2. This presentation includes:
What is Dengue
Fever?
How does it
occur?
Epidemiology
of DENGUE
Fever.
Types of
Dengue fever.
Clinical
presentation of
Dengue fever.
Investigations
Treatment of
Dengue Fever.
9. Definition of DENGUE FEVER:
Dengue fever is a mosquito-borne tropical disease caused by the
dengue virus.
10. Epidemiology:
40% of the world’s
population are at risk of
Dengue.
Dengue is endemic in at
least 100 countries in
Asia, the Pacific, the
Americas, Africa, and
the Caribbean.
WHO estimates that 50 to
100 million infections
occur yearly, including
500,000 DHF cases.
22,000 deaths yearly,
mostly children.
11. Some Informations about DENGUE FEVER:
First outbreak: 1779
Became global problem : 1945
Causative agent : Dengue Virus
Vector: Aedes Mosquito
First case in Bangladesh : 2000
Affected this year : 1900
Fatality this year: 4
12. Dengue Fever at a glance :
Complications/ Cure
Fever last for averagely 4-5 days
Sings symptoms of Dengue
Within 14 days
Aedes Mosquito bite
13. Mechanism of Dengue Fever:
if not corrected , death
Hemorrhagic manifestation
Decreased Platelet count
Infection to stromal tissue of Bone marrow
Low BP
Fluid leakage
Increased permeability of capillaries
Fever and Flu like symptoms, myalgia
Release of Cytokines and interferons
Engulf by macrophase
Dengue Virus enters into body
Biting of Aedes Mosquito
14. Classification of Dengue fever:
It is classified according to degree of severity:
1. Dengue fever
2. DHF, Grade 1
3. DHF, Grade 2
4. DHF, Grade 3
5. DHF, Grade 4
Lab. Feature in
DF:
Leukopenia,
Thrombocytopenia,
no change in HCT
Lab. Features in
DHF & DSS:
Thrombocytopenia,
HCT raises ≥ 20%
15. Clinical Features of Dengue:
Symptoms:
Fever
Malaise
Vertigo
Weakness
Rash
Retro-orbital pain
Joint pain
Bodyache
Bleeding in any form
18. Helpful Investigations:
For Diagnosis ( Confirm):
Upto 4 days: NS1 Antigen ( Non-Structural)
5th day onward: Anti-dengue antibody IgG and IgM
For Management purpose:
CBC
Chest x-ray
Serum albumin: may be reduced
Prothombin time: may be elevated
Serum electrolyte: may be altered
For Exclusion:
MP test
To see the prognosis:
1. Platelet
2. Leukocytes
3. Hematocrit
19. Management of Dengue Fever:
1. Counselling
2. for Dengue fever:
Supportive management at home:
Rest
Antipyretic: only paracetamol
Fluids: more, including ORS
Food: Family diet
Referral knowledge to parents
When to take hospital:
Abdominal pain
Passage of black tarry stool
Bleeding in skin/nose/gums
Excessive sweating
Cold skin
20. 3. For Dengue hemorrhagic Fever and Dengue Shock Syndrome:
Major Objectives of Management:
Circulatory volume and hemodynamic status
Blood Osmolality
Fluid and Electrolyte balance
Prevention and treatment of complications
Treatment options:
Fluid replacement
Blood transfusion
21. Choice of fluids:
Crystalloids:
5% dextrose in isotonic normal saline
5% dextrose in half strength normal saline
5% dextrose in Ringer’s lactate solution
Colloids:
Dextran 40
Plasma expander e.g. haemaccel
Plasma
22. Fluid Replacement Algorithm:
DHF Grades 1 and 2:
Initial IV crystalloid 6ml/kg/hr- 2 hour
Improvement No improvement
Reduce IV, 3ml/kg/hr- 6 to 12 hr Crystalloid 10ml/kg/hr-2hr
Further improvement Improvement No improvement
Discontinue IV after 24 hr Reduce IV 6ml,3ml/kg/hr
HCT Raise: Colloid
H falls: Blood
23. DHF Grades 3 and 4
IV crystalloid 10-20 ml/kg/hr
Improvement no improvement
IV therapy reduce to 3 ml/kg/hr give oxygen
Further improvement HCT raise: give colloid
Discontinue IV after 24-48 hr HCT falls: Blood
24. DON’Ts in Dengue: Give aspirin or
NSAID
Give antibiotic
Give steroid
Change the rate
of infusion
Give transfusion
unless indicated
28. Prevention:
1. using
mosquito net
during sleeping
specially at
evening and
morning time.
2. Destroying
the habitant of
Aedes
mosquito
3. vaccination
against Dengue
4. Using
repellent
5. Using anti
mosquito
cream.
29. So, Keep the Aedes mosquito away,
be safe from Dengue !!!
