Prevention Of Dengue An overview… M. Afzal Naeem (Lecturer in Botany) Govt. Post Graduate College of Science, Samanabad, Faisalabad.
Dengue fever is a virus infection caused by the dengue virus. There are 4 kinds of dengue viruses. Close up of Aedes aegypti Mosquito
50-100 million dengue fever infections per year globally 500,000 cases of severe dengue, dengue hemorrhagic fever or dengue shock syndrome 100-200 cases annually in U.S. Average case fatality 5%
Endemic in more than 100 tropical and subtropical countries. Pandemic began in Southeast Asia after WW II with subsequent global spread. Several epidemics since 1980s. Distribution is comparable to malaria.
• New infections annually: 50 million• Deaths: 24,000 annually• People at risk: 2.5-3 billion• Hospitalized cases: 500 000/year (90% of those affected are children)• Disease burden: 465,000 DisabilityAdjusted Life Years (DALY)
Dengue fever and dengue hemorrhagic fever are the most common mosquito- borne viral disease in the world. Only the female mosquito feeds on blood. This is because they need the protein found in blood to produce eggs. Male mosquitoes feed only on plant nectar.
The mosquito is attracted by the body odors, carbon dioxide and heat emitted from the animal or humans. •The female Aedes mosquito searches for suitable places to lay their eggs. •Aedes are day-biters, most active during dawn and dusk.
1-2 Days Pupae 4-5 Days Larvae 2 – 3 Days Eggs =300
Transmitted by the biteof Aedes mosquito(Aedes aegypti)Incubation 3-14 daysAcute illness andviremia 3-7 daysRecovery or progressionto leakage phase
ASYMPTOMATIC Undifferentiated Fever Without haemorrhageSYMPTOMATIC Dengue Fever With unusual haemorrhage Dengue No shock Haemorrhagic Fever DSS
May be the most common manifestation of dengue Prospective study found that 87% of students infected were either asymptomatic or only mildly symptomatic Other prospective studies including all age- groups also demonstrate silent transmission DS Burke, et al. A prospective study of dengue infections in Bangkok. Am J Trop Med Hyg 1988; 38:172-80.
1. Fever, or recent history of acute fever2. Hemorrhagic manifestations3. Low platelet count (100,000/mm3 or less)4. Objective evidence of “leaky capillaries:” ◦ elevated hematocrit (20% or more over baseline) ◦ low albumin ◦ pleural or other effusions
Abdominal pain - intense and sustained Persistent vomiting Abrupt change from fever to hypothermia, with sweating and prostration Restlessness or somnolence Martínez Torres E. Salud Pública Mex 37 (supl):29-44, 1995.
Fluids Rest Antipyretics (avoid aspirin and non-steroidal anti-inflammatory drugs) Monitor blood pressure, hematocrit, platelet count, level of consciousness
All above treatment + – In case of severe bleeding, give fresh whole blood 20 ml/kg as a bolus – Give platelet rich plasma transfusion exceptionally when platelet counts are below 5,000–10,000/ mm3 . – After blood transfusion, continue fluid therapy at 10 ml/kg/h and reduce it stepwise to bring it down to 3 ml/kg/h and maintain it for 24-48 hrs
Papaya Juice vs. Dengue ? Raw papaya leaves, 2 pcs just cleaned and pound and squeeze with filter cloth. You will only get one tablespoon per leaf. So two tablespoon per serving once a day. Do not boil or cook or rinse with hot water, it will loose its strength. Only the leafy part and no stem or sap. It is very bitter and you have to swallow it like Won Low Kat. But it works. Source: from Indonesia March 2005
Biological: Target larval stage of Aedes in large water storage containers Larvivorous fish (Gambusia), endotoxin producing bacteria (Bacillus), copepod crustaceans (mesocyclops)Chemical: Insecticide treatment of water containers Space spraying (thermal fogs)
A. STATE/ GOVERNMENT B. COMMUNITY LEVEL C. INDIVIDUAL MEASURESLEVEL MEASURES MEASURES1. ERADICATION OF MOSQUITO 1. FORMULATE A HEALTH 1. SHEILDING THE HOME , BREEDING SITES & MOSQUITO RELATED REPRESENTAIVE BODY OWNSELF & FAMILY FROM ERADICATION MOSQUITOES 2. STOP FORMATION OF 2. MOSQUITO ERADICATION MOSQUITO BREEDING SITES & DO MOSQUITO ERADICATION2. HEALTH EDUCATION 3. PARTICPATION IN HEALTH 3. EDUCATING MEMBERS OF PROGRAMMES FAMILY3. DIAGNOSIS & TREATMENT OF 4. COMMUNITY BASED 4. CONSULTING THE PHYSICIANSDENGUE CASES MECHANISM OF REFERAL & ON SEEING SYMPTOMS AND SIGNS TRANSPORTATION OF SUSPECTED AS EARLY AS POSSIBLE. CASES
It is the prime duty of the government to clean up all mosquito breeding sites e.g. Stagnant Water Ponds Garbage Heaps Choked Sewerage and drainage system Regular Anti Mosquito spray in all localities 3.Lifting the living standard of people and bringing them out of slums
I. Continuous liaison with Health DepartmentII. To be aware of and spread the awareness about the Health Programmes offered by the Government and to efficiently participate in them.III. To raise funds for the betterment of community healthIV. To keep a vigilant eye on proper execution of Health Related Programmes offered by Government.
This is what you can do to help… Change water in vases on alternate days.
Use of Mosquito Nets and Mosquito Repellent Oils
Spread the dengue prevention message to others…Let your family, friends and neighbours knowabout the dangers
Itcan carry the dengue virus and infect a healthy person with dengue fever.
Name the 5 steps in the 10-Minute Dengue Wipe-out Exercise
1. Change water in vases on alternate.2. Remove water from flowerpot plates on alternate days.3. Turn over all pails and water storage containers.4. Cover bamboo pole holders when not in use.5. Clear blockages and put in Bti insecticide in roof gutters monthly.
• Cover all toilet bowls in your home.• Seal off the overflow pipe of the flushing cistern.• Cover all gully/floor traps.• Add sand granular insecticide to places that mosquitoes could potentially breed, such as flower vases and places where stagnant water could not be removed.• Clear blockages and add Bti insecticide in roof gutters. • Turn over all pails and water storage containers.• Ask a relative or close friend to check your home regularly for stagnant water if you are going away for a long period of time.• Leave your contact with your neighbours or the neighbourhood police post/ centre so that you can be reached easily.