dengue fever and how to prevent it
TRANSCRIPT
Dengue fever is a virus infection caused by the dengue virus. There are 4 kinds of dengue viruses.
What is dengue fever?
Close up of Aedes aegypti Mosquito
50-100 million dengue fever infections per year globally
500,000 cases of severe dengue, dengue hemorrhagic fever or dengue shock syndrome
Average case fatality 5%
Incidence
Endemic in more than 100 tropical and subtropical countries.
Pandemic began in Southeast Asia after WW II with subsequent global spread.
Several epidemics since 1980s. Distribution is comparable to malaria.
Distribution
Most Common Preys of Mosquito BitePeople of Humid Areas
• New infections annually: 50 million• Deaths: 24,000 annually• People at risk: 2.5-3 billion• Hospitalized cases: 500 000/year
(90% of those affected are children)• Disease burden: 465,000 DisabilityAdjusted Life Years (DALY)
GLOBAL STATUS
Aedes mosquito
Aedes aegypti Aedes albopictus
Symptoms of Dengue Fever
Dengue fever and dengue hemorrhagic fever are the most common mosquito-borne viral disease in the world.
Only the female mosquito feeds on blood. This is because they need the protein found in blood to produce eggs. Male mosquitoes feed only on plant nectar.
Do you know…
The mosquito is attracted by the body odors, carbon dioxide and heat emitted from the animal or humans.
•The female Aedes mosquito searches for suitable places to lay their eggs.
•Aedes are day-biters, most active during dawn and dusk.
Do you know…
Life Cycle Of Aedes Aegypti 14-21 days
4-5 Days 2 – 3 Days Eggs =300LarvaePupae
1-2 Days
Virology Flavivirus familySmall enveloped viruses containing single stranded RNA Four distinct viral serotypes (Den-1, Den-2, Den-3, Den-4)
PathophysiologyTransmitted by the bite of Aedes mosquito (Aedes aegypti) Incubation 3-14 days Acute illness and viremia 3-7 daysRecovery or progression to leakage phase
Manifestation Of Dengue Virus Infections
ASYMPTOMATIC
DSS
SYMPTOMATICWithout haemorrhage
With unusual haemorrhage
No shock
Undifferentiated Fever
Dengue Fever
DengueHaemorrhagicFever
May be the most common manifestation of dengue
Prospective study found that 87% of students infected were either asymptomatic or only mildly symptomatic
Other prospective studies including all age- groups also demonstrate silent transmission
DS Burke, et al. A prospective study of dengue infections in Bangkok. Am J Trop Med Hyg 1988; 38:172-80.
A) Undifferentiated Fever
Skin hemorrhages: petechiae, purpura, ecchymoses Gingival bleeding Nasal bleeding Gastro-intestinal bleeding:
hematemesis, melena, hematochezia Hematuria Increased menstrual flow
2B)Hemorrhagic Manifestationsof Dengue
purpura petechiae
Gingival bleeding Nasal bleeding
hematemesis
1. Fever, or recent history of acute fever2. Hemorrhagic manifestations3. Low platelet count (100,000/mm3 or less)4. Objective evidence of “leaky capillaries:”
◦ elevated hematocrit (20% or more over baseline)
◦ low albumin◦ pleural or other effusions
C1) Clinical Case Definition forDengue Hemorrhagic Fever
Abdominal pain - intense and sustained Persistent vomiting Abrupt change from fever to hypothermia,
with sweating and prostration Restlessness or somnolence
Martínez Torres E. Salud Pública Mex 37 (supl):29-44, 1995.
Danger Signs inDengue Hemorrhagic Fever
Fluids Rest Antipyretics (avoid aspirin and non-steroidal
anti-inflammatory drugs) Monitor blood pressure, hematocrit, platelet
count, level of consciousness
Treatment of Dengue Fever & DHF I & II
All above treatment + – In case of severe bleeding, give fresh whole blood
20 ml/kg as a bolus – Give platelet rich plasma transfusion exceptionally
when platelet counts are below 5,000–10,000/ mm3 .
– After blood transfusion, continue fluid therapy at 10 ml/kg/h and reduce it stepwise to bring it down to 3 ml/kg/h and maintain it for 24-48 hrs
Treatment of DHF III & IV
Papaya Juice vs. Dengue ? Raw papaya leaves, 2 pcs just cleaned and pound and
squeeze with filter cloth. You will only get one tablespoon per leaf. So two tablespoon per serving once a day.
Do not boil or cook or rinse with hot water, it will loose its strength. Only the leafy part and no stem or sap.
