2. डेगु के हो ?
• यो लामखुट्टेको टोकाईबाट सर्ने एक प्रकारको िकटजन्य सर्रुवा
रोग हो
• एिडसर् एिजप्टाई/Pnaf]lkS6;{ (Aedes
aegypti/Albopicturs) जातको सर्ंक्रमिमत लामखुट्टेको टोकाई बाट
मात्रै यो रोग सर्दछर्दछ
• यो लामखुट्टेलाई Tiger Mosquito पनिन भनिनन्छ
• वषार्दतको मौसर्ममा महामारीको रूपन िलने गदछर्दछ
3. • नेपनालमा यो रोग सर्न २००६ दछेिख चर्चर्ार्दमा आएको हो
• अन्टािकाक्टका बाहेक सर्बै महाद्वीपनमा यो रोग फै लेको छ
• हाल िवश्वका १०० भनन्दछा बढ़ी दछेशमा यो रोग
फै िलएको छ
• सर्ंसर्ारको ४० प्रितशत eGbf a9L जनसर्ंख्या यो
रोगको जोिखममा छ
• एिशयामा बालबािलकामा यो रोग अस्पनताल भननार्द र
मृत्युको महत्वपनूर्ण र्द कारण बन्दछैछ
• मुख्यत: तातो हवापनानी भनएका सर्हर र सर्हरोंमुख
वस्तीहरुमा बढ़ी मात्रामा पनाइन्छ
4. Background
• Dengue, a mosquito‐borne disease emerged form of
Dengue Fever (DF), Dengue Hemorrhagic Fever
(DHF) and Dengue Shock Syndrome (DSS).
• Dengue was first recognized in the 1950s during
dengue epidemics in the Philippines and Thailand.
• Today, severe dengue affects most Asian and Latin
American countries and has become a leading cause
of hospitalization and death among children in these
regions.
• There are 4 serotypes of the virus that cause dengue
(DEN‐1, DEN‐2, DEN‐3 and DEN‐4).
• The disease is widespread throughout the tropics,
with local variations in risk influenced by rainfall,
temperature and unplanned rapid urbanization.
5. Global burden of dengue
• The incidence of dengue has grown dramatically around
the world in recent decades.
• The actual numbers of dengue cases are underreported
and many cases are misclassified.
• Today about 2.5 billion people, or 40% of the world’s
population, live in areas where there is a risk of dengue
transmission (WHO)
• Another study, of the prevalence of dengue, estimates
that 390 million people, in 128 countries, are at risk of
infection with dengue viruses.
• The World Health Organization (WHO) estimates that 50
to 100 million infections occur yearly, including 500,000
DHF cases and 22,000 deaths, mostly among children.
Comprehensive Guideline for prevention and control of Dengue WHO/SEAR
8. Global burden.........
• Before 1970, only 9 countries had experienced
severe dengue epidemics.
• The disease is now endemic in more than 100
countries
• The America, South‐East Asia and Western Pacific
regions are the most seriously affected.
• Cases across 1.2 million in 2008 and over 3
million in recently the number of reported cases
has continued to increase.
• In 2013, 2.35 million cases of dengue were
reported in the Americas alone, of which 37,687
cases were of severe dengue.
9. • Not only is the number of cases increasing as the
disease spreads to new areas
• The threat of a possible outbreak of dengue fever
now exists in Europe and local transmission of
dengue was reported for the first time in France and
Croatia in 2010 and imported cases were detected
in 3 other European countries.
• In 2012, an outbreak of dengue on the Portugal
resulted in over 2000 cases
• In 2013, cases have occurred in Florida (United
States of America) and Yunnan province of China.
Dengue also continues to affect several South
American countries, notably Costa Rica, Honduras
and Mexico.
Global burden.........
WHO, Special Programme for Research & Training in Tropical Diseases (TDR)
10. • In Asia, Singapore has reported an increase in cases
after a lapse of several years and outbreaks have
also been reported in Laos.
• In 2014, trends indicate increases in the number of
cases in the People's Republic of China,
• In 2015 an increase in the number of cases was
reported in Brazil and several neighboring countries.
• The Pacific island countries of Fiji, Tonga and French
Polynesia have continued to record cases.
• An estimated 500 000 people with severe dengue
require hospitalization each year,
• Affected large no of those die.
Global burden.........
11. • Dengue is a mosquito‐borne viral disease that has
rapidly spread in all regions of WHO in recent years.
• Dengue virus is transmitted by female mosquitoes
• The Aedes aegypti mosquito is the primary vector of
dengue.
– The Aedes aegypti mosquito lives in urban habitats
and breeds mostly in man‐made containers.
• Aedes albopictus, a secondary dengue vector in Asia
Vector
12. • The virus is transmitted to humans through the bites of
infected female mosquitoes.
• Infected humans are the main carriers and multipliers of
the virus,
Carriers
13. Situation of dengue in Nepal
• The earliest cases were detected as early as
2005.
• The sporadic cases continued and outbreaks
occurred in 2006 and 2010.
