Presentation about dangue

1. Dengue fever is a disease caused by a family of
viruses that are transmitted by mosquitoes. Strikes
people with low levels of immunity. Because it is
caused by one of four serotypes of virus, it is
possible to get dengue fever multiple times.
However, an attack of dengue produces immunity
for a lifetime to that particular serotype to which
the patient was exposed.
Introduction

2. The transmission cycle of dengue virus by the mosquito Aedes
aegypti begins with a dengue infected person. This person I will
have virus circulating in the blood-a viremia that lasts for about
five days.During the viremic period, an uninfected female Aedes
aegypti mosquito bites the person and ingests blood that
contains dengue virus.Then, within the mosquito, the virus
replicates during an extrinsic incubation period of eight to
twelve days.The mosquito then bites a susceptible person and
transmits the virus.
PATHOPHYSIOLOGY

3. Dengue infection is caused by dengue virus (DENV), which
is a single-stranded RNA virus (approximately 11 kilobases
long) with an icosahedral nucleocapsid and covered by a
lipid envelope. The virus is in the family Flaviviridae, genus
Flavivirus, and the type specific virus is yellow fever.
Transmission of dengue virus into the host is through the
vectors
Dengue is transmitted by infected female mosquito.
ETIOLOGY/ RISK FACTORS

4. Symptoms
Symptoms, which usually begin four to six days after infection and last
for up to 10 days, may include
Sudden, high fever
Severe headaches
Pain behind the eyes
Severe joint and muscle pain
Fatigue
Nausea
Vomiting
Skin rash, which appears two to five days after the onset of fever
Mild bleeding (such a nose bleed, bleeding gums, or easy bruising)

5. Types
Dengue fever (DF)
Is an acute febrile viral illness presenting with headache ,
bone or joint and muscular pains, rash and leukopenia
caused by arthropod - borne viruses.
 Dengue hemorrhagic fever (DHF ) : -Is characterized by
four major manifestations :High grade fever,a
hemorrhagic phenomenona HepatomegalySigns of
circulatory failure=
 Dengue shock syndrome (DSS): -Hypovolemic shock
resulting from plasma leakage

6. • Complications
Cardiomyopathy.
Seizures, encephalopathy, and viral encephalitis.
Hepatic injury.
Depression.
Pneumonia.
Complications & Investigations
• Investigations
Laboratory diagnosis methods for confirming
dengue virus infection may involve detection of the
virus, viral nucleic acid, antigens or antibodies, or a
combination of these techniques. After the onset of
illness, the virus can be detected in serum, plasma,
circulating blood cells and other tissues for 4–5 days.

7. Later in the illness (≥4 days after fever onset), IgM against
dengue virus can be detected with MAC-ELISA. For patients
presenting during the first week after fever onset,
diagnostic testing should include a test for dengue virus
(rRT-PCR or NS1) and IgM.
For patients presenting >1 week after fever onset, IgM
detection is most useful, although NS1 has been reported
positive up to 12 days after fever onset (Figure 3-01). In the
United States, both MAC-ELISA and rRT-PCR are approved
as in vitro diagnostic tests.
Diagnostic test

8. For a mild form of the disease:
Drinking plenty of fluids to avoid dehydration from vomiting
and high fever.
Taking acetaminophen (Tylenol, others) to alleviate pain and
reduce fever. Don't take aspirin or other nonsteroidal anti-
inflammatory drugs, such as ibuprofen (Advil, Motrin,others)
and naproxen sodium (Aleve, others). These can increase the
risk of bleeding complications.
For a more severe form of the disease, treatment consists of:
Supportive care in a hospital
Intravenous (IV) fluid and electrolyte replacement
Blood pressure monitoring
Transfusion to replace blood loss
Treatment

9. Management
Reduction of high fever: paracetamol only, tepid sponge
Promote oral feeding: soft diet, milk, fruit juice, oral rehydration solution
(ORS). Avoid IV fluid if there is no vomiting and moderate/ severe
dehydration
Follow up CBC everyday
Nursing diagnosis
Based on the assessment data, the major nursing diagnoses for a patient
with DHF are:
Risk for bleeding related to possible impaired liver function.
Deficient fluid volume related to vascular leakage.
Pain related to abdominal pain and severe headaches.
Risk for ineffective tissue perfusion related to failure of the circulatory
system.
Risk for shock related to dysfunction in the circulatory system.
Management & Nursing diagnosis

10. Conclusion
Though Dengue fever has various clinical
manifestations none were specific to the disease.
Fever was the only clinical feature which was
maximally associated.
Total leucocyte count may determine the outcome
More prospective study and more number of
cases are to be analyzed to know the exact clinical
manifestation which may determine the outcome.