Source: from Indonesia March 2005
Treatment of Dengue Fever
Biological: Target larval stage of Aedes in large water
storage containers Larvivorous fish (Gambusia), endotoxin
producing bacteria (Bacillus), copepod crustaceans (mesocyclops)
Chemical: Insecticide treatment of water containers Space spraying (thermal fogs)
Prevention
Timings Of the Mosquito Bite
Dawn Dusk
People Sleeping In Open Areas
People with more exposure
Common Sites of Aedes Growth
LEVELS OF DENGUE CONTROL
A. STATE/ GOVERNMENT LEVEL MEASURES
B. COMMUNITY LEVEL MEASURES
C. INDIVIDUAL MEASURES
1. ERADICATION OF MOSQUITO BREEDING SITES & MOSQUITO ERADICATION
1. FORMULATE A HEALTH RELATED REPRESENTAIVE BODY
1. SHEILDING THE HOME , OWNSELF & FAMILY FROM MOSQUITOES
2. STOP FORMATION OF MOSQUITO BREEDING SITES & DO MOSQUITO ERADICATION
2. MOSQUITO ERADICATION
2. HEALTH EDUCATION 3. PARTICPATION IN HEALTH PROGRAMMES
3. EDUCATING MEMBERS OF FAMILY
3. DIAGNOSIS & TREATMENT OF DENGUE CASES
4. COMMUNITY BASED MECHANISM OF REFERAL & TRANSPORTATION OF SUSPECTED CASES
4. CONSULTING THE PHYSICIANS ON SEEING SYMPTOMS AND SIGNS AS EARLY AS POSSIBLE.
A. State responsibilities
It is the prime duty of the government to clean up all mosquito breeding sites e.g.
Stagnant Water Ponds Garbage Heaps Choked Sewerage and drainage system Regular Anti Mosquito spray in all localities 3.Lifting the living standard of people and
bringing them out of slums
A. State responsibilities1. Eradication of Mosquito breeding sites
State Responsibilities1. Eradication of Mosquito Breeding Sites
Stagnant Wate r Ponds
A. State responsibilities1. Eradication of Mosquito breeding sites
Regular emptying of Garbage Drums
A. State responsibilities1. Eradication of Mosquito breeding sites
CHOKED SEWERAGE & DRAINAGE SYSTEM MUST BE REPAIRED
State Responsibilities1. Eradication of Mosquito Breeding Sites
Regular Anti Mosquito Sprays in Homes/ Farms/ Ponds and other potential mosquito breeding sites
State ResponsibilitiesLIFTING THE LIVING STANDARD OF PEOPLE
Raise the standard of living of its people and bring them out of filth
State Responsibilities2. Health Education
HEALTH EDUCATION IS KEY STEP IN PREVENTION OF ANY HEALTH PROBLEM
State Responsibilities2. Health Education
Disperse the information through electronic & Print media and Personal Communication
State Responsibilities3. Early Diagnosis & Treatment of Dengue Cases
Early Diagnosis And Treatment can Save All Lives
B . Community Responsibilities
Community Responsibilities1. Formulate a Health Related Representative Body
I. Continuous liaison with Health DepartmentII. To be aware of and spread the awareness about the
Health Programmes offered by the Government and to efficiently participate in them.
III. To raise funds for the betterment of community health
IV. To keep a vigilant eye on proper execution of Health Related Programmes offered by Government.
The functions of this body should include:
B. Community Responsibilities1. Stop Formation Of Mosquito Breeding Sites
Do not pollute your area
Keep Lid Covered Dusts Bins in Streets
Ask Municipality to regularly Collect
the Garbage
C. Individual Responsibilities
The 10-MinuteMosquito Wipe-Out Exercise
This is what you can do to help…
C. Individual Responsibilities1. Eradication of Mosquito Breeding Sites
Change water in vases on alternate days.
Remove water from flowerpot plates on alternate days.
Turn over all pails and water storage containers.
Clear blockages and put Bti insecticide in roof gutters
monthly.
Do not litter. Rubbish such as cups and bottles can collect rain water and breed
mosquitoes.
If you are going on a holiday or vacating your home
C. Individual Level Measures
2.Ways to keep the Mosquitoes away
Ways to keep the Mosquitoes away
Use Of Anti Mosquito Sprays
Ways to keep the Mosquitoes away
Use of Coils Mats Electric Devices
Ways to keep the Mosquitoes away
Use of Mosquito Nets and Mosquito Repellent Oils
Ways to keep the Mosquitoes away
Use Doors with net
Spread the dengue prevention message to others…
C. Individual Responsibilities
Let your family, friends and neighbours know about the dangers
Quiz
Why is the Aedes mosquito dangerous to us?
It can carry the dengue virus and infect a healthy person with dengue fever.
ANSWER:
Name the 5 steps in the 10-Minute Dengue Wipe-out Exercise
1. Change water in vases on alternate.
2. Remove water from flowerpot plates on alternate days.
3. Turn over all pails and water storage containers.
4. Cover bamboo pole holders when not in use.
5. Clear blockages and put in Bti insecticide in roof gutters monthly.
ANSWER:
What are the things that you should do before going for a holiday?
• Cover all toilet bowls in your home.
• Seal off the overflow pipe of the flushing cistern.
• Cover all gully/floor traps.
• Add sand granular insecticide to places that mosquitoes could potentially breed, such as flower vases and places where stagnant water could not be removed.
• Clear blockages and add Bti insecticide in roof gutters.
• Turn over all pails and water storage containers.
• Ask a relative or close friend to check your home regularly for stagnant water if you are going away for a long period of time.
• Leave your contact with your neighbours or the neighbourhood police post/ centre so that you can be reached easily.
Thank You!