Dengue fever is caused by the dengue virus and transmitted by Aedes mosquitoes. It causes flu-like symptoms and in severe cases, bleeding and organ impairment. While there is no vaccine, prevention focuses on eliminating mosquito breeding sites and reducing exposure to bites. Dengue is widespread in tropical and subtropical regions, with over half of the global population at risk and an estimated 50 million infections annually. The Philippines experiences major outbreaks, reporting over 50,000 cases in the first half of 2012. Control relies on reducing mosquito habitats and populations through environmental management and insecticide spraying.

1. DENGUE
FEVER GROUP#7

2. QUESTIONS
What causes dengue?
Can someone be infected with dengue by physical contact?
Can someone with dengue take an antibiotic?
I have dengue before, am I immune to dengue?
Our barangay offers free fogging service, is it safe to do
fogging?

3. INFECTIOUS AGENT
• Dengue virus (DEN)
• small single-stranded RNA virus
• 4 distinct serotypes (DEN-1 to 4)
• Genus Flavivirus, family Flaviviridae

4. VECTOR
Aedes albopictus
• Asian tiger mosquito
• Bites people, pets and
wild animals
• Has spread from Asia
to Africa, the Americas
and Europe

5. VECTOR
Aedes Aegypti
• a small, dark mosquito
with white lyre shaped
markings and banded
legs
• Major vector for
dengue
• They prefer to bite
indoors and primarily
bite humans

6. AEDES AEGYPTI
• Lays eggs during the day:
• In water containing organic material in
containers with wide openings
• Prefer dark-colored containers located in
the shade
• Entire immature or aquatic cycle
(eggadult): 7-8 days
• Life span (adult): 3 weeks

7. TRANSMISSION
• During feeding, female mosquitoes ingest
the DEN circulating in the blood of viraemic
humans
• The virus infects the mosquito mid-gut and
subsequently spreads systemically over a
period of 8-12 days.

8. PORTAL OF ENTRY
• Via the skin while an infected mosquito is
taking a bloodmeal

9. THE HOST
• Incubation period: 4-10 days
• Infection produces a wide spectrum of illness
• Most are asymptomatic or subclinical
• Primary infection  induce lifelong protective
immunity to the infecting serotype
• No long-term cross-protective immunity, only
within 2-3 months of the primary infection
• Young children: greater risk of dengue shock;
less able to compensate for capillary leakage

10. SEVERE DENGUE
(i) plasma leakage that may lead to shock
(dengue shock) and/or fluid accumulation,
with or without respiratory distress
(ii) severe bleeding
(iii) severe organ impairment

11. PHASES
I. Febrile phase
II. Critical phase
III.Recovery phase

12. FEBRILE PHASE
• First 4 days
• High fever, abdominal
pain, headache, facial
flushing, skin erythema,
generalized body ache,
myalgia, arthralgia;
vomiting, epistaxis,
conjunctival infection
• Progressive decrease in
total WBC count (earliest
abnormality)

13. CRITICAL PHASE (TOXIC
HEMORRHAGIC STAGE)
• Days 4-7 of illness
• Time of defervescence
• Temperature drops to 37.5 - 38 °C
• Increase in capillary permeability,
increasing haematocrit levels
• Plasma leakage (24-48 hours) 
Progressive leukopenia  rapid decrease in
platelet count

14. • Severe abdominal pain, vomiting and
frequent bleeding from GI tract, unstable
BP, narrow pulse pressure and shock
• Death may occur

15. RECOVERY PHASE
(CONVALESCENT STAGE)
• Days 7-10
• a gradual reabsorption of extravascular
compartment fluid takes place
• General well-being improves, appetite
returns, gastrointestinal symptoms abate,
haemodynamic status stabilizes and diuresis
ensues, BP stable
• Recovery of platelet count is typically later
than that of white blood cell count.

16. DIAGNOSIS
Presumptive Test
• Tourniquet test or Rumpel Leads Test
• Platelet count
Diagnostic Test
• Dengue Ns1 Ag/ IgG IgM Ab

17. MANAGEMENT
• Supportive and symptomatic treatment should
be provided
• Fever: paracetamol for muscle pains
• Headache: analgesic, NEVER aspirin
• Rapid replacement of body fluids: most important
• Includes intensive monitoring and follow-up
• ORESOL to replace fluid as in moderate
dehydration at 75 mL/kg in 4-6 hours or up to 2-3
L in adults

18. EPIDEMIOLOGY

19. EPIDEMIOLOGY
• most rapidly spreading mosquito-
borne viral disease in the world
• In the last 50 years, incidence has
increased 30-fold
• increasing geographic expansion to
new countries
• in the present decade, from urban
to rural settings

20. • Dengue infections
• Estimated 50 million annually
• Approximately 2.5 billion people
live in dengue endemic countries

22. • Some 1.8 billion (more than 70%) of
the population at risk for dengue
worldwide live in member states of
the WHO South-East Asia Region
and Western Pacific Region, which
bear nearly 75% of the current
global disease burden due to
dengue.

26. EPIDEMIOLOGY

27. • 2001 and 2008:
• 1, 020, 333 cases reported in
Cambodia, Malaysia, Philippines, and
Vietnam (Western Pacific Region)
• highest numbers of cases and deaths
• The combined death toll for these four
countries was 4798

28. • 2008
• Compared with other countries in
the same region, the number of
cases and deaths remained highest
in Cambodia and the Philippines

29. PHILIPPINES

32. TREND
• January 1 to July 14, 2012
• 51,597 dengue cases was reported
nationwide
• 16.43% higher compared to the
same time period last year (44,315)

33. GEOGRAPHIC DISTRIBUTION
• National Capital Region (22.24%)
• Region IV-A (14.08%)
• Region III (13.65%)

36. PROFILE OF CASES
• Range: less than 1 month - 90 years old
(median = 12.67 years)
• Majority of cases were male (53%)
• 40% of cases belonged to the 1 to 10
years age group
• There were 324 deaths (CFR 0.63%)
reported.
• Reported cases with CFR greater than 1
came from Regions IVB, VI, VIII, XI, XII,
CARAGA and ARMM

40. • January 1 to August 26, 2013:
• A total of 3367 dengue cases were
admitted to different sentinel hospitals
region wide
• – 15.53% lower compared to the same
time period last year (3986)
• Range of ages: 4 days to 86 years of age
(Median= 10.00)

42. • Misamis Oriental (40.70%)
• highest CFR of 1.02%
• Misamis Occidental Province
• highest increase by percentage (188.89%) for
this year compared to all other province

43. • Cagayan de Oro
• highest number of cases region wide
(21.70%)
• Malaybalay City
• highest percentage change at 317.50%
• Iligan City
• highest CFR at 1.12% compared to all
other cities

45. • 52% are males.
• There were 28 deaths with a Case Fatality
Rate (CFR) of 0.83%.
• All deaths were <15 years (CFR=1.24 %)
with the highest among the age group 5-9
years old with a CFR of 1.58%.

48. PREVENTION AND CONTROL
• Control Measures:
• 1.) Eliminate vector:
• A.) Change water and scrubbing sides of lower vases
once a week
• B.) Destroy breeding places of mosquito
• C.) Proper disposal of rubber tires, empty bottles and cans
• D.) Keep water containers covered
• 2.) Avoid too many hanging clothes inside the house
• 3.) Residual spraying with insecticides