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Dengue fever is found mostly during and shortly after the rainy season in tropical

and subtropical areas of:

i Africa

i Southeast Asia and China

i India

i Middle East

i Caribbean and Central and South America

i Australia and the South and Central Pacific

An epidemic in Hawaii in 2001 is a reminder that many states in the United

States are susceptible to dengue epidemics because they harbor the particular types of

mosquitoes that transmit it. Worldwide, more than 100 million cases of dengue infection

occur each year. This includes 100 to 200 cases reported annually to the Centers for

Disease Control and Prevention (CDC), mostly in people who have recently traveled

abroad. Many more cases likely go unreported because some health care providers do

not recognize the disease. During the last part of the 20th century, many tropical

regions of the world saw an increase in dengue cases. Epidemics also occurred more

frequently and with more severity. In addition to typical dengue, dengue hemorrhagic

fever and dengue shock syndrome also have increased in many parts of the world.

Dengue fever can be caused by any one of four types of dengue virus: DEN-1,

DEN-2, DEN-3, and DEN-4. You can be infected by at least two, if not all four types at

different times during your lifetime, but only once by the same type.
You can get dengue virus infections from the bite of an infected Aedes mosquito.

Mosquitoes become infected when they bite infected humans, and later transmit

infection to other people they bite. Two main species of mosquito, Aedes aegypti and

Aedes albopictus, have been responsible for all cases of dengue transmitted in this

country. Dengue is not contagious from person to person.

Symptoms of typical uncomplicated (classic) dengue usually start with fever

within 5 to 6 days after you have been bitten by an infected mosquito and include:

i High fever, up to 105 degrees Fahrenheit

i Severe headache

i Retro-orbital (behind the eye) pain

i Severe joint and muscle pain

i Nausea and vomiting

i Rash

The rash may appear over most of your body 3 to 4 days after the fever begins.

You may get a second rash later in the disease. Symptoms of dengue hemorrhagic

fever include all of the symptoms of classic dengue plus:

i Marked damage to blood and lymph vessels

i Bleeding from the nose, gums, or under the skin, causing purplish bruises

This form of dengue disease can cause death. Symptoms of dengue shock

syndrome-the most severe form of dengue disease-include all of thesymptoms

of classic dengue and dengue hemorrhagic fever, plus:

i Fluids leaking outside of blood vessels

i Massive bleeding
 i Shock (very low blood pressure)

This form of the disease usually occurs in children (sometimes adults)

experiencing their second dengue infection. It is sometimes fatal, especially in children

and young adults.

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This case presentation aims to identify and determine the general health

problems and needs of the patient with an admitting diagnosis of Dengue Hemorrhagic

Fever, Type 1. This presentation also intends to help patient promote health and

medical understanding of such condition through the application of the nursing skills.

 

i To raise the level of awareness of patient on health problems that she may

encounter.

i To facilitate patient in taking necessary actions to solve and prevent the identified

problems on her own.

i To help patient in motivating her to continue the health care provided by the

health workers.

i To render nursing care and information to patient through the application of the

nursing skills.

Dengue fever is an infectious disease carried by mosquitoes and caused by any

of four related dengue viruses. This disease used to be called ³break-bone´ fever

because it sometimes causes severe joint and muscle pain that feels like bones are

breaking, hence the name. Health experts have known about dengue fever for more

than 200 years¦

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Dengue fever, a contagious disease transmitted by the Aedes aegypti mosquito,

infects between 50 million and 100 million people worldwide each year. Also known as

breakbone or dandy fever, dengue fever is found in the tropical and subtropical regions

of the world. Exposure to the flavivirus that causes dengue fever results in one of three

pathophysiologies: dengue fever, the more severe dengue hemorrhagic fever (DHF) or

dengue shock syndrome.

Dengue fever can be caused by any one of four types of dengue virus: DEN-1,

DEN-2, DEN-3, and DEN-4. You can be infected by at least two, if not all four types at

different times during your lifetime, but only once by the same type.

You can get dengue virus infections from the bite of an infected Aedes mosquito.

Mosquitoes become infected when they bite infected humans, and later transmit

infection to other people they bite. Two main species of mosquito, Aedes aegypti and

Aedes albopictus, have been responsible for all cases of dengue transmitted in this

country. Dengue is not contagious from person to person.

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1. 2 main pathophysiological changes occur in DHF/DSS:

i Increase vascular permeability

i Disorder in hemostasis
 Ĺ vascular permeability

Loss of plasma from the vascular compartment

Hemoconcentration, low pulse pressure, and other signs of shock

2. Disorder in hemostasis involves:

i Vascular changes

i Thrombocytopenia

i Coagulopathy

3. Activation of complement system, with profound depression of C3 and C5 levels, is a

constant.

4. Platelet defects may be both qualitative and quantitative.

Dengue viral infections frequently are not apparent. Classic dengue primarily

occurs in nonimmune, nonindigenous adults and children. Symptoms begin after a 5- to

10-day incubation period. DHF/DSS usually occurs during a second dengue infection in

persons with preexisting actively or passively (maternally) acquired immunity to a

heterologous dengue virus serotype. Illness begins abruptly with a minor stage of 2-4

days' duration followed by rapid deterioration. Increased vascular permeability,

bleeding, and possible DIC may be mediated by circulating dengue antigen-antibody

complexes, activation of complement, and release of vasoactive amines. In the process

of immune elimination of infected cells, proteases and lymphokines may be released

and activate complement coagulation cascades and vascular permeability factors.


  
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