features are
high fever consistent symptoms with that of classic
dengue fever. Potential complications would include
dehydration due to decreased fluid intake, emesis,
and increased metabolic state, convulsions due to
high fever and severe hemorrhage (rare).
Phases:
2.) Critical Phase
Shock from plasma leakage(24 to 48 hours) : severe
hemorrhage organ impairment. This occurs 2 to 3
days after febrile phase/stage of illness thus
increases capillary permeability and hematocrit
levels.
Phases:
2.) Recovery Phase
After the occurrence of plasma leakage, in DHF
patients, plasma leakage stops and is followed by
reabsorption of extravascular fluid. In the recovery
phase or convalescent phase (7-10 days after critical
stage), further improvement of general condition
and return of appetite is observed.
Signs and Symptoms
 Fever
 Hemorrhagic Manifestations
 Low Platelet Count
 Elevated Hematocrit
 Nausea and Vomiting
 Rash
Individual Risk Factors
 Age
 Ethnicity
 Chronic Illnesses
 Living or travelling in tropical areas/countries
 Prior infection with dengue fever virus
Prevention and Control
A. Vector Control
Eliminate vector by:
 Changing water and scrubbing sides of flower vases
once a week
 Destroy breeding places of mosquito by cleaning
surroundings, proper disposal of rubber tires,
emptying bottles and cans
 Keep water containers covered
 Avoid too many hanging clothes inside the house
B. Preventive Measures
o Avoid crowded places as it may be places where dengue
mosquitoes are waiting.
o Practice the use of insect repellent products that are proven
safe to use.
o Exclusion from childcare, preschool, school or work is
usually not necessary but people experiencing fever from
dengue infection should not be in an environment where
they may be bitten by mosquitoes. If this is not possible,
they should stay at home until they have no fever and are
therefore no longer infectious (usually 3 to 5 days).
C. Immunization
Dengue vaccine is a vaccine to prevent dengue fever in humans.
The World Health Organization recommends that countries
should consider vaccination with the dengue vaccine CYD-TDV
only if the risk of severe dengue in seronegative individuals can
be minimized either through pre-vaccination screening or recent
documentation of high seroprevalence rates in the area (at least
80% by age 9 years). In 2017 the manufacturer recommended that
the vaccine only be used in people who have previously had a
dengue infection, as outcomes may be worsened in those who
have not been previously infected.
Nursing Response, Interventions, and
Management
 Close monitoring of hypotension or shock
 Monitoring pain
 Medication regimen
 Fluid replacement
 Monitor Hematocrit (Htc) and Platelet count
References
Belleza, M. (2016). Dengue Hemorrhagic Fever. Retrieved from:
https://nurseslabs.com/dengue-hemorrhagic-fever/#Nursing-Interventions
Gehrke, S. (2016). ACLS Guide to Dengue Fever. Retrieved from:
https://pacificmedicalacls.com/acls-guide-to-dengue-fever.html
Khetarpal, N. and Khanna, I. (2016). Dengue Fever: Causes, complications, and vaccine
strategies. Retrieved from: https://www.hindawi.com/journals/jir/2016/6803098/
Laflamme, M. R. (2015). Dengue Hemorrhagic Fever. Retrieved from:
https://www.healthline.com/health/dengue-hemorrhagic-fever#treatment
Orenstein, W. (2016). Dengue and dengue hemorrhagic fever. Retrieved from:
https://wonder.cdc.gov/wonder/prevguid/p0000373/p0000373.asp