Who Dengue Guidelines - Lecture Type 593t1e
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DENGUE FEVER and DENGUE HEMORRHAGIC FEVER
DENGUE FEVER the
most common and most important mosquito-borne viral disease in the world found in both tropical and subtropical regions transmitted by aedes aegypti
Aedes Aegypti
primarily a daytime feeder lays eggs and produces larvae preferentially in artificial containers highly urbanized
DENGUE VIRUS An arbovirus. Dengue is transmitted though mosquito bites Causes dengue fever and dengue hemorrhagic fever Has four serotypes (den 1, den 2, den3, den4) All serotypes can cause severe and fatal disease All serotypes are immunologically related but do not provide crossprotective immunity against each other
Dengue in the Philippines Quick Facts: •Affects all regions in the Philippines, especially those which are highly populated •Region X (Mindanao) NCR, Region VII (Cebu) with the highest number of cases •28% increase in Dengue cases during the period of Jan to Sep ’05 vs Jan to Sep ’04 •Ages of people with Dengue range from 1 to 95 yrs old with a median of 10 years old; 43% belong to 1-9 yr age group and 52% of dengue cases are males •26 – 81% of Dengue cases are unreported
SOURCES: www.doh.gov.ph/nec/dengue/dusept2005.pdf www.bayanihan.org/html/article.php/20060926152921347
REPLICATION AND TRANSMISSION OF DENGUE VIRUS
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
REPLICATION AND TRANSMISSION OF DENGUE VIRUS
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
CLINICAL CHARACTERISTICS of DENGUE FEVER Fever
Headache Muscle
and t pain Nausea and vomiting Rash Hemorrhagic manifestation
PETECHIAE
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
DIAGNOSIS Clinical
evaluation in Dengue
Fever - blood pressure - evidence of bleeding in skin or other sites - hydration status - evidence of increase vascular permeability (effusions, ascites) - (+) torniquet test
POSITIVE TORNIQUET TEST
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
CLINICAL CASE DEFINITION DENGUE HEMORRHAGIC FEVER
4 necessary criteria Fever or recent history of acute fever Hemorrhagic manifestation Low platelet count - 100,000/mm3 or less Objective evidence of leaky capillaries
Pleural Effusion
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
HEMORRHAGIC MANIFESTATIONS OF DENGUE HEMORRHGIC FEVER Skin hemorrhages - purpura, petechia, ecchymoses Gingival bleeding Nasal bleeding Gastrointestinal bleeding - hematemesis, melena, hematochezia Hematuria Increase menstrual flow
DANGER SIGNS OF DHF Abdominal
pain – intense &
sustained Persistent vomiting Abrupt change from fever to hypothermia with sweating & prostration Restless or somnolence
4 GRADES OF DHF Grade 1 - fever & non specific constitutional s & sx - positive torniquet test Grade 2 - grade 1 + spontaneous bleeding Grade 3 - signs of circulatory failure Grade 4 - profound shock
LABORATORY TEST Clinical
-
laboratory tests CBC liver function tests Chest X-ray Urinalysis
VIRUS ISOLATION CELL CULTURE
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
VIRUS ISOLATION CELL CULTURE
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
VIRUS-ISOLATION MOSQUITO-INOCULATION
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Disease
Treatment Fluids
Rest Antipyretics
– avoid aspirin/NSAID Monitor blood pressure, hct, platelet count, PT, PTT and level of consciousness May need transfusion
Dengue
Undifferentiated fever
Classical Dengue Fever
Dengue Hemorrhagic Fever
NATIONAL EPIDEMIOLOGY CENTER
NATIONAL EPIDEMIOLOGY CENTER
4S 1)Search and Destroy, mosquito breeding places 2)Self protection measures 3)Seek early treatment 4)Say “NO” to fogging
NATIONAL EPIDEMIOLOGY CENTER
They Hide, We Seek
NATIONAL EPIDEMIOLOGY CENTER
Thou Shalt Protect
NATIONAL EPIDEMIOLOGY CENTER
Mistakes to Avoid
