Tuesday 16 August 2016

6 facts about Dengue | How much do you know?




Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash. The presence of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles.

Dengue usually strikes people with low levels of immunity. Because it is caused by one of four serotypes of virus, it is possible to get dengue fever multiple times. However, an attack of dengue produces immunity for a lifetime to that particular serotype to which the patient was exposed.

Below are a summary of info on dengue:
1. Dengue has an incubation of 3-14 days (average 4-7 days)

2. How does dengue spread?
'How does Dengue spread?' in simplify diagram.
2. Diagnostic criteria for Dengue Fever:
Acute fever with 2 or more symptoms of the following, will be a confirmed dengue case:
  1. Headache, retro-orbital pain
  2. Myalgia
  3. Arthralgia
  4. Rash
  5. Hemorrhagic complications
Signs and symptoms of dengue.
3. Warning signs of dengue:

  1. Worsening of abdominal pain or tenderness
  2. Ongoing vomiting
  3. Enlargement of the liver > 2cm
  4. Mucosal bleeding
  5. High hematocrit combined with low platelet count
  6. Lethargy or restlessness
  7. Serosal effusion (clinical fluid accumulation)
4. Classification of Dengue Hemorrhagic Fever

  1. GRADE 1 – Fever on and off with bone pain.
  2. GRADE 2 – All signs of GRADE 1 plus bleeding from the nose, gum, GIT are present.
  3. GRADE 3 – There is a presence of circulatory failure as manifested by weak pulse, narrow pulse pressure, hypotension, cold clammy skin and restlessness. 
  4.   GRADE 4 – There is a profound shock, undetectable blood pressure and pulse.
 
Dengue warning signs.
5. Laboratory / Diagnosis Findings (for Malaysian):

Normal Reference Range (Norms)
Hemoglobin
11.5-16g/dl
Hematocrit
0.37-0.47 l/l
WBC count
4-12
Platelets
150-400
 
Blood test parameters for dengue and its reference range.
6. Medications prescribed by doctors:

  1. Paracetamol 1000mg QID (PRN)
  2. ORS
  3. Vitamin C 1000mg OD
  4. Increased oral fluid intake
  5. Encourage nutritious food like vegetables, meat and fruits.

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