1. 1. /
2. 2.
3. 3. 1. 2. ? 3. I/O?
4. 4.
5. 5.
6. 6.
7. 7.
8. 8.
9. 9. Population Infection Clinical Cases DHF/DSS Asymptomatic Infection DF (non-DHF) survive Death 5% 24% 6% 0.8% 76% 94% 99.2% Fig. 1 Rates in dengue model by Shepard et al. Vaccine. 2004, 22:1275-1280.
10. 10. AGE IN YEARS 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70- CASES 0 100 200 300 400 500 600 700 AGE IN YEARS 0-4 5-910-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-69 70- CASES 0 10 20 30 40 50 60 AGE IN YEARS 0-4 5-910-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-69 70- CASES 0 1 2 3 4 5 6 7 Age in years 0-4 5-910-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-69 70- CASES/100000 0 200 400 600 800 Age in years 0-4 5-910-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-69 70- CASES/100000 0 10 20 30 40 50 60 70 Age in years 0-4 5-910-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-69 70- CASES/100000 0 1 2 3 4 5 6 7 DF DHF/DSS Fatal Age-specific prevalent rate of DF, DHF/DSS and fatal cases in 2002 Kaohsiung outbreak.
11. 11.
12. 12.
13. 13.
14. 14.
15. 15. (Critical phase)
16. 16. critical phase 24~48
17. 17. Warning sign!! !
18. 18.
19. 19.
20. 20.
21. 21. + ()
22. 22.
23. 23. 24
24. 24. Critical phase?
25. 25. Table 5. Duration from the onset of warning signs to dengue hemorrhagic fever (DHF) and severe dengue (SD). Thein TL, Gan VC, Lye DC, Yung CF, Leo YS (2013) Utilities and Limitations of the World Health Organization 2009 Warning Signs for Adult Dengue Severity. PLoS Negl Trop Dis 7(1): e2023. doi:10.1371/journal.pntd.0002023 http://127.0.0.1:8081/plosntds/article?id=info:doi/10.1371/journal.pntd.0002023
26. 26. (Severe Dengue) !!! (NSAIDs,iatrogenic)
27. 27. !!!!!!
28. 28.
29. 29. History taking 1. ?? 2. 3. T.O.C.C.
30. 30.
31. 31. Clinical 1. 2. 3. CCTV-R
32. 32.
33. 33. Investigation CBC: : NS1/IgM
34. 34.
35. 35. Diagnosis, phase of disease, severity ()
36. 36. Recovery phase
37. 37. WHO Dengue Clinical Management