community medicine

1. Introduction

4. In World 390 million dengue
infections per year
In India cases are increasing
During 2017, the highest number of
cases were reported from Tamil
Nadu, followed by Kerala ,
Karnataka

5. Epidemiological
factors

6. Agent
Flavivirus
Four serotype
DENV-1
DENV-2
DENV-3
DENV-4

7. VECTOR
Aedes
Aegypti
Aedes
Albopictus

8. Environmental
factors

9. Host factor
Man is the only host
Both sex equally effect
High risk: infants, elderly,
obesity, patients on steroids
and NSAIDS, chronic diseases
Occupation

12. Clinical
manifestations
Asymptomatic
Undifferentiated fever
Classical dengue fever
Dengue hemorrhagic
fever

13. Undifferentiated fever
Fever
Maculopapular rashes
Upper respiratory and
gastrointestinal
symptoms

14. Classical dengue fever
3-10 days
Sudden onset
Chills, high fever, intense
headache
Muscle and joint pain
Retro orbital pain
Extreme weakness

15. Classical dengue fever
Anorexia
Constipation
Altered taste sensation
Abdominal tenderness
Pain in inguinal region
Sore throat
General depression
Rashes

17. Severe dengue
Plasma leakage led to shock
Severe bleeding
Severe organ damage

18. Criteria for clinical diagnosis
DF
 Clinical manifestations
 Leucopenia (<= 5000cells/mm3)
 Thrombocytopenia (<150,000 cells/mm3)
 Rising haematocrit
 Testing IgG titre
 IgM antibody
 Isolation of virus

19. Laboratory diagnosis
 Virus isolation
 Viral nucleic acid detection
 Immunological response and
serological tests
 Viral antigen detection
 Rapid diagnostic test
 Analysis of haematological
parameters

21. Management of DF
ORS
Juice
P mol
Tepid sponge
Avoid aspirin
NSAIDS
Monitor urine output

22. Management of DHF
Fluid intake
Tepid sponge
ORS, IV fluids
Watch for initial signs of shock
BP fall
O2 administration
Blood transfusion
Platelet transfusion

23. Control measures
Mosquito control
Vaccines
Other measures

25. Mosquito control measures

34. Vaccines
CYD- TDV live attenuated
viral vaccine
0.5ml
3 injections administered at
6 month intervals

36. Assignment
 Prepare for a discussion on Dengue
hemorrgahic fever , dengue shock
syndrome and its clinical phases in
next class.

37. References
Gulani K, K . Community Health Nursing:
Principles and practice. KPH pub. NewDelhi
Park K. Park’s Text book of preventive and social
medicine, Banarsidas Bhanot Pub, Jabalpur
Suryakantha AH .Community Medicine with recent
advances, Jaypee Brothers medical pub. Delhi
Rahim A. Principles and practice of community
medicine, jaypee pub.Delhi