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8/12/2019 Dengue Umra
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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