Dengue Zai IM

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Transcript of Dengue Zai IM

a potentially lethal complication called
severe dengue.
• !p to 0-"00 million infections are no#
estimated to occur annually in over "00
endemic countries$ putting almost half of the
#orld%s population at risk.
  Severe dengue &previously kno#n as dengue haemorrhagic fever' #as "st recogni(ed in the ")0%s during dengue epidemics in the philippines and thailand.
• +edes aegypti is the most common vector that can carry the dengue virus and it has serotypes DEN-1$ DEN-2$ DEN3$ and DEN-4.
• Recovery from infection by one provides lifelong immunity against that particular serotype.
• /o#ever$ cross immunity to the other serotypes after recovery is only partial and temporary.
  *he female Aedes aegypti mosquito is the primary vector of dengue.
  Infected humans are the main carriers and multipliers of the virus$ serving as a source of the virus for uninfected mosquitoes.
1 2ello# fever mosquito. 1 +sian tiger mosquito.
1 /as bright silvery lyre-shaped dorsal pattern and #hite banded legs
1 /as a single longitudinal silvery dorsal stripe and #hite banded legs.
1 ccupies urban areas #ith or #ithout vegetation.
1 +ssociated #ith thickets and arboreal vegetation.
1 4ites$ rests$ and lay eggs both indoors and outdoors.
1 5ostly and outdoor &garden' mosquito.
1 Sneaky biter. 1 +ggressive biter.
 Aedes aegypti Aedes albopictus
1 /igh preference for taking blood meals from humans and to lesser e6tent from domestic mammals$ #hich makes it a very capable vector of dengue viruses .
1 4ites humans but also a variety of available domestic and #ild vertebrates that do not carry the dengue viruses$ #hich lo#ers its capacity to transmit them
1 *he ma7or production places are human-made containers$ treeholes and bamboo internodes holding #ater
1 Sho#s preference for treeholes and bamboo internodes #ith #ater but can also utili(e human-made containers for its immature development
1 5ost containers #ith #ater used for immature development are #ithin or in close pro6imity to households
•  Aedes aegypti  – ,ives in urban habitats and breeds mostly in man-made
 – Is a daytime feeder$ its peak biting periods are early in the morning and in the evening before dusk.
•  Aedes albopitus
 – Secondary dengue vector in +sia.
children and adults$ but seldom causes death.
 – Should be suspected #hen a high fever
&0 :;"0 <' is accompanied by = of the ff s6 • severe headache
• pain behind the eyes • muscle and 7oint pains
• >;?
• s#ollen glands or rash
• Severe dengue$ is a potentially deadly complication due to  – plasma leaking$
 – fluid accumulation$
 – respi. 9istress$
 – severe bleeding$
 – or organ impairment.
  ".' <ebrile  pts typically develop high grade fever
 usually [email protected] days and is often accompanied by facial flushing$ skin erythema$ gen. body ache$ in7ected pharyn6 and con7unctival in7ection.
9ifficult to distinguish dengue clinically from non-dengue febrile diseases
  =.' :ritical phase +roung the time of defervescence$ #hen the temp drops
to [email protected] – 3B: or less
  =.' :ritical phase Shock occurs #hen a critical volume of plasma is
lost through leakage.
Aith prolonged shock$ the consequent organ hypoperfusion results in progressive organ impairment$ metabolic acidosis and disseminated intravascular coagulation.
  3.' Recovery phase If the patient survives the =-B hour critical
phase$ a gradual reabsorption of e6travascular compartment fluid takes in the follo#ing [email protected]= h.
Ceneral #ell-being improves$ appetite returns$ gastrointestinal symptoms abate$ haemodynamic status stabili(es and diuresis ensues.
  3.' Recovery phase Respiratory distress from massive pleural
effusion and ascites #ill occur at any time if e6cessive intravenous fluids have been administered.
<ever may lead to false positive result
".Cet blood pressure first
=.*hen get the sum of systolic and diastolic divided by =
3.86. "=0;B0 F = G "00
.Inflate in "00 mm/g
.*hen #ait for min
• *here is no specific treatment for dengue fever.
• +t present$ the only method to control or prevent the transmission of dengue virus is to combat vector mosquitoes through  – reventing mosquitoes from accessing egg-laying
habitats by environmental management and modificationJ
 – disposing of solid #aste properly and removing artificial man-made habitatsJ
 – covering$ emptying and cleaning of domestic #ater storage containers on a #eekly basisJ
 – applying appropriate insecticides to #ater storage outdoor containersJ
• using of personal household protection such as #indo# screens$ long-sleeved clothes$ insecticide treated materials$ coils and vapori(ersJ
• improving community participation and mobili(ation for sustained vector controlJ
• A/ responds to dengue in the follo#ing #ays  – supports countries in the confirmation of outbreaks
through its collaborating net#ork of laboratoriesJ
 – provides technical support and guidance to countries for the effective management of dengue outbreaksJ
 – supports countries to improve their reporting systems and capture the true burden of the diseaseJ
 – provides training on clinical management$ diagnosis and vector control at the regional level #ith some of its collaborating centresJ
 – formulates evidence-based strategies and policiesJ
  develops ne# tools$ including insecticide products and application technologiesJ
  gathers official records of dengue and severe dengue from over "00 5ember StatesJ