Ayurvedic & Unani tibbia college

DENGU
E
CONTENTS:-
•Introduction
•Epidemiology
•Aetiology
•Life cycle
•Stages of DENGUE FEVER
•Symptoms & Signs
•StagesExamination
•Laboratory tests
•Risk factors
•Prevention
•Treatment
•Vaccination
 INTRODUCTION
• Dengue fever(DF)
DF severe form:-
• Dengue haemorrhagic fever DHF)/Dengue shock syndrome(DSS
• Dengue Fever is an infectious disease caused by a virus.
• The virus is transmitted to humans through the bites of female
mosquitoes (Aedes aegypti),(aedes albopictus)
• This disease used to be called breakbone fever because it
sometimes causes severe joint pain and muscle pain that
feel like bones are breaking.

DENGUE VIRUS:

• It is an RNA virus belonging to genus flavivirus and family

flaviviridae.
• Consists of 4 serotypes, DENV-1, DENV-2 , DENV-3 , DENV-4
• All serotypes can cause severe and fatal diseases.
• There is a short lived cross immunity between these species.
 EPIDEMIOLOGY
o In India first outbreak of dengue was recorded in 1812
o A double peak hemorrhagic fever epidemic occurred in India
for the first time in Kolkata between July 1963 &
March 1964
o In New Delhi, outbreaks of dengue fever reported in
1967, 1970, 1982, 1996, 2012 & 2015
o An estimated 5,00,000 cases of DHF require
hospitalization each year, of which a very large
proportion are children.
o A rapid rise in urban population is bringing greater
number of people.
Etiology
Non human primates likes pigs,bats etc
LIFE CYCLE OF AEDES
AEGYPTI
TRANSMISSION CYCLE OF
DENGUE~
SYNONYMS OF DENGUE FEVER
1.Breakbone fever
2.Dandy fever
3.Dengue hemorrhagic
fever
4.Dengue shock syndrome
5.Seven day fever

STAGES OF DENGUE FEVER

1.Febrile stage
2.Critical stage
3.Recovery
stage
FEBRILE s t a g e ~
(first 4 days)

✔ High fever 40°C

✔Headache
✔ Petechiae
✔Generalized arthralgia
✔ Myalgia
✔ Bleeding from mucous
membrane
✔ A rash occurs in 50-80%
 CRITICAL s t a g e ~
(4t h t o 7t h day)
✔Leukopenia
✔Thrombocytopenia
✔ Increase capillary
permeability leading to
plasma leakage that lead
to metabolic acidosis
RECOVERY s t a g e ~
(7t h t o 10t h d a y )
✔ Stabilized hemodynamic
status
✔ Increase urine output
✔ Stable appetite
SIGN AND SYMPTOMS OF DENGUE
FEVER-
o The incubation period is 4 to 7
days
o Headache
o Joint pain and muscle pain
o Nausea
o Vomiting
o Pain behind the eyes
o Swollen glands rash
 ON
o Low BP (90/60 mm/hg)
EXAMINATION
o Rashes (appears on 6 th

day)
o Lymphadenopathy
o Hepatomegaly
o A weak, rapid pulse
o Red eyes
 LABORATORY TESTS
o In blood test of dengue patient, antibodies like IgM
and IgG or NS-1 protein are in increasing number.
o If NS-1 is present in dengue patient, it confirms
dengue fever.
o Among IgG and IgM if IgG is positive then patient is
previously suffered from dengue fever.
o In dengue is important to check the levels of
platelets and PCV in blood
o Neutralization test NT
o ELISA
o RT PCR TEST
 RISK FACTORS
Factors that put you at greater risk of developing dengue
fever or a more severe form of the disease include:
• Living or travelling in tropical areas: being in tropical
and subtropical areas increases your risk of exposure
to the virus that causes dengue fever.
• Prior infection with a dengue fever virus: previous
infection with a dengue virus increases your risk of
having severe symptoms if you are infected again.

COMPLICATIONS
If severe, dengue fever can damage the lungs, liver or
heart. Blood pressure can drop to dangerous levels,
causing shock and in some cases, death.
 WARNING SIGNS

✔Abdominal pain or or tenderness

✔Vomiting
✔diar rhea
✔S igns of fluid accumulation
✔Ascites
✔Lethargy
✔ Ra p id increase in haematocrit with fall in
platelet
SIGN AND SYMPTOMS OF DENGUE HAEMORRHAGIC
FEVER AND SHOCK SYNDROM

o Symptoms similar to dengue fever

o Skin becomes pale,cold
o Bleeding from nose,mouth and gums
o Vomiting with or without blood
o Rapid weak pulse
o Difficulty in breathing
o Patient feels thirsty and mouth becomes dry
 PREVENTION
Environmental:
• Solid waste management
• Reduced vector breeding sites
• Empty water containers and cut
grass
• Personal protection

Chemical:
• Space spraying of insecticides
• Insecticide treatment of water containers
Personal protection
Use of mosquito nets, repellant
creams, mosquito coils.
 TREATMENTS
o Increased oral fluid intake is recommended to
prevent dehydration.
o Supplementation with intravenous fluids may be
necessary to prevent dehydration if the patient is
unable to maintain oral intake.
Use paracetamol.
o A platelet transfusion is indicated in rare cases if
the platelet level drops (below 20,000). And
the
presence of melena may indicate internal
gastrointestinal bleeding requiring platelet and
RBC transfusion.
o Use of pain relievers with acetaminophen.
o Avoid ibrufen,aspirin causes Reye’s syndrome.
 VACCINATION
o Development of dengue vaccines began in
the 1920s, but was hindered by the need to
create immunity against all four dengue
serotypes.
o As of 2019, The Dengue
Vaccine(Dengvaxia) is only recommended
in those who had previously had dengue
fever or populations in which most people
have been previously infected.
o The value of vaccine is limited by the
fact
that it may increase the risk of severe
dengue in those who have not previously
been infected.
o It is given as three injections over a year.