DENGUE AWARENESS

Prepared by: Mark Anthony Malubag, RN,MSN

Dengue fever also known as breakbone fever, is an infectious tropical disease caused by the dengue virus

Symptoms Dengue is a mosquito-borne infection which leads to a flulike illness. It is characterized as an acute illness suddenly acquired by an individual that "usually follows a benign course with fever, headache, exhaustion, rashes, and severe muscle pain, frequently accompanied by sore throat, dizziness, loss of appetite, vomiting, and diarrhea." Dengue is transmitted to people through the bite of an Aedes mosquito infected with any one of the four dengue viruses. The virus itself cannot be spread by mere personto-person contact. Tropical and subtropical areas of the world are often affected by dengue, and as many as 100 million people are infected yearly.

Dengue symptoms may appear within three to fourteen days after being bitten by an infected Aedes mosquito. Anyone can be affected by dengue - infants, young children, and adults. People with weak immune systems are more susceptible to the virus. It is possible for dengue to strike a person several times. During medical examination, a person with dengue may exhibit "low blood pressure, skin rashes, sore throat, rapid pulse, swollen glands, and enlarged liver."

Dengue hemorrhagic fever (DHF) Dengue may cause a potentially lethal complication known as dengue hemorrhagic fever (DHF). Symptoms of DHF include fever, abdominal pain, vomiting, and bleeding. Vital signs of bleeding to look out for are blood spots in the skin, spitting of blood, blood in the stool, gum bleeding, and nose bleeding. Complications of DHF are pneumonia and inflammation of the heart.

It was in the 1950s when the DHF was first observed during dengue epidemics in the Philippines and Thailand. As of today, DHF is reported in most Asian countries. It is one of the primary causes of hospitalization and death among children in Asian regions. Dengue cases are increasing in Southeast Asia particularly in Thailand, Vietnam, Singapore, and Malaysia. An estimated 50 million cases of dengue fever with 500,000 cases of DHF requiring hospitalization each year was reported by WHO.

Dengue shock syndrome (DSS) Nearly 30 percent of patients exhibiting DHF may experience dengue shock syndrome (DSS). The patient often feels acute abdominal pain prior to its development. It is possible for the patient to have an apparent recovery from fever and body temperature becomes normal within three to seven days after onset of fever. DHF strikes when the patients condition abruptly deteriorates after short recovery.
DSS can be reversed within 24 hours with corrective fluid replacement therapy. But it can lead to death within 12 to 24 hours if treatment is not given immediately or the patient does not respond. It is crucial that medical assistance be given without delay

Laboratory Diagnosis The diagnosis of dengue fever normally involves testing of the patients blood. Clinical lab findings would include "low levels of white blood cells (leukopenia) and platelets (thrombocytopenia) and, often, an elevated level of the enzyme serum aminotransferase." A normal persons blood platelet count is from 150,000 to 450,000. When a dengue patients blood platelets drop to 80,000 and below, there is potential risk of haemorrhaging. It is important for the patient to be admitted in the hospital for constant blood platelet monitoring.

Treatment and possible future vaccine As of now, there is no specific medication or vaccine that can treat dengue. Treatment is focused on relieving the patient's dengue symptoms. Paracetamol can be given to bring down the fever. However, aspirin, ibuprofen, and mefenamic acid are discouraged because such medicines can increase the risk of bleeding. Intravenous fluids and electrolytes are administered to the patient to treat dehydration and electrolyte imbalances. Blood transfusion may also be necessary if the patient experiences signs of bleeding. A person diagnosed with dengue needs lots of rest to recover his strength.

Prevention and Control

4S Strategy Against Dengue.

1. Search and destroy possible breeding places of dengue-causing mosquitoes like flower pots, vases, discarded plastic bags, bottles, old tires, cans, jars, coconut husks, roof gutters, water drums, and other containers that might hold clean stagnant water. Preventing dengue can be easier achieved by doing your part in keeping the environment clean. Change water in vases frequently. Make sure all water containers are kept covered.

2. Self-protection measures include wearing long sleeves or long pants. It is also best to avoid darkcolored clothes like dark shades of blue and black, as dark clothing has been observed to attract mosquitoes. Apply mosquito repellant on the skin to deter mosquito bites. Mosquito repellant lotions and liquid sprays are available on the market; however, parents are cautioned against using strong repellants on small children because of potentially harsh chemicals. There are organic mosquito repellant alternatives such as all-natural citronella bug spray. You can also use mosquito coils, electric vapour mats and mosquito spray during the daytime. Screens and mosquito nets are also good deterrents against mosquitoes.

3. Seek early consultation because dengue is crucial. See a doctor immediately if you show early signs and symptoms of dengue.

4. Say no to indiscriminate fogging. In the past, fogging was considered as a temporary solution against dengue-carrying mosquitoes. At present, fogging is only advisable and recommended when outbreaks and epidemics are positively determined in a particular area. Fogging can only kill the adult infected mosquito; it cannot get rid of the larvae, locally known as kiti-kiti. Indiscriminate fogging will only drive away other mosquitoes to other places to find new breeding grounds.

THANK YOU