Morbidity:

DENGUE FEVER
ROSAL, IJA LOURICE P.
Post Graduate Intern
 DENV1, DENV2, DENV3, Transmitt ed by day biti ng
DENV4
female Aedes aegypti
(Urban dengue) and
Aedes albopti cus
(Rural dengue) mosquitos
Common i n >100 c ou n tr i e s A mosquito-borne
around the world v i r a l infection

WHAT IS 75% of i n d i v i d u a l s
i n f e ct e d with a DENV

The l a r g e s t number of
DENGUE? w i l l be asymptomati c
T r op i ca l and s u b t ro p i c a l
dengue cases ever climates worldwide, mostly
reported g l o b a l l y was i n i n urban and semi-urban
2019 areas

~5% of i n d i v i d u a l s t hat
High number of cases were reported develop dengue w i l l
https://www.cdc.gov/dengue/index.html
https://www.who.int/news-room/fact-sheets/detail
i n Malaysia (131, 000), P h i l i p p i n e s progress t o s eve re dengue
/dengue-and-severe-dengue (420, 000), Vietnam (320, 000) i n Asia
https://www.who.int/denguecontrol/epidemiology/
en/
 DENGUE FEVER
● This i s an a l l - y e a r ro u n d d i s e a s e here i n the P h i l i p p i n e s
● The v i r u s respon sibl e f o r causing dengue, i s c a l l e d dengue
v i r u s (DENV).
● Affects mostly are male (52%) and 5 - 9 y e a r s o l d (23%)
● Most cases are from DENV-3 (67%), DENV-1 (17%), DENV-2 (14%), and
Mixed serotype (0.4%)

https://www.doh.gov.ph/Health-Advisory/Dengue
https://www.doh.gov.ph/sites/default/files/statistics/2019%20Dengue%20Monthly%20Report%20No.%208.pdf
 Burden of the Disease

https://doh.gov.ph/sites/default/files/statistics/PIDSR%20Weekly%20Surveillance%20Report%20No.%2015%202021.pdf
Burden of the Disease
PIDSR Philippine Integrated Disease
Surveillance and Response

● There i s 56% decrease on t he

number o f dengue cas es from
2020 t o 2021

https://doh.gov.ph/sites/default/files/statistics/PIDSR%20Weekly%20Surveillance%
20Report%20No.%2015%202021.pdf
 Burden of the Disease

https://ro4a.doh.gov.ph/2-transparency/940-dengue-cases-in-calabarzon-up-
40-in-jan-july-2022
Burden of the Disease
Burden of the Disease
 Disease Causation
● The v a r i o u s serotypes of the
dengue v i r u s are transmitted t o
humans through the bites of
i n f ec t e d Aedes a e g y p t i .
● The immature stages are found
mostly i n a r t i fi c i a l contai ners
closely associated with human
d w e l l i n g s and often indoors.

https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue
https://www.ncbi.nlm.nih.gov/books/NBK430732/
Disease Causation

https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue
https://www.ncbi.nlm.nih.gov/books/NBK430732/
 Spectrum of Disease

Source: Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Haemorrhagic Fever, WHO
2011
 Natural History of the Disease
● Begins a f t e r an inc ubation period of 4-7 days
when a t y p i c a l p a t i e n t experience:
○ sudden onset of f e v e r, f r o n t a l
headache, r e t r o - o r b i t a l p a i n and back p a i n
a l o n g w i t h s ev e r e m y a l g i a ( c l a s s i c
symptoms of dengue o r a.k.a
“ b r e a k - b o n e fever”)

Source: Harrison’s Principles of Internal Medicine 20th

Edition
 Natural History of the Disease
● I n i t i a l symptoms: t r a n s i e n t macular rash, adenopathy,
p a l a t a l v e s i c l e s , and s c l e r a l i n j e c t i o n

● Addit i o n a l symptoms: anor ex ia , nausea/vomit i n g ,

and cutaneous h y p e r s e n s i t i v i t y

● Days 3-5: m a c ul op a pu l ar r a s h s t a r t i n g a t t he t r u n k and

spreads t o extremities and face,
epistaxis and p r e - e x i s t i n g g a s t r o i n t e s t i n a l
lesions

Source: Harrison’s Principles of Internal Medicine 20th

Edition
 Natural History of the Disease

Source:PPD-CPM, DOH: Revised Dengue Clinical Case Management Guidelines

2011,
 Natural History of the Disease

Source:PPD-CPM, DOH: Revised Dengue Clinical Case Management Guidelines

2011,
 Spectrum of Disease

Source: Dengue Guidelines for Diagnosis, Treatment, Prevention and Control, New Edition, WHO;
2009
 Spectrum of Disease

Source: Dengue Guidelines for Diagnosis, Treatment, Prevention and Control, New Edition, WHO;
2009
 LEVELS OF PREVENTION
PRIMORDIAL PRIMARY
HEALTH SPECIFIC PROTECTION
PROMOTION BEFORE DISEASE
OCCURENCE
• Increasing the • Dengue Vaccine
knowledge of • Elimination of breeding places
the public about of mosquito
Dengue • Use mosquito repellents and
mosquito bed nets
• Dress the babies and children
in clothing that covers arms
and legs
• Drinking water storage
containers are to be drained
at the interval of 3-4 days
• Proper cleaning of overhead
water storage tanks (never
leave tanks uncovered)
• Used tyres, bottles and
containers should be
disposed of properly
SECONDARY TERTIARY
EARLY DIAGNOSIS AND PROMPT DISABILITY LIMITATION AND
TREATMENT REHABILITATION
• Laboratory tests such as • Adherence to treatment
Dengue NS1, Dengue to prevent complications
IgM/IgG, Polymerase Chain
Reaction (PCR), Plaque
Reduction N e u t r a l i z a t i o n
Test (PRNT), and NAAT-LAMP
• Other la b t es t: Complete
blood count with p l a t e l e t
count
• O r al and IV fl u i d s
• Blood tr ansf usion
AEDES-BORNE VIRAL DISEASES PREVENTION
AND CONTROL PROGRAM
THANK YOU