DENGUE DENGUE HEMORRHAGIC FEVERHEMORRHAGIC FEVER

ALTERNATIVE NAMESALTERNATIVE NAMES

Hemorrhagic dengueHemorrhagic dengue Dengue shock syndromeDengue shock syndrome Philippine hemorrhagic feverPhilippine hemorrhagic fever Thai hemorrhagic feverThai hemorrhagic fever Singapore hemorrhagic feverSingapore hemorrhagic fever

Dengue Hemorrhagic Fever is an Dengue Hemorrhagic Fever is an acute infectious viral disease acute infectious viral disease

usually affecting infants and young usually affecting infants and young children. It is carried by children. It is carried by

mosquitoes and caused by any of mosquitoes and caused by any of four related dengue viruses. This four related dengue viruses. This disease used to be called break-disease used to be called break-bone fever because it sometimes bone fever because it sometimes causes severe joint and muscle causes severe joint and muscle pain that feels like bones are pain that feels like bones are

breaking.breaking.

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

SYMPTOMSSYMPTOMSTypical uncomplicated (CLASSIC) Typical uncomplicated (CLASSIC)

DENGUE usually start with fever within DENGUE usually start with fever within 5 to 6 days after you have been bitten 5 to 6 days after you have been bitten by an infected mosquito and includes by an infected mosquito and includes the following:the following:

High fever, up to 40 degrees CelsiusHigh fever, up to 40 degrees Celsius Severe headache Severe headache Retro-orbital (behind the eye) pain Retro-orbital (behind the eye) pain Severe joint and muscle pain Severe joint and muscle pain Nausea and vomiting Nausea and vomiting Rash (The rash may appear over most Rash (The rash may appear over most

of your body 3 to 4 days after the fever of your body 3 to 4 days after the fever begins. A second rash may appear later begins. A second rash may appear later in the disease)in the disease)

Symptoms of DENGUE HEMORRHAGIC FEVER Symptoms of DENGUE HEMORRHAGIC FEVER includes all of the symptoms of classic includes all of the symptoms of classic dengue, plus :dengue, plus :

Marked damage to blood and lymph vessels Marked damage to blood and lymph vessels Bleeding from the nose, gums, or under the Bleeding from the nose, gums, or under the

skin, causing purplish bruises (This form of skin, causing purplish bruises (This form of dengue disease causes some deaths)dengue disease causes some deaths)

Symptoms of DENGUE SHOCK SYNDROME Symptoms of DENGUE SHOCK SYNDROME (the most severe form of dengue disease) (the most severe form of dengue disease) includes all of the symptoms of classic includes all of the symptoms of classic dengue and dengue hemorrhagic fever, dengue and dengue hemorrhagic fever, plus :plus :

Fluids leaking outside of blood vessels Fluids leaking outside of blood vessels Massive bleeding Massive bleeding Shock Shock

SIGNS AND TESTSIGNS AND TEST

Physical Examination may reveal the Physical Examination may reveal the following:following:

Low blood pressureLow blood pressure A weak, rapid pulse A weak, rapid pulse Rash Rash Red eyes Red eyes Red throat Red throat Swollen glands Swollen glands Enlarged Liver (hepatomegaly) Enlarged Liver (hepatomegaly)

Tests may include the following: Tests may include the following: HematocritHematocrit Platelet count Platelet count ElectrolytesElectrolytes Coagulation studies Coagulation studies Liver enzymes Liver enzymes Blood gases Blood gases Tourniquet test (causes petechiae below the Tourniquet test (causes petechiae below the

tourniquet) tourniquet) X-ray of the chest (may demonstrate pleural X-ray of the chest (may demonstrate pleural

effusion) effusion) Serologic studies (demonstrate antibodies to Serologic studies (demonstrate antibodies to

Dengue viruses) Dengue viruses) Serum studies from samples taken during acute Serum studies from samples taken during acute

illness and convalescence (increase in titer to illness and convalescence (increase in titer to Dengue antigen) Dengue antigen)

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

Other complications are the following:Other complications are the following:

Shock Shock Encephalopathy Encephalopathy Residual brain damage Residual brain damage Seizures Seizures Liver damage Liver damage

TREATMENTTREATMENTThere is no specific treatment for There is no specific treatment for classic dengue fever, and like classic dengue fever, and like most people you will recover most people you will recover completely within 2 weeks. To completely within 2 weeks. To help with recovery, health care help with recovery, health care experts recommends:experts recommends:

Getting plenty of bed rest Getting plenty of bed rest Drinking lots of fluids Drinking lots of fluids Taking medicine to reduce fever Taking medicine to reduce fever

PREVENTIONPREVENTION

The best way to prevent dengue fever is The best way to prevent dengue fever is to take special precautions to avoid to take special precautions to avoid contact with mosquitoes. When outdoors contact with mosquitoes. When outdoors in an area where dengue fever has been in an area where dengue fever has been found ;found ;

Use a mosquito repellant Use a mosquito repellant Dress in protective clothing (long-sleeved Dress in protective clothing (long-sleeved

shirts, long pants, socks, and shoes)shirts, long pants, socks, and shoes) Because Aedes mosquitoes usually bite Because Aedes mosquitoes usually bite

during the day, be sure to use during the day, be sure to use precautions especially during early precautions especially during early morning hours before daybreak and in morning hours before daybreak and in the late afternoon before dark. the late afternoon before dark.

Other precautions includes; Other precautions includes;

Keeping unscreened windows and doors closed Keeping unscreened windows and doors closed Keeping window and door screens repaired Keeping window and door screens repaired Getting rid of areas where mosquitoes breed, Getting rid of areas where mosquitoes breed,

such as standing water in flower pots, such as standing water in flower pots, containers, birdbaths, discarded tires, tin cans, containers, birdbaths, discarded tires, tin cans, bottles or drain accumulated water from trees, bottles or drain accumulated water from trees, etc. etc.

Cover water storage containers to prevent Cover water storage containers to prevent breeding of mosquitoesbreeding of mosquitoes

Clean house gutters to prevent stagnation of Clean house gutters to prevent stagnation of rain waterrain water

Isolate patients suffering from Dengue H-Fever Isolate patients suffering from Dengue H-Fever for at least 5 daysfor at least 5 days

Report to the nearest health center any Report to the nearest health center any suspected case of Dengue H-Fever in the suspected case of Dengue H-Fever in the neighborhood neighborhood