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Dengue Fever

Dengue Fever

Inroduction

Dengue is a mosquito-borne infection found in tropical and sub-tropical regions around the world. Lack of proper sanitation and collection of rain water in stagnant pools are the major cause of spurts in the epidemic

Severe dengue (previously known as Dengue Haemorrhagic Fever) affects most Asian and Latin American countries and has become a leading cause of hospitalization and death among children in these regions.

There are four distinct, but closely related, serotypes of the virus that cause dengue (DEN-1, DEN-2, DEN-3 and DEN-4). Recovery from infection by one provides lifelong immunity against that particular serotype. However, cross-immunity to the other serotypes after recovery is only partial and temporary. Subsequent infections by other serotypes increase the risk of developing severe dengue.

Transmission of Dengue

The Aedes aegypti mosquito is the primary vector of dengue. The virus is transmitted to humans through the bites of infected female mosquitoes. After virus incubation for 410 days, an infected mosquito is capable of transmitting the virus for the rest of its life.

Infected humans are the main carriers and multipliers of the virus, serving as a source of the virus for uninfected mosquitoes. Patients who are already infected with the dengue virus can transmit the infection (for 45 days; maximum 12) via Aedes mosquitoes after their first symptoms appear.

The Aedes aegypti mosquito lives in urban habitats and breeds mostly in man-made containers and stagnant pools of rain water. Unlike other mosquitoes Ae. aegypti is a daytime feeder; its peak biting periods are early in the morning and in the evening before dusk. Female Ae. aegypti bites multiple people during each feeding period.

Characteristics of the Infection

Dengue should be suspected when a high fever (40C/ 104F) is accompanied by two of the following symptoms: severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. Symptoms usually last for 27 days, after an incubation period of 410 days after the bite from an infected mosquito.

Severe dengue is a potentially deadly complication due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs occur 37 days after the first symptoms in conjunction with a decrease in temperature (below 38C/ 100F) and include: severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, restlessness, blood in vomit. The next 2448 hours of the critical stage can be lethal; proper medical care is needed to avoid complications and risk of death.

How to Treat?

There is no specific treatment for dengue fever.

For severe dengue, medical care by physicians and nurses experienced with the effects and progression of the disease can save lives decreasing mortality rates from more than 20% to less than 1%. Maintenance of the patient's body fluid volume is critical to severe dengue care.

Immunization

There is no vaccine to protect against dengue.

Prevention of Dengue

At present, the only method to control or prevent the transmission of dengue virus is to combat vector mosquitoes through:

  • preventing mosquitoes from accessing egg-laying habitats such as stagnant pools of clear water;
  • disposing of solid waste properly;
  • covering, emptying and cleaning of domestic water storage containers on a weekly basis;
  • applying appropriate insecticides to water storage outdoor containers;
  • using of personal household protection such as window screens, long-sleeved clothes, insecticide treated materials, coils and vaporizers;
  • improving community participation and mobilsation for sustained mosquito control;
  • applying insecticides as space spraying during outbreaks as one of the emergency control measures;
  • active monitoring and surveillance of mosquitoes should be carried out to determine effectiveness of control interventions.


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