1. Dengue is caused by a virus transmitted by mosquitoes and causes fever, joint pain, and rash. It was previously called "breakbone fever" due to severe joint pain. 2. There are four dengue virus serotypes that can all cause severe disease. Infection provides short-term immunity to other serotypes. 3. Dengue fever progresses through febrile, critical, and recovery stages with symptoms like high fever, headache, rash and bleeding. Severe cases can lead to dengue hemorrhagic fever or shock syndrome.

1. DENGUE

2. INTRODUCTION
• Dengue is an infectious disease caused by a virus.
• The virus is transmitted to humans through the bites of female
mosquitoes (Aedes aegypti).
• This disease used to be called breakbone fever because it
sometimes causes severe
joint pain and muscle pain that feels like bones are breaking.
DENGUE VIRUS:
• It is an RNA virus belonging to genus flavivirus and family flaviviridae.
• Consists of 4 serotypes, DEN-1, DEN-2 , DEN-3 , DEN-4
• All serotypes can cause severe and fatal diseases.
• There is a short lived cross immunity between these species.

3. TRANSMISSION CYCLE OF DENGUE~

4. LIFE CYCLE OF AEDES AEGYPTI

5. STAGES OF DENGUE FEVER
1.Febrile stage
2.Critical stage
3.Recovery stage
SYNONYMS OF DENGUE FEVER
1.Breakbone fever
2.Dandy fever
3.Dengue hemorrhagic fever
4.Dengue shock syndrome
5.Seven day fever

6. FEBRILE stage ~
(first4 days)
✔High fever 40°C
✔Headache
✔Petechiae
✔Generalized arthralgia
✔Myalgia
✔Bleeding from mucous membrane
✔A rash occurs in 50-80%

7. CRITICAL stage~
(4th to 7th day)
✔Leukopenia
✔Thrombocytopenia
✔Increase capillary
permeability leading to
plasma leakage that lead
to metabolic acidosis

8. RECOVERY stage~
(7th to 10th day)
✔Stabilized hemodynamic
status
✔Increase urine output
✔Increase in fluid overload
can cause cerebral edema

10. SIGN AND SYMPTOMS OF DENGUE FEVER-
o Headache
o Joint pain and muscle pain
o Nausea
o Vomiting
o Pain behind the eyes
o Swollen glands rash
o The incubation period is 4 to 7 days

12. ON EXAMINATION
oLow BP (90/60 mm/hg)
oRashes (appears on 6th day)
oLymphadenopathy
oHepatomegaly
oA weak, rapid pulse
oRed eyes

13. LABORATORY TESTS
o In blood test of dengue patient, antibodies like IgM
and IgG or NS-1 protein are in increasing number.
o If NS-1 is present in dengue patient, it confirms
dengue fever.
o Among IgG and IgM if IgG is positive then patient is
previously suffered from dengue fever.
o In dengue is important to check the levels of
platelets and PCV in blood.

14. RISK FACTORS
Factors that put you at greater risk of developing dengue fever
or a more severe form of the disease include:
• Living or travelling in tropical areas: being in tropical and
subtropical areas increases your risk of exposure to the
virus that causes dengue fever.
• Prior infection with a dengue fever virus: previous infection
with a dengue virus increases your risk of having severe
symptoms if you are infected again.
COMPLICATIONS
If severe, dengue fever can damage the lungs, liver or heart.
Blood pressure can drop to dangerous levels, causing shock
and in some cases, death.

15. WARNING SIGNS
✔Abdominal pain or or tenderness
✔Vomiting
✔diarrhea
✔Signs of fluid accumulation
✔Ascites
✔Lethargy
✔Rapid increase in haematocrit with fall in
platelet

16. SIGN AND SYMPTOMS OF DENGUE HAEMORRHAGIC
FEVER AND SHOCK SYNDROM
o Symptoms similar to dengue fever
o Skin becomes pale,cold
o Bleeding from nose,mouth and gums
o Vomiting with or without blood
o Rapid weak pulse
o Difficulty in breathing
o Patient feels thirsty and mouth becomes dry

17. EPIDEMIOLOGY
o In India first outbreak of dengue was recorded in 1812
o A double peak hemorrhagic fever epidemic occurred in
India for the first time in Kolkata between July 1963 &
March 1964
o In New Delhi, outbreaks of dengue fever reported in
1967, 1970, 1982, 1996, 2012 & 2015
o An estimated 5,00,000 cases of DHF require
hospitalization each year, of which a very large
proportion are children.
o A rapid rise in urban population is bringing greater
number of people.

18. RECENT CASES RECORDED

19. PREVENTION
Environmental:
• Solid waste management
• Reduced vector breeding sites
• Empty water containers and cut grass
• Personal protection
Chemical:
• Space spraying of insecticides
• Insecticide treatment of water containers
Personal protection
Use of mosquito nets, repellant creams,
mosquito coils.

20. TREATMENTS
o Increased oral fluid intake is recommended to
prevent dehydration.
o Supplementation with intravenous fluids may be
necessary to prevent dehydration if the patient is
unable to maintain oral intake.
o A platelet transfusion is indicated in rare cases if
the platelet level drops (below 20,000). And the
presence of melena may indicate internal
gastrointestinal bleeding requiring platelet and
RBC transfusion.
o Use of pain relievers with acetaminophen.
o Avoid aspirin.

21. VACCINATION
o As of 2019, The Dengue
Vaccine(Dengvaxia) is only recommended
in those who had previously had dengue
fever or populations in which most people
have been previously infected.
o The value of vaccine is limited by the fact
that it may increase the risk of severe
dengue in those who have not previously
been infected.
o It is given as three injections over a year.
o Development of dengue vaccines began in
the 1920s, but was hindered by the need to
create immunity against all four dengue
serotypes.