This document discusses dengue fever, also known as breakbone fever. It is caused by a virus spread through the bites of infected Aedes mosquitoes. The document covers the typical symptoms of dengue fever, which include high fever, joint and muscle pain. It also discusses dengue hemorrhagic fever, a potentially deadly complication. Key points include that dengue occurrence is highest during rainy seasons and among children under 15. The largest recorded outbreak was in the Philippines in 1998 when over 38,000 cases occurred, potentially triggered by the El Niño phenomenon. There is concern another major outbreak could happen in the Philippines in 2011 for the same reason.

2. ALTERNATIVE NAMES
 Hemorrhagic dengue
 Dengue shock syndrome
 Philippine hemorrhagic fever
 Thai hemorrhagic fever
 Singapore hemorrhagic fever

3. Dengue Hemorrhagic
Fever
 acute infectious viral diseaseaffecting infants and young
children
 called break-bone fever- severe joint and muscle pain
that feels like bones are breaking
 deadly infection spread by certain species of
mosquitoes (Aedesaegypti)
 Philippine Hemorrhagic Fever was first reported in 1953.

4. OCCURENCE
 Dengue occurrence is sporadic throughout the year.
 Epidemic usually occurs during the rainy seasons
June – November.
 Peak months are September and October.
 DHF are observed most exclusively among children
of the indigenous population under 15 years of age.
 Occurrence is greatest in the areas of high
AedisAegypti prevalence.

5. SYMPTOMS OF DENGUE
FEVER

6. How AedesMosquitos
Transmit Diseases

7. DENGUE FEVER
CATEGORIES
 Severe, frank type – with flushing, sudden high
fever, severe hemorrhage, followed by sudden drop
of temperature, shock and terminating in recovery or
death.
 Moderate – with high fever, but less hemorrhage, no
shock
 Mild – with slight fever, with or without petechial
hemorrhage but epidemiologically related to typical
cases usually discovered in the course of
investigation of typical cases.

8. EPIDEMIOLOGY
 Globally, there are an estimated 50 to 100 million cases of dengue
fever (DF) and several hundred thousand cases of dengue hemorrhagic
fever (DHF) per year.
 2.5 billion people are at risk world-wide
 In the last 20 years, dengue transmission and the frequency of dengue
epidemics has increased greatly in most tropical countries
 It is a resurgent (re-emergent) disease worldwide in the tropics

9. SUSCEPTIBILITY, RESISTANC
E AND OCCURRENCE
 Bothe sexes are equally affected. Age groups predominantly affected
are the preschool age and school age. Adults and infants are not
exempted. Peak age affected 5-9 years.
 Occurrence is sporadic through out the year. Epidemic usually occur
during the rainy seasons June – November. Peak months are
September and October.
 Occurs wherever vector mosquito exists. Susceptibility is universal.
Acquired immunity may be temporary but usually permanent.

10. Factors contribute to the emergence and
re-emergence of arthropod-borne diseases
 Major global demographic changes (urbanization and
population growth)
 These demographic changes have resulted in sub-standard
environmental sanitation that facilitates transmission of Ae.
aegypti-borne disease; (Overcrowding in cities with poor
sanitation)

11.  Increased travel by airplane resulting in a frequent exchange
of dengue viruses and other pathogens.
 Inadequate mosquito control services; the use of insecticide
space sprays for adult mosquito proved ineffective approach
for controlling Ae. aegypti. (Domestic habitat)
 The emergence of resistance to insecticides linked to their
increased misuse.

12. INCREASED PROBABILITY OF
DHF

13. TRENDS
 DENGUE CASES  DENGUE DEATHS
Highest: Year 1998- 38, 135 cases Highest- Year 1998- 510 cases
1998, 2006, 2007 Lowest- Year 2000- 90 cases
Lowest: Year 1994- 5,166 cases
1993,1994, 2000

14. REASONS
In 1998, epidemics began to appear in March in
Aurora province in southern Luzon and in June
in lloiloprovince in the western Visayas
The 1998 dengue outbreak was also triggered by
El Niño

15.  The sudden increases in the incidence of dengue in
1993, 1998 and 2001 were expected because of the
cyclical nature of the disease --- the reason why
dengue remains a threat to public health despite low
incidences reported in recent years
 Mosquito vector control is the main strategy
recommended by the DOH for the prevention of
dengue.

21. 2011 OUTBREAK?
 DENGUE has been grabbing headlines again in
various local papers and in publications in Asia
about the possibility of another outbreak in the
Philippines next year, worst than the one we
had in 1998, where there were more than
38,000 cases.
 According to experts, a 2011 outbreak in the
Philippines can happen because of the El Nino
phenomenon, which triggered the one in 1998.