Dengue

DENGUE FEVER AND DENGUE HAEMORRHAGIC FEVER

Dengue fever and Dengue Haemorrhagic fever (DF/DHF) is a viral disease transmitted by Ae. aegypti mosquito. There are four sero-types of dengue virus, DEN-1; DEN-2; DEN-3; and DEN-4; all producing similar manifestations, which may be asymptomatic, undifferentiated fever, dengue fever (DF) and dengue haemorrhagic fever (DHF) with plasma leakage and shock(Dengue Shock Syndrome-DSS).The global population at risk is estimated to be 2.5-3.0 billion in the urban areas of the tropical and sub-tropical regions. In Bangladesh there had been Dengue outbreaks in

2000 (5,555 cases and 93 deaths);2001 (2,430 cases and 44 deaths) and 2002 (6,104 cases and 58 deaths). Cases were reported from the metropolitan cities (Dhaka, Chittagong, Khulna, Rajshahi) and as per the sero-survey findings, 3 sero-types of the virus circulating. No vaccine is available yet and there is no specific treatment. Hence DF/DHF control is primarily dependent on control of Ae. aegypti mosquito.

This mosquito breeds in small collection of clean water in domestic and peri-domestic containers.

Clinical Presentation

Undifferentiated fever: Infants, children and some adults who have been infected with dengue virus for the first time (i.e. primary dengue infection) will develop a simple fever indistinguishable from other viral infections

Dengue fever: It is generally an acute biphasic fever (390 C to 400 C) with headache, myalgia, arthralgias, rashes and leucopenia. Although DF is commonly benign, it may be an incapacitating disease with severe muscle and joint pain (break-bone fever), particularly in adults, and occasionally with unusual haemorrhage.

Dengue haemorrhagic fever: Dengue haemorrhagic fever is most common in children less than 15 years of age, but it also occurs in adults. DHF is characterised by the acute onset of fever and associated non-specific constitutional signs and symptoms. There is a haemorrhagic diathesis and a tendency to develop fatal shock (dengue shock syndrome). Abnormal haemostasis and plasma leakage are the main patho-physiological changes, with thrombocytopenia and haemoconcentration.

Hemorrhage: It may occur from the beginning with fever in case of Dengue Fever. But if this is found after a few days during afebrile period DHF is the possibility. DHF is a potentially dangerous condition threatening life. Hemorrhage may be of any description including prolongation of menstrual bleeding in case of female. The common sites are conjunctiva, skin, gum, nose and GI tract usually evident in the form of hematemesis, malena and hematokezia.

Incubation period is 4-6 days (range 3-14 days).

What to do?

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For prevention:

• Avoid mosquito bites, use long sleeve shirts and protective clothing
• Sleep under mosquito nets (preferably Insecticide treated nets)
• Destroy all domestic and peri-domestic breeding sources of Ae. aegypti mosquito (artificial containers, coconut shells, canes, used tires, earthen pots, flower vase, ant-traps etc.)
• Use of mats, coils, aerosol house spray, vaporising mosquito repellents etc. may be useful
• Use of Repellent: Essential oils from plant extracts (neem oil, lemon grass, citronella oil etc.) gives protection from mosquito bites.

For Treatment

• Complete bed rest is essential and patient should take sufficient fluid drinks (fruit juice, ORS etc.). This will help correction of dehydration due to fluid loss from vomiting and high fever.
• Should consult the physician immediately for appropriate management of the illness and must be referred to the hospital if needed.
• DO NOT use ASPIRIN or NSAID-these drugs may trigger gastritis and provoke bleeding.
• DO NOT give antibiotic as these do not help

Standby Emergency Treatment

• Any patient with sudden onset of high spell of fever without any upper respiratory features or common cold symptoms is a suspect of Dengue Syndrome.
• This is more so when there is accompanying muscle and bone pain.
• Patient should be observed, fever to be lowered to the tolerable level with preferably room temperature tepid water sponging and or judicious use of paracetamol.
• Fluid balance to be maintained with ORS along with nutrition and fresh fruit juices.
• Observation should be continued for two weeks for the danger signs that are: abdominal pain, bleedings, low blood pressure, prostration, decreased urine volume, or any other unusual features.
• In any case appropriate consultation and referral to hospital may be needed

courtesy by...
SAGAR RESTUARANT

Sagar Restaurant offers an extensive choice of traditional Bangladeshi, Pakistani and Indian cuisine together with new mouthwatering recipes, but if you have a preferred dish that isn't on the menu, please don't hesitate to ask the management who will be more than happy to have our chef specially prepare it for you. We provide 100% halal meat.

Location: Sagar Restuarant

168-25B, Hillside Avenue,
Jamaica, New York 11432
PHONE: 718-298-5696
718-657-2855
718-213-4338(for catering only)
Web Site: www.sagarfood.com

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