DENGUE FEVER

MR.O 2023
DEFINITION
• Dengue is a febrile illness caused by dengue virus
• Also known as breakbone fever
EPIDEMILOGY
• It is endemic in Asia, the Pacific, Africa and the Americas
Approximately 50 million infections occur annually and dengue is the
most rapidly spreading mosquito-borne viral illness.
• Mortality is 1-5% without treatment and less than 1% with adequate
treatment. However sever disease has a mortality of 26%
ETIOLOGY
• Dengue fever virus (DENV)
• An RNA virus of the family flaviviridae, genus flavivirus
• Transmitted by arthropods( mosquitoes, or ticks )therefore reffered to
as arbovirus (arthropod – born virus )
• Four types i.e. DENV 1 – 4 all can cause full spectrum of disease
• The principal vector is the mosquito Aedes aegypti, which breeds in
standing water
Transmission
• Several species of mosquitoes with in genus aedes mainly A. aegypti.
• Life cycle
PATHOPHYSIOLOGY
MORE
• Mosquito bite
• Binds to and enters white blood cells, multiplies
• In severe forms the rate of multiplication is high and and affects
organs like liver and bone marrow.
• Fluid from blood stream leaks to body cavities
• Hypotension developes
• Reduced platelets hence bleeding tendency
Clinical features
• Sudden onset of fever
• Headache located behind the eyes
• Muscle and joint aches( break bone ) and a rash
• The disease curse takes three phase ie
Febrile phase …………..
Critical phase………….
Recovery phase ………….
More
• Dengue hemorrhagic fever is divided into four grades
Grade one – presence of easy bruising or positive tourniquet test
Grade ii spontaneous bleeding into the skin and elsewhere
Grade iii – clinical evidence of shock
Grade 4 – severe shock ( Bp and pulse un detectable)
Grade iii and iv referred to as dengue shock syndrome
Differentials
Diagnosis
• Symptoms ( fever, nausea and vomiting)and
• physical examination
• Low white blood cell count
• Low platelets and metabolic acidosis
• Hypoalbuminemia
• Plural effusion or ascites
• Demonstration of fluid on ultra sound scan
• positive tourniquet test
treatment
complications
Prevention