This document discusses dengue fever, a mosquito-borne tropical disease. It defines dengue fever as a viral infection transmitted through the bites of infected Aedes mosquitoes. The document outlines the typical phases of dengue fever including febrile, critical, and recovery phases. It describes common signs and symptoms like high fever, headache, muscle and joint pains. The document also discusses diagnostic tests, management, nursing care, prognosis and potential complications of dengue fever.

1. PRESENTED BY:-
OM VERMA
ASSISTANT PROFESSOR
RELIANCE INSTITUTE OF NURSING

2. INTRODUCTION
Dengue fever is a
painful debilitating
mosquito born
disease caused by
any one of four
closely related
dengue virus

3. DEFINITION
Dengue fever is transmitted by the bite of an
Aedes mosquito infected with a dengue
virus. The mosquito becomes infected when
it bites a person with dengue virus in
their blood. It can’t be spread directly from
one person to another person.

4. DEFINITION
• Dengue fever is also known as breakbone fever
is a mosquito born tropical disease caused by
the mosquito bite.
• The alternative name for dengue, "breakbone
fever", comes from the associated muscle and
joint pains.
• It is caused by the female aedes aegypti
mosquito bite, which transmit the dengue virus
to human.

5. INCIDENCE
Each year an estimated 100 millions
cases of dengue occur world wide.
• The global incidence of dengue has
grown dramatically in recent decades.
• In INDIA the cases has increase sharply
over past five years there have been
38,000 so far in 2013.

6. Tropical regions are :-
 Indian sub continent
 Mexico
 Africa
 Southern China

9. PHASES

10. Febrile Phase x 7days
High fever 40 °C (104 °F)
headache
generalized arthalgia
myalgia
petechiae
bleeding from mucus membrane.
A rash occurs in 50–80%

11. Critical Phase x 2days
Leukopenia
thrombocytopenia.
Increase capillary permeability
leading to plasma leakage that lead
to metabolic acidosis.
In children febrile phase is common
carries nausea, vomiting,
thrombocytopnea.

12. Recovery phase x 2-3 days
Stabilize hemodynamic status
increase urine output
overall clinical improvement.
Increase in fluid overload can cause
cerebral edema.

14. SIGN & SYMPTOMS
• Fever ( more than 105 )
• Headache
• Muscle, joint pain
• skin rash ( appear 4-5 days after fever )
• Pain behind eyes
• Nausea
• Vomiting
• Mild bleeding

16. WARNING SIGNS
• Severe abdominal pain
• Persistent vomiting
• Vomit with blood
• Drowsiness or irritability
• Dyspnoea
• Swollen lymph node
• Prostration
• diarrhea

17. Dengue with warning signs
• Probable dengue plus one of:
• Abdominal pain or tenderness
• Persistent vomiting
• Signs of fluid accumulation, e.g. pleural effusion or
• ascites
• Mucosal bleed
• Lethargy
• Hepatomegaly > 2 cm
• Rapid increase in haematocrit with fall in platelet
• count
• Needs medical intervention, e.g. intravenous fluid

18. • Severe dengue
• • Severe plasma leakage leading to:
• Shock (dengue shock syndrome)
• Fluid accumulation with respiratory distress
• • Severe haemorrhagic manifestations, e.g. GI
• haemorrhage
• • Severe organ involvement:
• Liver AST or ALT ≥ 1000U/L
• CNS: impaired consciousness
• Cardiomyopathy
• Other organs, e.g. renal impairment
• Needs emergency medical treatment and specialist care with

22. DIAGNOSTIC
TEST

23. WHO-proposed clinical
definition of dengue
PROBABLE DENGUE
• • Exposure in an endemic area
• • Fever
Two of:
• Nausea/vomiting
• Rash
• Aches/pains
• Positive tourniquet test
• Leucopenia
• Any warning sign
• Laboratory confirmation important
• Needs regular medical observation and
instruction in the
warning signs
• If there are no warning signs,
need for hospitalisation is
• influenced by age,
comorbidities, pregnancy and
social factors

25. LABORATORY FEATURES
• include leucopenia, neutropenia, thrombocytopenia
• elevated alanine aminotransferase (ALT) or
aspartate aminotransferase (AST)
• serology or detection of dengue viral material in
blood by RT-PCR

26. • Dengue-specific IgG and IgM ELISA { positive for IgM
antibodies on or after day 5 of the fever}
IgM ELISA has a sensitivity of 83.9–98.4% and
a specificity of 100%
Dengue 2 virus enhancement in asthmatic
and non asthmatic individual.Guzman MG,
Kouri G, Soler M, Bravo J, Rodríguez de
La Vega A, Vazquez S, Mune M

27. • Extravasation of fluid due to vascular leakage can be
detected radiologically (chest radiography for pleural
effusions, echocardiography for pericardial effusions,
ultrasonography for ascites).
[Dengue haemorrhagic fever in children:
ten years of clinical experience].Méndez A,
González G
Biomedica. 2003 Jun; 23(2):180-93.

30. MANAGEMENT
• Bleeding prevention & control.
• Fluid & water replacement.
• Symptoms relief & fever control.

40. NURSING MANAGEMENT
• Increased body temperature related to infection as evidence
by vital sign monitoring.
• Hypovolemic shock related to hemorrhage.
• Fluid volume deficit related to migration of intravascular fluid
into extravascular fluid.
• Impaired nutrition less than body requirement related to
decreased appetite.

42. PROGNOSIS
• For the majority of peoples the people infected with
dengue virus fever the prognosis is excellent.
• Although they are likely to feel very ill during first 1-2
week of acute illness.
• Overall the fatality rate is about 1% for all denge
fever infection.

43. COMPLICATION
• A small percentage of individual who have dengue fever can develop
a more serious form of disease.
• Dengue haemorrhagic fever and disseminated intravascular
• coagulation
• Dengue shock syndrome
• Hepatitis, cerebral haemorrhage or oedema, encephalitis,
• cranial nerve palsies, rhabdomyolysis, myocarditis
• Vertical transmission if infection within 5 wks of delivery