DENGUE FEVER

Dengue is a viral infection transmitted to humans through the bite of infected mosquitoes. It is transmitted by female mosquitoes mainly of the species Aedes aegypti and to a lesser extent Aedes albopictus. These mosquitoes are also vectors of chikungunya, yellow fever and zika virus.

The virus responsible for causing dengue, is called dengue virus. There are four DENV serotypes and it is possible to be infected four times. Dengue is found in tropical and subtropical climates worldwide, mostly in urban and semi-urban areas. It is also known as breakbone fever due to severity of muscle spasms and joint pain.

SYMPTOMS

Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms during the febrile phase(2-7days).

• Severe headache

• Pain behind the eyes

• Muscle and joint pains

• Nausea

• Vomiting

• Swollen glands

• Rashes

A patient enters the critical phase normally about 3-7 days after the onset of illness. During 24-48 hours of critical phase, a small portion of patients may manifest sudden deterioration of symptoms. It is at this time, when fever is dropping(below 38°C/100°F) in the patient, that warning signs associated with severe dengue can manifest. Severe dengue is a potentially fatal complication, due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.

Warning signs include

• Severe abdominal pain

• Persistent vomiting

• Rapid breathing

• Bleeding gums or nose

• Fatigue

• Restlessness

• Liver enlargement

• Blood in vomit or stool.

If the patient manifest these symptoms during the critical phase, close observation for next 24-48 hours is essential to avoid complications and risk of death.

DIFFERENTIAL DIAGNOSIS

• Malaria

• Influenza

• Zika

• Chikungunya

• Measles

• Yellow fever

COMPLICATIONS

• Liver injury

• Cardiomyopathy

• Pneumonia

• Orchitis

• Oophoritis

• Seizures

• Encephalopathy

• Encephalitis

PREVENTION

• Prevention of mosquito breeding-

- destroying the egg laying habitat of mosquitoes by environmental management and modifications.

-disposing of solid waste properly and removing artificial manmade habitats that can hold water.

-covering , emptying and cleaning of domestic water storage containers.

-applying appropriate insecticides to water storage outdoor containers.

• Prevent mosquito bites-

-stay in air conditioned or well-screened housing

-wear protective clothing

-use mosquito repellent

• Community engagement-

-educating the community on the risk of mosquito-borne diseases.

-engaging with the community to improve participation and mobilization for sustained vector control.