Dengue fever in Singapore & Pakistan

Introduction

The most common mosquito-borne viral disease in the world

Caused by a virus transmitted by the Aedes mosquito (DENV-1 to 4)

Could escalate into Dengue Hemorrhagic fever (Dengue Shock Syndrome - Potentially fatal)

Dengue fever is not contagiousDoes not spread by contact with an infected personSpreads by blood

Dengue statistics in Singapore & Pakistan

Year Suspected cases

Cases laborator

y-confirme

d

Deaths

2006 4961 1931 41

2007 2304 1226 18

2008 2792 2469 17

2009 1940 1085 13

2010 15 901 11 024 40

2011 252 935 17 057 219

Table 1. Denge fever cases reported from Pakistan, 2009–2011

The Aedes Mosquito

Characteristic black and white stripesOnly female mosquito bitesViral incubation period of 7 daysPeak biting period is at dawn and duskLife span of approximately 14 daysLays egg 3 times per lifetimeEggs can remain dormant for a period of up to 9 month

Dengue Fever Virus (DENV)

A type of RNA virus from the Flaviviridae familyTransmitted by anthropods i.e. arboviruses11,000 nucleotide bases in genome Code for C, prM & E protein molecules5 strains of virus (DENV-1, DENV-2, DENV-3, DENV-4)Difference is based on their antigenicity

Dengue Virus (TEM microscopy)

Dengue fever diagnosis

In laboratory, detection of specific antibodies in patients’ serum

Repeated 2-3 weeks later if necessary Commercial rapid test kits are availableMolecular detection (Polymerase Chain Reaction)Dengue antigen testing Blood of patient should be taken as soon as possible after the

onset of related symptoms

Transmission

The virus are transmitted through the bites of infected female mosquitos

Symptoms

Dengue fever is like a severe flu-like illness that affects infants, young children, but seldom causes death

High fever Severe headachePain behind the eyesMuscle and joint painsNausea and vomittingSwollen glands or rash

Symptoms

Usually last 2-7 days, after an incubation period of 4-10 days once bitten by an infected mosquito

Treatment

Treatment is purely concerned with the relief of the symptoms

RestFluid intake for adequate hydrationAspirinNSAIDAcetoaminophenCodeine

Treatment

Chemeri Vax Dengue

A tetravalent vaccineUses Yellow Fever Vaccine as a base20% conversionStill under research

Prevention

Vector control

Use mosquito nets, sprays and repellant oilDrain stagnant water sitesWear full clothes at dusk and dawnFumigationPublic awareness/education

Sources

http://www.channelnewsasia.com/news/singapore/rise-in-dengue-type-2/1334776.html

http://www.moh.gov.sg/content/moh_web/home/diseases_and_conditions/d/dengue.html

http://www.dengue.gov.sg/subject.asp?id=12http://www.dengue.gov.sg/subject.asp?id=100http://

www.cgh.com.sg/Lists/Health%20Library/Attachments/79/CGH%20AllAbout%20Dengue.pdf

http://www.emro.who.int/surveillance-forecasting-response/outbreaks/dengue-fever-in-pakistan.html