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Dengue
• The word dengue is derived from African word denga: meaning fever with hemorrhage .
• Is caused by virus transmitted due to bites of the Aedes mosquito (different from the malaria mosquito).
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Epidemiology
• In India first outbreak of dengue was recorded in 1812
• A double peak hemorrhagic fever epidemic occurred in India for the first time in Calcutta between July 1963 & March 1964
• In New Delhi, outbreaks of dengue fever reported in 1967,1970,1982, &1996
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Dengue
• Caused by a family of viruses that are transmitted by mosquitoes.
• The virus is contracted from the bite of a mosquito called Aedes aegypti mosquito that has previously bitten an infected person.
• The mosquito flourishes during rainy seasons but can breed in water-filled flower pots year-round.
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Characteristics of the Aedes Mosquito• It is also called as Tiger mosquito (because they have
black and yellow stripes all over)
• Bites during the early morning or at dawn and during the day.
• Lays its eggs in clean, stagnant water.
• Only the female Aedes mosquito feeds on blood. This is because
they need the protein found in blood to produce eggs.
Male mosquitoes feed only on plant nectar.
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Watch out ! This Mosquito
• Day biting – normally catches the patient unawares.
• Loves / lives in fresh water in homes.
• Lays eggs preferentially in jars, discarded containers, coconut shells, old tyres etc.
• Year round breeding
• Tropical regions like India are its favorite zones.
• It is an urban mosquito. This disease can affect the rich & affluent too & is not limited to patients from low socio-economic strata only.
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Symptoms of Dengue
• Appear 3—14 days after the bite.
• Symptoms: –Range from a mild to high fever–Severe headache– Pain behind the eyes–Muscle and joint pain–Swollen glands, and rash.
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Dengue Presentations
• Like any other viral fever- not clear cut
• Dengue Fever with Muscle pains
this is classical presentation in 90% cases
• Dengue Fever with bleeding in 7%
• Dengue – the dangerous form in 3%
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What does the patient experience ?
2–7 days after the mosquito bite, the patient may develop
• Sudden onset of fever, chills, headache
• Back pain with severe muscle and joint pains
• Pain behind the eyes and on moving the eyes
• Nick name - Break bone fever.
• Red patches or spots on the skin
• Mild nose bleedsThis is the ordinary classical
Non dangerous form!
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Bleeding from where?
• Bleeding into skin
• From Gums
• From Nose
• Into the food passage
• Blood in urine
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What is the end result?
• Complete recovery is the rule
• Severe weakness may persist for many days after the fever subsides.
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Dengue – The bleeding form
• Blood vessels are affected
• There is severe oozing into tissues
• Bleeding into all possible parts of body
• Blood clotting mechanism is disrupted
• Blood pressure falls and many end in collapse and death
• In the best centers 5% of this type of Dengue will reach their forefathers
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Rare types of Dengue
• Brain fever
• Liver damage
• Heart damage
• Severe bleeding into stomach
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What are the tests needed?
• Routine blood test
• Tests to check the clotting process
• Special tests to identify Dengue or its foot marks in blood
• Urine to check protein leak
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Management Dengue fever • There is no specific anti viral treatment
• The management is essentially supportive and symptomatic (Bedrest)
• The key to success is frequent monitoring and changing strategies depending on clinical and laboratory evaluations.
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Tips to reduce risk of mosquito bites
• Reschedule outdoor activities. –Avoid being outdoors at dawn, dusk and early
evening
• Wear protective clothing. –Wear clothes that cover your arms, legs and feet
• Use mosquito repellent.
• Prevent breeding of mosquito. – The mosquitoes that carry the dengue virus
breed in stagnant water –Remove all sources of stagnant water. Don’t let it
lay its eggs.
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Remember
• Don’t ignore fever that is persistent & associated with body ache & pain while moving the eyes.
• Look out for red spots/patches on the skin.
• Keep yourself hydrated- drink lots of water.
• Consult your Doctor IMMEDIATELY.
• DO NOT SELF MEDICATE.
• Remove stagnant water from containers, flower pots etc.
• Wear full sleeves when going out.
• DENGUE IS NOT CONTAGIOUS. Not spread by the patient but the MOSQUITO!!!
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