Salient features of Dengue

1. Integrated Strategy for Dengue Prevention and Control

2. The Global Impact of Dengue Virus Dengue Fever & Dengue Hemorrhagic Fever Endemic in more than 100 countries 50 million cases each year Areas infested with Aedes aegypti Areas with Aedes aegypti and dengue epidemic activity

3. Examples of Emerging and Re-Emerging Infectious Disease: past 10 years A Fauci, NIAID/NIH, 2005

4. 2 HIV Dengue H Papilloma v Ebola Hanta virus West Nile virus Tobacco Malaria Non- HIV tuberculosis Road accidents 3 5 6 Influenza Polio SARS vCJD Measles HBV + HCV 4 RSV, Rota virus 7 Hospital infection Suicide Major and minor killers: global impact viewed on a ‘Richter’ (logarithmic) scale Weiss & McMichael, 2004 1 Viruses Infant/child ARI & diarrhoeal dis Log 1 0 10,000-fold difference in impact

5. Reemergence of Dengue Environmental Factors Climate change Alteration of ecosystems Alteration of Geographical distribution of pathogens and vectors Increase in vector-borne diseases Dengue Yellow Fever Ideal conditions for Dengue: Latitude : 35 0 north 35 0 south Altitude: 2,200 m Temperature: 15-40 °C Relative humidity: high-moderate Changes in transmission Ecological changes Socio-economic changes

10. Source: Vilas, 1995. Poverty

13. — continued and frequently unplanned urbanization; — inadequate municipal services such as water supply and solid waste disposal; — the escalating rate and geographical range of virus transmission brought about by intercontinental travel; — the circulation of multiple strains and serotypes in one area; — the adaptability of the vectors (Aedes aegypti and, to a lesser extent, Aedes albopictus mosquitoes); — the unrestrained production and use of non-biodegradable food and drink packaging, and drums and other water storage vessels that often become larval habitats; — the importation of used tyres by developing countries at risk for dengue; and — non-existent, inconsistent, or fragmented national programmes The reasons for dengue’s emergence as a major global health problem have been well documented and include:

20. UNDIFFERENTIATED FEBRILE ILLNESS * With Rash. * With Resp symp. * Both * With none. CLASSICAL DF BREAKBONE FEVER DHF DSS D H F. OR DENGUE ILLNESSES.

21. UNDIFFERENTIATED FEBRILE ILLNESS . CLASSICAL DF DHF DSS OPD. HOSPITALIZATION ICU

28. URBAN BREEDING SITES

29. PROTECTION OF ELDERLY AND CHILDREN IS OF VITAL IMPORTANCE

30. ELIMINATION OF BREEDING SITES--- THE INITIATIVE MOSTLY LIES WITH INDIVIDUALS

31. … ..And Before it is too late......... Fight The Bite......... .....Prevent Dengue.

33. Knowing is not enough; we must apply. Willing is not enough; we must do. (Goethe)