Dengue

1. RELIANCE INSTITUTE OF NURSING
TOPIC
PRESENTED BY :-
MR. ROMAN BAJRANG
BASIC BS.C NURSING 2ND YEAR
RELIANCE INSTITUTE OF NURSING

2. DENGUE
DEFINITION
1.Dengue is a disease caused by one of a number of viruses that are carried by
mosquitoes. These mosquitoes then transmit the virus to humans.
2.Dengue is a mosquito-borne tropical disease caused by the dengue virus.
Symptoms typically begin three to fourteen days after infection. These may include
a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin
rash. Recovery generally takes two to seven days.
3. A debilitating viral disease of the tropics, transmitted by mosquitoes, and
causing sudden fever and acute pains in the joints.
Dengue fever- An acute, infectious tropical disease caused by an arbovirus
transmitted by mosquitoes, and characterized by high fever, rash, headache, and
severe muscle and joint pain. Also called breakbone fever, dandy fever; Also called
dengue fever.
dengue fever (dĕng'gē, –gā) , acute infectious disease caused by four closely
related viruses and transmitted by the bite of the female Aedes mosquito;
it is also known as breakbone fever and bone-crusher disease.
Dengue hemorrhagic fever, a severe form of the disease, can cause hemorrhage,
shock, and encephalitis.
It occurs when a person who has acquired immunity to one of the viruses that
cause dengue fever is infected by a different dengue virus.
It is a leading cause of death among children in Southeast Asia and in recent years
has become increasingly prevalent in tropical America.
There is no specific treatment for dengue fever except good nursing care. Both
diseases can be controlled by eradicating the mosquitoes and destroying their
breeding places.

3. ETIOLOGY
Dengue fever is caused by Dengue virus (DENV), a mosquito-borne flavivirus.
DENV is a ssRNApositive-strand virus of the family Flaviviridae; genus
Flavivirus.
SIGNS AND SYMPTOMS
High fever - up to 105 degrees Fahrenheit
Severe headache
Retro-orbital pain - pain behind the eye
Severe joint pains
Muscle pains
Muscle aches
Swollen lymph nodes
General weakness
Nausea
Vomiting
Rash
Children get non-typical symptoms
Fever
Weakness
Prostration

4. Severe headache
Pain behind the eyes
Severe muscle pain
Slowed heart rate
Enlarge lymph nodes
Maculopapular rash
DIAGNOSIS
The diagnosis of dengue is usually made clinically. The classic picture is high
fever with no localising source of infection, a petechial rash with
thrombocytopenia and relative leukopenia - low platelet and white blood cell
count. Care has to be taken as diagnosis of DHF can mask end stage liver disease
and vice versa.
1. Fever, bladder problem, constant headaches, eye pain, severe dizziness and
loss of appetite.
2. Hemorrhagic tendency (positive tourniquet test, spontaneous bruising,
bleeding from mucosa, gingiva, injection sites, etc.; vomiting blood, or
bloody diarrhea)
3. Thrombocytopenia (<100,000 platelets per mm³ or estimated as less than 3
platelets per high power field)
4. Evidence of plasma leakage (hematocrit more than 20% higher than
expected, or drop in haematocrit of 20% or more from baseline following IV
fluid, pleural effusion, ascites, hypoproteinemia)
5. Encephalitic occurrences.
Dengue shock syndrome is defined as dengue hemorrhagic fever plus:
 Weak rapid pulse,
 Narrow pulse pressure (less than 20 mm Hg)
 Cold, clammy skin and restlessness.

5. A dependable immediate information of the Dengue diagnostics in the rural areas
can be performed by the introduction of Rapid Diagnostic Test kits which also
differentiates between primary and secondary dengue infections. Serology and
polymerase chain reaction (PCR) studies are available to confirm the diagnosis of
dengue if clinically indicated. Dengue can be a life threatening fever.
TREATMENT
The mainstay of treatment is timely supportive therapy to tackle shock due to
hemoconcentration and bleeding.
Close monitoring of vital signs in critical period (between day 2 to day 7 of fever)
is critical.
Increased oral fluid intake is recommended to prevent dehydration.
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.
A platelet transfusion is indicated in rare cases 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.
Aspirin and non-steroidal anti-inflammatory drugs should be avoided as these
drugs may worsen the bleeding tendency associated with some of these infections.
Patients may receive paracetamol preparations to deal with these symptoms if
dengue is suspected.

6. PREVENTION
Mosquito control
Primary prevention of dengue mainly resides in mosquito control.
There are two primary methods: larval control and adult mosquito control.
In urban areas, Aedes mosquitos breed on water collections in artificial containers
such as plastic cups, used tires, broken bottles, flower pots, etc.
Periodic draining or removal of artificial containers is the most effective way of
reducing the breeding grounds for mosquitos.
Larvicide treatment is another effective way to control the vector larvae but the
larvicide chosen should be long-lasting and preferably have World Health
Organization clearance for use in drinking water.
There are some very effective insect growth regulators (IGRs) available which are
both safe and long-lasting (e.g. pyriproxyfen). For reducing the adult mosquito
load, fogging with insecticide is somewhat effective.
Prevention of mosquito bites is another way of preventing disease. This can be
achieved by using insect repellent, mosquito traps or mosquito nets
THANKYOU!