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OVERVIEW
Dengue (break-bone fever) is a viral infection that spreads from
mosquitoes to people. It is more common in tropical and subtropical climates.
Most people who get dengue will not have symptoms. But for those who do, the most common symptoms are high fever, headache, body aches, nausea, and rash. Most will get better in 1–2 weeks. Some people develop severe dengue and need care in a hospital.
You can lower your risk of dengue by avoiding mosquito bites especially during the day. Dengue is treated with pain medicine as there is no specific treatment currently.
Risk Factor:
• Rainy Season
The outbreaks are most common during the monsoon season when mosquito populations tend to increase. The risk of dengue transmission can be higher in some areas, for example in waterlogged areas after the rains.
• People in Urban Areas
Urban places are one of the risk factors since mosquitoes are most likely to spread through the stagnant water because people like to store water that sometimes they forget to keep it covered.
• Previous Dengue Infection
A person’s body develops immunity to only that strain of the virus after they have been infected with one. This implies that a person may contract dengue fever three more times during their lifetime. Furthermore, the risk of contracting dengue fever again is significantly higher than it was before.
• Secondary Infection
There is currently no approved vaccine to prevent dengue fever, yet some
research indicates that infection with one serotype confers lifetime immunity, whereas the other three only provide temporary protection. It follows that the probability of developing a serious disease from secondary infection rises if an individual previously exposed to serotype DENV1 catches serotype DENV2 or DENV3, or if an individual previously exposed to DENV3 acquires DENV2.
Signs and Symptoms:
Grade 1 Undifferentiated Fever (mild)
- Bone and joint
- Generalized flushing of the skin. - Hermans sign
Grade 2 Classic Dengue Fever (moderate)
- Bone and joint
- Generalized flushing of the skin. - Hermans sign - Epistaxis (bleeding in nose) - Nausea and vomiting - Headache - Gums bleeding - Melena (GI bleeding)
In human serum samples, real-time RT-PCR has emerged as a crucial
method for the early and precise detection of dengue virus genomes.
• NS1 ANTIGEN (DENGUE SPECIFIC IgG and Igm)
The nonstructural protein 1 (NS1 antigen) test was developed in 2006 as a
dengue diagnostic. It enables prompt identification on the initial day of fever, prior to the appearance of antibodies five or more days later. • BLOOD TEST
A positive test result indicates that genetic material from the virus was discovered in your blood sample. You are most likely infected with dengue. A negative test result indicates that no dengue virus was detected in your blood sample.
• VIRAL CELL CONTROL
Viral culture is a scientific procedure whereby virus samples are inserted into several cell lines to assess the virus’s capacity to infect them. The culture is positive if the cells exhibit cytopathic effects, or alterations.
• CBC (Complete Blood Count)
To check for a low platelet count, which is indicative of the illness’s later stages, as well as to search for signs of anemia—a drop in hemoglobin, hematocrit, and red blood cell count—which would come with blood loss linked to severe dengue fever.
Medical Surgical Management:
Supportive care with analgesics, fluid replacement, and bed rest
usually is sufficient. Acetaminophen may be used to treat fever and relieve other symptoms. Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids should be avoided.
and capillary refill time frequently. • Fluid status: Assess for signs of dehydration or fluid overload (e.g., dry mucous membranes, decreased urine output, edema). • Neurological status: Check for changes in mental status, confusion, or seizures. • Hematological parameters: Monitor platelet count, hematocrit, and coagulation tests. • Pain assessment: Assess for pain and discomfort.
Fluid Management:
• Oral rehydration: Encourage oral intake of fluids, especially in the
febrile phase. • Intravenous fluids: Administer intravenous fluids as ordered, depending on the patient’s fluid status and severity of the disease. • Monitor fluid balance: Carefully monitor fluid intake and output.
Pain Management:
• Analgesics: Administer acetaminophen as prescribed for fever and pain
relief. • Avoid NSAIDs: Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) as they may increase the risk of bleeding. • Hemorrhage Management: • Monitor for bleeding: Assess for signs of bleeding, such as epistaxis, gum bleeding, or hematuria. • Prepare for blood transfusion: If necessary, prepare for blood or platelet transfusion.
Supportive Care:
• Rest: Encourage bed rest to promote recovery.
• Nutrition: Provide a balanced diet as tolerated. • Hygiene: Maintain good hygiene to prevent infection.
Education:
• Disease transmission: Educate the patient and family about the
transmission of dengue fever and prevention measures. • Signs of worsening: Teach them to recognize signs of worsening illness, such as severe abdominal pain, persistent vomiting, or bleeding.
PREVENTION:
Dengue vaccine (Dengvaxia) has been produced and is now
commercially accessible in the Philippines, Thailand, Singapore, and other dengue-endemic nations. The vaccination should be administered in three doses every six months. It is suggested for persons who have already been infected with dengue).
The primary prevention strategies are public education, active case
surveillance, and mosquito control. Mosquito management through the destruction of mosquito breeding sites is the most effective method of illness prevention. Secondary precautions include using mosquito repellants, wearing thick clothes, and screening windows and doors to avoid mosquito bites.
PROGNOSIS:
Untreated severe dengue fever may have a mortality rate of 10% to
20%. However, with appropriate supportive care, the mortality rate can be reduced to approximately 1%.
