DENGUE HEMORRHAGIC FEVER

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DENGUE HEMORRHAGIC FEVER
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ALTERNATIVE NAMES

• Hemorrhagic dengue
• Dengue shock syndrome
• Philippine hemorrhagic fever
• Thai hemorrhagic fever
• Singapore hemorrhagic fever

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Dengue Hemorrhagic Fever is an acute infectious
viral disease usually affecting infants and young
children. It is carried by mosquitoes and caused
by any of four related dengue viruses. This
disease used to be called break-bone fever
because it sometimes causes severe joint and
muscle pain that feels like bones are breaking.
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TRANSMISSION

• People get dengue virus infections from the bite
  of an infected Aedes mosquito. Mosquitoes become
  infected when they bite infected humans, and
  later transmit infection to other people they
  bite. The two main species of mosquito, Aedes
  aegypti and Aedes albopictus, have been
  responsible for all cases of dengue transmitted
  in this country. Dengue is not contagious from
  person to person. The transmitter of the disease
  is a day-biting mosquito which lays eggs in clear
  water container, such as flower vases, cans, rain
  barrels, old rubber tires, etc. The adult
  mosquitoes rest in dark places of the house.

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SYMPTOMS

• Typical uncomplicated (CLASSIC) DENGUE usually
  start with fever within 5 to 6 days after you
  have been bitten by an infected mosquito and
  includes the following
• High fever, up to 40 degrees Celsius
• Severe headache
• Retro-orbital (behind the eye) pain
• Severe joint and muscle pain
• Nausea and vomiting
• Rash (The rash may appear over most of your body
  3 to 4 days after the fever begins. A second rash
  may appear later in the disease)

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• Symptoms of DENGUE HEMORRHAGIC FEVER includes all
  of the symptoms of classic dengue, plus
• Marked damage to blood and lymph vessels
• Bleeding from the nose, gums, or under the skin,
  causing purplish bruises (This form of dengue
  disease causes some deaths)
• Symptoms of DENGUE SHOCK SYNDROME (the most
  severe form of dengue disease) includes all of
  the symptoms of classic dengue and dengue
  hemorrhagic fever, plus
• Fluids leaking outside of blood vessels
• Massive bleeding
• Shock

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SIGNS AND TEST

• Physical Examination may reveal the following
• Low blood pressure
• A weak, rapid pulse
• Rash
• Red eyes
• Red throat
• Swollen glands
• Enlarged Liver (hepatomegaly)

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• Tests may include the following
• Hematocrit
• Platelet count
• Electrolytes
• Coagulation studies
• Liver enzymes
• Blood gases
• Tourniquet test (causes petechiae below the
  tourniquet)
• X-ray of the chest (may demonstrate pleural
  effusion)
• Serologic studies (demonstrate antibodies to
  Dengue viruses)
• Serum studies from samples taken during acute
  illness and convalescence (increase in titer to
  Dengue antigen)

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COMPLICATION

• Most people who develop dengue fever recover
  completely within 2 weeks. Some, however, may go
  through several weeks to months of feeling tired
  and/or depressed. Others develop severe bleeding
  problems. This complication, dengue hemorrhagic
  fever, is a very serious illness which can lead
  to shock (very low blood pressure) and is
  sometimes fatal, especially in children and young
  adults.
• Other complications are the following
• Shock
• Encephalopathy
• Residual brain damage
• Seizures
• Liver damage

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TREATMENT

• There is no specific treatment for classic
  dengue fever, and like most people you will
  recover completely within 2 weeks. To help with
  recovery, health care experts recommends
• Getting plenty of bed rest
• Drinking lots of fluids
• Taking medicine to reduce fever

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PREVENTION

• The best way to prevent dengue fever is to take
  special precautions to avoid contact with
  mosquitoes. When outdoors in an area where dengue
  fever has been found
• Use a mosquito repellant
• Dress in protective clothing (long-sleeved
  shirts, long pants, socks, and shoes)
• Because Aedes mosquitoes usually bite during the
  day, be sure to use precautions especially during
  early morning hours before daybreak and in the
  late afternoon before dark.

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• Other precautions includes
• Keeping unscreened windows and doors closed
• Keeping window and door screens repaired
• Getting rid of areas where mosquitoes breed, such
  as standing water in flower pots, containers,
  birdbaths, discarded tires, tin cans, bottles or
  drain accumulated water from trees, etc.
• Cover water storage containers to prevent
  breeding of mosquitoes
• Clean house gutters to prevent stagnation of rain
  water
• Isolate patients suffering from Dengue H-Fever
  for at least 5 days
• Report to the nearest health center any suspected
  case of Dengue H-Fever in the neighborhood