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  2. 2. Contents:Contents:  What is dengue fever?  What are dengue fever signs and symptoms?  What areas are at high risk for contracting dengue fever?  How is dengue fever contracted?  What is the treatment for dengue fever?  What is dengue hemorrhagic fever?  How can dengue fever be prevented?
  3. 3. What is dengue fever?What is dengue fever?  Dengue fever is a disease caused by a family of viruses (genus Flavivirus, family Flaviviridae) that are transmitted by mosquitoes (Aedes aegypti).  It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash.
  4. 4. Other names for DengueOther names for Dengue Break bone fever- Victims of dengue often have contortions due to the intense joint and muscle pain Dandy fever- Slaves in the West Indies who contracted dengue said to have dandy fever because of their postures and gait
  5. 5. Dengue triadDengue triad  fever  rash  headache
  6. 6. What are dengue fever signs andWhat are dengue fever signs and symptoms?symptoms? After being bitten by a mosquito carrying the virus, the incubation period ranges from three to 15 (usually five to eight) days before the signs and symptoms of dengue appear.
  7. 7.  Dengue starts with chills, headache, pain upon moving the eyes, and lower backache.  Painful aching in the legs and joints occurs during the first hours of illness.  The temperature rises quickly as high as 104 F (40 C), with relative slow heart rate (bradycardia) and low blood pressure (hypotension).  The eyes become reddened.  A flushing or pale pink rash comes over the face and then disappears.
  8. 8.  The glands (lymph nodes) in the neck and groin are often swollen.  Fever and other signs of dengue last for two to four days, followed by a rapid drop in body temperature with profuse sweating.  This precedes a period with normal temperature and a sense of well-being that lasts about a day.  A second rapid rise in temperature follows.
  9. 9.  A characteristic rash appears along with the fever and spreads from the extremities to cover the entire body except the face.  The palms and soles may be bright red and swollen.  hemorrhagic tendency (positive Tourniquet test, spontaneous bruising, bleeding from mucosa, gingiva, injection sites, etc.; vomiting blood, or bloody diarrhea)
  10. 10. Thrombocytopenia(<100,000 platelets per mm³ or estimated as less than 3 platelets per high power field) Evidence of plasma leakage (hematocrit more than 20% higher than expected, or drop in hematocrit of 20% or more from baseline following IV fluid, pleural effusion, ascites, hypoproteinemia) Encephalitic occurrences.
  11. 11. What areas are at high risk forWhat areas are at high risk for contracting dengue fever?contracting dengue fever? Dengue is prevalent throughout the tropics and subtropics including northern Argentina, northern Australia, Barbados, Brazil, Cambodia,Colombia, Panama, Paraguay, Philippines, Malaysia etc..
  12. 12. How is dengue fever contracted?How is dengue fever contracted? The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots, plastic bags, and cans year-round. One mosquito bite can inflict the disease.
  13. 13. The virus is not contagious and cannot be spread directly from person to person. There must be a person-to- mosquito-to-another-person pathway.
  14. 14. What is the treatment for dengueWhat is the treatment for dengue fever?fever?  There is no tested and approved vaccine for the dengue flavivirus.  There is no specific medicine or antibiotic to treat it.  For typical dengue, the treatment is purely concerned with relief of the symptoms (symptomatic). Close monitoring of vital signs in the critical period
  15. 15.  Rest and fluid intake for adequate hydration is important.  Supplementation with intravenous fluids may be necessary to prevent dehydration and significant concentration of the blood if the patient is unable to maintain oral intake.  Acetaminophen (Tylenol) and codeine may be given for severe headache and for the joint and muscle pain (myalgia)
  16. 16.  Platelet transfusion may be indicated if the platelet level drops significantly (below 20,000) or if there is significant bleeding The presence of melena may indicate internal gastrointestinal bleeding requiring platelet and/or red blood cell transfusion.  Aspirn and non-steroidal infalammatory drugs should be avoided as these drugs may worsen the bleeding tendency
  17. 17. What is dengue hemorrhagic fever?What is dengue hemorrhagic fever?  A more severe form of the viral illness  Tends to affect children under 10 years of age.  It causes abdominal pain hemorrhage (bleeding) circulatory collapse (shock).  DHF starts abruptly with high continuous fever and headache.  There are respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain.
  18. 18.  Shock occurs two to six days after the start of symptoms with sudden collapse, cool, clammy extremities (the trunk is often warm), weak pulse, and blueness around the mouth (circumoral cyanosis).
  19. 19. Manifestations include:Manifestations include:  Petechiae (small red or purple blisters under the skin)  Black stools, or easy bruising are all possible signs of hemorrhage  spitting up blood (hematemesis)  blood in the stool (melena)  bleeding gums, and nosebleeds (epistaxis)  Pneumonia is common, and inflammation of the heart (myocarditis) may be present.
  20. 20.  Patients with DHF must be monitored closely for the first few days since shock may occur or recur precipitously (dengue shock syndrome).  Cyanotic (bluish) patients are given oxygen. Vascular collapse (shock) requires immediate fluid replacement.  Blood transfusions may be needed to control bleeding.  The mortality (death) rate with DHF is significant. It ranges from 6%-30%. Most deaths occur in children. Infants under a year of age are especially at risk of dying from DHF.
  21. 21. How can dengue fever be prevented?How can dengue fever be prevented?  The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue.  People are urged to empty stagnant water from old tires, trash cans, and flower pots.  To prevent mosquito bites, wear long pants and long sleeves or personal protection use mosquito repellant sprays  Avoid visiting places where dengue is endemic.
  22. 22. The END !