• During 2014, 356 confirmed cases were reported
from 19 districts with the highest case incidence
in Chitwan
• most of the reported cases had travel history to
neighboring country (India), however lately
indigenous cases were also reported.
16. Situation analysis Of Dengue
• During the 2014 total number of dengue case
reported from 17 district were 356.
• Among them, 149 cases were reported from
chitawan,
• 105 from Parsa and
• 28 cases from Makawanpur district
• Remaining 74 cases were reported from 14 district
(Jhapa, Moramg, Kapilbastu,Rupandehi, Kathmandu, Kailali,
Nawal parasi, kailali, Bara, Nawalparasi, Kanchanpur, Palpa,
Dadeldhura, Sanjya, Nuakot and Dhading.)
• Dengue cases are diagnosed in hospital and
reported to DHO and EDCD through EWARS.
17.
18. Goal
• To reduce the morbidity and mortality due to
Dengue Fever (DF), Dengue Hemorrhagic Fever
(DHF)and Dengue Shock Syndrome (DSS)
Program
19. Objectives
• To develop an Integrated Vector Management
(IVM) approach for prevention and control.
• To develop capacity on diagnosis and case
management of DF/DHF/DSS
• To intensify health education/IEC activities and
• To strengthen the surveillance system for
prediction, early detection, preparedness and
early response to outbreak of dengue.
20. Strategies
• Early case detection, diagnosis , management
and reporting of the DF,DHF & DSS
• Regular monitoring of cases and surveillance
through the EWARS
• Mosquito vector surveillance in different
municipalities.
• Integrated vector control approach
• A combination of several approaches directed
towards container management and source
reduction (Search & destroyed)
21. • यो लामखुट्टेले सामान्यत: जमेको सफा पानीमा अण्डा पाने
गर्दछर्दछ
• जीवन चक वयशक
पानीपानी
अण्डा
२-३ िदछन
लाभार्दप्यूपा
४-५ िदछन
१-२ िदछन
22. • एउटा लामखुट्टेको जीवन काल जम्मा १४-२१ िदछन को
हुन्छ
• एउटा लामखुट्टेले आफ्नो जीवन भर ३०० वटा सम्म
अण्डा पाने गर्दछर्दछ
• संकिमत लामखुट्टेका सबै अण्डा संकिमत नै हुन्छन्
• यसको अण्डा पानी िबना पिन मिहिनौसम्म जीिवत
रहिन सक्छ
• यो लामखुट्टेले सामान्यत उज्यालोमा टोक्ने गर्दछर्दछ
• यो लामखुट्टे १०० मीटरको पिरिधि िभत्रै िसिमत रहिन्छ
23. कारण
• डेंगर्ु भाईरस
• यो भाईरसका चार ४ प्रजाितहिरु छन
• DEN-1, DEN-2, DEN-3, DEN-4
• जुनसुकै प्रजाितबाट पिन यो रोगर् लाग्न सक्छ
24. • After virus incubation for 4–10 days,
• an infected mosquito is capable of transmitting
the virus for the rest of its life.
incubation Period
27. • Dengue should be suspected when a high fever
(40°C/104°F) is accompanied by 2 of the
following symptoms:
–severe headache,
–pain behind the eyes,
–muscle and joint pains,
–nausea,
–vomiting,
–swollen glands or rash.
Suspected Dengue
28. लकण / िचन्हि
संकमणकाल: ३ - १०िदछन
• एक्कासी उच्च ज्वरो आउनु १०२ F/१०३ F
• टाउको दछुख्ने : िवशेष गर्री अगर्ाड़ीको भागर्
• पेट दछुख्ने
• वाकवाकी लाग्ने
• आँखाको गर्ेडी दछुख्ने
• जोनी दछुख्ने
• जीउ सबै दछुख्ने
• रातोरातो िबिमराहिरु दछेखा पनुर्द
– सामान्यत: ज्वरो आएको ३-५ िदछन पिछ दछेखापदछर्दछ
29.
