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PRESENTED BY:

DR UMRAH BALOCH

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What is Dengue

Self limited viral infection

Transmitted between mosquitoes andhumans

Day time biting mosquito

Found in:

Over crowding areas

Urban centers

Warm and humid climates

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1-2 days

Stagnant water

Pupae

4-5 days

Life cycle of the AedesMosquito

Larvae Eggs

2-3 days

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Characteristics of theAedes

MosquitoOne distinct physicalfeature black and

white stripes on itsbody and legs.

Bites during the day.

Lays its eggs inclean, stagnant water.

Close-up of an Aedes mosquito

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Only the femaleAedesmosquitofeeds on blood. This is becausethey need the protein found inblood to produce eggs. Malemosquitoes feed only on plantnectar.

On average, a femaleAedesmosquito can lay about 300 eggsduring her life span of 14 to 21days.

Do you know

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ITEOLOGY

There are atleast 4 distinct antigenic type of

viruses which is member of family

flavivirdae.in addition 3 other arthropodborn viruses causes similer febrile with rash

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VIRUS GEOGRAPHIC

GENUS +

DISEASE

VECTOR DISTRIBUTION

TogaVirus

Chikungunya AedesAegypti

Aedes

Africanus

Africa IndiaSouth Asia

Toga Virus Onyong -Nyong

AnophelesFunestus

East Africa

Flavi Virus West NileFever

CulexMolestus

Culex

Univittatus

Europe,Africa,

Middle East,

India

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EPIDRMOLOGY

Globel burden of dengue is large estimated 50

milion infection per year occurs aprox 100

countries with potentiol primery vector ,urbanadopted aedes aegpti has widely distributed in 15th

n 19thcent.

Epidemolgical studies have identifeid young

age,female sex,high bmi,MHC1,PHOSPHOLIPASE C,EPSILON 1genes are

more prone to having sever dengue

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Vector control thru chemical n biological

targeting of mosquito n removal of their

breading sites is mainstay of prevention butthis aproch failed to so where dengue is

endemic

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Dengue fever

It is bengin syndrom in which biphasic fevermylgia,artherlegia,headace,retroorbital

pain,rash,lekopenia,lymphadenopathy

Dengue Hemoragic Fever Fever lastin from 2,7 days,tendency to bleed

evidenced by positive torniqnet test/or spotenousbleeding.platelet less then 100,109 per lit.evidance

of plasma leak based on changes of hct n pluraleffusion to suport dx of den hemoragic fever

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Dengue Shock Syndrome

Systimic vasculer leak syndrome,evidanced

by inc in hct,hypoprotinmia,plural

effusion,ascites,narowing of pulse pressur

less than 20 mmhg accompnid by s/s of

collapse called dengue shock syndrome

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Clinical feature

Initial Febrile Phase

High temprature,headace,vomiting,myalgia.joint

pain,transint maculer rash,mild hemoragicmenefestation like petechei n brusising at

venepuncture

site,hepatomegaly,luekocytopenia,thrombocytope

nia,elevation of transaminase.this phase last 3 to 7days,after which most patient recover without

complication

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Critical Phase

A systimic vasculer leak syndrome,evidanced byincreased hematocret,hypoprotinimia,plural

effuion,acites,narrowing of pulse presur 20mmhg

or less accompinied by sign of vasculer

collapse,dengue shock syndrome is dx nurgent,death may occure if resusitation not done.

Hemoragic menefestation are most comon during

critical phase,moderate to sever thrombocytopenia

count below 20/9 pr lit during this phase,liver

failour,encephalopathy,myocarditis may acour

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Recovery Phase

Altered vasculor permibilty is short

lived,reverting sponteniously to normal

level after approx 48 to 72 hrs,concourentwith improving in symptoms.second rash

appears during this phase,that resolves with

desquamation over period of 1 to 2 weaks

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DIAGNOSIS

History n examination

Labs,viral componet in serum or indirectly

by serologic means Detection of viral nuclic acid in serum by

means of revers transcriptase-PCR assay or

detection of virus expresed solublenonstructrual protein1 by means of ELISAOR LATRAL FLOW RAPID TEST

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Serum IGM incresed CBC dec WBC N Platelets

LFT inc transaminase

Others on ECG bradicardia,ectopicfoci,flate t wave,PR prolonged.on XRAY

plural effusions

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TREATMENT

No effective antiviral only supportive

RX of uncomplicated dengue fever,bed

rest,analgesic,antipyretic,mildsedation.aspirin is contraindicated,bcx

effect on hemostasis.

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Initial crystalloid therapy for den shock Blood

transfuion,platelet,FFP,cryoprecipitate may

b given.use of prophylatic platelet

transfuion where dengue z endemic For sever infection,adjunt therpy like

vasopresor,inotropics,renal transplant may b

necessary

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10-Minute Mozzie

Wipe-Out Exercise

D th 10 Mi t M i Wi t d

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Do the 10-Minute Mozzie Wipe-out everyday.

Change water in vases on alternate days.

D th 10 Mi t M i Wi t d

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Do the 10-Minute Mozzie Wipe-out everyday.

Remove water from flowerpot plates onalternate days.

D th 10 Mi t M i Wi t d

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Do the 10-Minute Mozzie Wipe-out everyday.

Turn over all pails and waterstorage containers.

D th 10 Mi t M i Wip t d

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Do the 10-Minute Mozzie Wipe-out everyday.

Cover bamboo pole holderswhen not in use.

D th 10 Minut M zzi Wip ut v r d

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Do the 10-Minute Mozzie Wipe-out everyday.

Clear blockages and put Bti insecticide in roofgutters monthly.

Unwanted items

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Unwanted items

Do not litter. Rubbish such as cupsand bottles can collect rain water

and breed mosquitoes.

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Thank You