NATIONAL EPIDEMIOLOGY CENTER
DENGUE FEVER the
most common and most important mosquito-borne viral disease in the world found in both tropical and subtropical regions transmitted by aedes aegypti
Aedes Aegypti
primarily a daytime feeder lays eggs and produces larvae preferentially in artificial containers highly urbanized
DENGUE VIRUS An arbovirus. Dengue is transmitted though mosquito bites Causes dengue fever and dengue hemorrhagic fever Has four serotypes (den 1, den 2, den3, den4) All serotypes can cause severe and fatal disease All serotypes are immunologically related but do not provide crossprotective immunity against each other
Dengue in the Philippines Quick Facts: •Affects all regions in the Philippines, especially those which are highly populated •Region X (Mindanao) NCR, Region VII (Cebu) with the highest number of cases •28% increase in Dengue cases during the period of Jan to Sep ’05 vs Jan to Sep ’04 •Ages of people with Dengue range from 1 to 95 yrs old with a median of 10 years old; 43% belong to 1-9 yr age group and 52% of dengue cases are males •26 – 81% of Dengue cases are unreported
SOURCES: www.doh.gov.ph/nec/dengue/dusept2005.pdf www.bayanihan.org/html/article.php/20060926152921347
REPLICATION AND TRANSMISSION OF DENGUE VIRUS
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
REPLICATION AND TRANSMISSION OF DENGUE VIRUS
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
CLINICAL CHARACTERISTICS of DENGUE FEVER Fever
Headache Muscle
and t pain Nausea and vomiting Rash Hemorrhagic manifestation
PETECHIAE
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
DIAGNOSIS Clinical
evaluation in Dengue
Fever - blood pressure - evidence of bleeding in skin or other sites - hydration status - evidence of increase vascular permeability (effusions, ascites) - (+) torniquet test
POSITIVE TORNIQUET TEST
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
CLINICAL CASE DEFINITION DENGUE HEMORRHAGIC FEVER
4 necessary criteria Fever or recent history of acute fever Hemorrhagic manifestation Low platelet count - 100,000/mm3 or less Objective evidence of leaky capillaries
Pleural Effusion
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
HEMORRHAGIC MANIFESTATIONS OF DENGUE HEMORRHGIC FEVER Skin hemorrhages - purpura, petechia, ecchymoses Gingival bleeding Nasal bleeding Gastrointestinal bleeding - hematemesis, melena, hematochezia Hematuria Increase menstrual flow
DANGER SIGNS OF DHF Abdominal
pain – intense &
sustained Persistent vomiting Abrupt change from fever to hypothermia with sweating & prostration Restless or somnolence
4 GRADES OF DHF Grade 1 - fever & non specific constitutional s & sx - positive torniquet test Grade 2 - grade 1 + spontaneous bleeding Grade 3 - signs of circulatory failure Grade 4 - profound shock
LABORATORY TEST Clinical
-
laboratory tests CBC liver function tests Chest X-ray Urinalysis
VIRUS ISOLATION CELL CULTURE
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
VIRUS ISOLATION CELL CULTURE
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases
VIRUS-ISOLATION MOSQUITO-INOCULATION
Centers for Disease Control and Prevention Division of Vector-Borne Infectious Disease
Treatment Fluids
Rest Antipyretics
– avoid aspirin/NSAID Monitor blood pressure, hct, platelet count, PT, PTT and level of consciousness May need transfusion
Dengue
Undifferentiated fever
Classical Dengue Fever
Dengue Hemorrhagic Fever
NATIONAL EPIDEMIOLOGY CENTER
NATIONAL EPIDEMIOLOGY CENTER
4S 1)Search and Destroy, mosquito breeding places 2)Self protection measures 3)Seek early treatment 4)Say “NO” to fogging
NATIONAL EPIDEMIOLOGY CENTER
They Hide, We Seek
NATIONAL EPIDEMIOLOGY CENTER
Thou Shalt Protect
NATIONAL EPIDEMIOLOGY CENTER
Mistakes to Avoid
NATIONAL EPIDEMIOLOGY CENTER
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