30. • जीउ गर्ल्ने
• थकान महिसूस हुने
• खाना रूचिच नहुने
• उल्टी हुने
• िदछशा नहुने / किब्जयत हुने
• नाकबाट रगर्त आउने
• मुखबाट रगर्त आउने
• िगर्जाबाट रगर्त आउने
• िदछशा कालो हुने
• रगर्त उल्टी हुने
• सास फे नर्द गर्ाहिो हुनु
• Blood Pressure िबसतारै कम हुदछै जान्छ
31. खतराका िचन्हिहिरूच
• अत्यिधिक पेट दछुख्ने
• लगर्ातार वान्ता भइरहिने
• शिररको िबिभन्न भागर्हिरूच जसतै: फोक्सो, पेट आिदछमा पानी
जमेको लकण दछेिखने
• आँखा वा छालामा रगर्त जमेको दछेिखने
• िबरामीमा असाधय अिल्छपना र िचिट्चटाहिट दछेिखने
• कलेजो फु ल्न थाल्ने
• platelet को मात्रा घट्दछै जाने
33. मृत्युदछर
• सामान्य डेँगर्ुमा ज्यादछै न्यून
• In DHF and DSS:
– कुनै उपचार नगर्रेको खण्डमा ५०% सम्म िबरामीको मृत्यु
हुन सक्छ।
– समयमा राम्रो उपचार पाएको खण्डमा मृत्युदछरलाई १-२%
सम्म झानर्द सिकन्छ।
34. उपचार
• आराम गर्ने
• पानी / झोिललो कुरा बढ़ी मात्रमा सेवन गर्ने
• ज्वरो कम गर्नर्द िसटामोलको प्रयोगर् गर्नर्द सिकन्छ तर Aspirin/
Brufen चािहि प्रयोगर् गर्नुर्द हुदछैन
• असपतालमा भनार्द गर्ने
• रगर्तको आवशयकता पनर्द सक्छ
• Antibiotics: खासै ठुलो भूिमका छैन
• There is no specific treatment but early detection and
access to proper medical care
35. रोकथामका उपायहिरूच
• पानी जम्न सक्ने भाँडाहिरु जसतैः गर्मला फु लदछानी खाली बट्टा
अल्कत्रा वा मिट्टतेलका खाली ड्रमहिरु गर्ाडीको काम नलाग्ने टायर
आिदछमा पानी जम्न निदछने उपाय गर्नुर्दपदछर्दछ ।
• पानीका ट्याङ्कीलाई लामखुट्टे प्रवेश गर्नर्द निदछने गर्री ढाकेर
राख्नुपछर्द ।
• कूलरमा रहिेको पानीमा प्रत्येक हिप्ता एक दछुई चम्चा मिट्टतेल
हिािलिदछने साथै जम्मा भएको पानी सफा गर्ने ।
36. रोकथाम................
• कुनै खोप छैन
• िकट नाशक औषिधिहिरुको प्रयोगर्बाट लामखुट्टे तथा
लावार्दहिरु नसट गर्ने
• जनचेतनामा ब्यापक अभीबृिद गर्ने
– झूल को प्रयोगर् गर्ने
– लामो बाउला भएको लुगर्ा लगर्ाउने
– पानी जमने खालड़ा खुल्ड़ी पुरने
– घर वािरपरी पानी जम्मा हुनसक्ने टायरहिरु नराख्ने
37. Prevention and control
control or prevent the transmission through:
• preventing mosquitoes from accessing egg-laying habitats by
environmental management and modification;
• disposing and removing artificial man-made habitats;
• covering and cleaning of domestic water storage containers on a
weekly basis;
• applying appropriate insecticides to water storage outdoor
containers;
• using of personal household protection such as window screens,
long-sleeved clothes, insecticide treated materials, coils and
vaporizers;
• improving community participation and mobilization;
• applying insecticides as space spraying during outbreaks as one of
the emergency vector-control measures;
• active monitoring and surveillance of vectors
72. Key facts
• Dengue is a mosquito-borne viral infection.
• The infection causes flu-like illness, and occasionally
develops into a potentially lethal complication called
severe dengue.
• The global incidence of dengue has grown dramatically in
recent decades.
• About half of the world's population is now at risk.
• Dengue is found in tropical and sub-tropical climates
worldwide, mostly in urban and semi-urban areas.
• Severe dengue is a leading cause of serious illness and
death among children in some Asian and Latin American
countries.
• There is no specific treatment for dengue/ severe
dengue, but early detection and access to proper medical
74. Headaches
Severe pain behind the eyes
Fever, chills
Red throat
Nasal congestion
Muscle pain
Bone pain
Skin symptoms:
Reddened skin
Increased sensitivity of skin to touch
Skin rash
Purple spots on the skin
Loss of appetite
Nausea
Vomiting
Liver and spleen enlargement
Hepatitis
Bad taste in the mouth
Minor bleeding from gums, nosebleeds,
blood in urine and stool
During recovery:
Low energy
Fatigue
Depression
75. A severe complication is dengue
hemorrhagic fever-dengue shock
syndrome. If you have this syndrome, you
may develop:
Dangerously low blood pressure
Weak pulse
Abdominal pain
Sweatiness
Pale or blue skin and lips
Uncontrolled bleeding (hemorrhage) from
gums, nose, urinary, and/or gastrointestinal
tract
![डेगु के हो ?
• यो लामखुट्टेको टोकाईबाट सर्ने एक प्रकारको िकटजन्य सर्रुवा
रोग हो
• एिडसर् एिजप्टाई/Pnaf]lkS6;{ (Aedes
aegypti/Albopicturs) जातको सर्ंक्रमिमत लामखुट्टेको टोकाई बाट
मात्रै यो रोग सर्दछर्दछ
• यो लामखुट्टेलाई Tiger Mosquito पनिन भनिनन्छ
• वषार्दतको मौसर्ममा महामारीको रूपन िलने गदछर्दछ](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)