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HOME CONDITIONS AND DISEASES DENGUE TREATMENT OF DENGUE - IMMUNITY

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Treatment of De ngue

Immunity

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Treatment of Dengue - Immunity

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Immunity

Infection with one serotype provides life long homologous

immunity but does not provide protection against other serotypes,

and instead may exacerbate subsequent infection.

Important Instructions for Treatment of Dengue hemorrhagic Fever

Cases of DHF should be observed every hour.

Serial platelet and haematocrit determinations, drop in platelets and rise in haematocrits are

essential for early diagnosis of DHF.

Timely intravenous therapy isotonic crystalloid solution can prevent shock and / or lessen

its severity.

If the patients condition becomes worse despite giving 20 ml / Kg / hr for one hour, replace

crystalloid solution with colloid solution such as dextran or plasma. As soon as

improvement occurs replace with crystalloid.

If improvement occurs, reduce the speed from 20 ml to 10 ml then to 6 ml, and finally to 3

ml / kg.

If haematocrit falls, give blood transfusion 10 ml / kg and then give crystalloid IV fluids at the

rate of 10 ml / kg / hr.

In case of severe bleeding, give fresh bloodtransfusion about 20 ml / kgfor 2 hours. Then

give crystalloid at 10 ml / kg for a short time (3060 min) & later reduce the speed.

In case of shock, give oxygen.

For correction of acidosis (sign: deep breathing), use sodium bi carbonate. (One third of thetotal fluids should consist of 0.167 mol / litre of s odium bicarbonate i.e. three quarters of

crystalloid solution plus glucose plus one quarter sodium bicarbonate).

For more details on management of DHF / DSS cases, the physician is advised to consult

other appropriate references on their treatment. A lis t of references is given as under:

Suchitra Nimmannitya, Clinical Manifestation of DF / DHF is WHO Regional

Publication No. 22monograph of Dengue / DHF pp 48 nn 54, WHO / SEARO,

New Delhi.

Suchitra Nimmannitya, Management of DF / DHF is WHO Regional Publication

No. 22 monograph of Dengue / DHF pp 5561, WHO / SEARO, New Delhi.

Suchitra Nimmannitya, Dengue Haemorrhagic Fever diagnosis and management,

pp 133145, in Dengue and Dengue Haemorrhagic Fever edited by D. J. Gubler

and G. Kuno, Published by CAB International, 1997.

Dengue Haemorrohagic fever diagnosis, treatment, prevention and control 2nd

Edition, WHO, Geneva, 1997.

Regional Guidelines for Prevention and Control of Dengue / DHF, WHO /

SEARO, New Delhi, 1998.

What not to do

Do not give Aspirin or Brufen for treatment of fever.

Avoid giving intravenous therapy before there is evidence of haemorrhage and

bleeding.

Avoid giving blood transfusion unless indicated, reduction in haematocrit or severe

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EXPERT'S ADVICE

Typhoid: Protection and

purification of drinking water

supplies, improvement of

basic sanitation, and

promotion of food hygiene

are essential measures to

interrupt transmission of

typhoid fever.

read more

Drinking hot water, tea or

coffee may help stimulate

the bowels.

Signs & Symptoms of Dengue

Prevent Transmission of Dengue

Mode of Transmission of Dengue

Diagnosis of Dengue

Treatment of Dengue

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bleeding.

Avoid giving steroids. They do not show any benefit.

Do not use antibiotics .

Do not change the speed of fluid rapidly, i.e. avoid rapidly increasing or rapidly

slowing the speed of fluids.

Insertion of Nasogastric Tube to determine concealed bleeding or to stop bleeding (by cold

lavage) is not recommended since it is hazardous.

Signs of Recovery from Dengue

Stable pulse, blood pressure & breathing rate.

Normal temperature.

No evidence of external or internal bleeding.

Return of appetite.

No vomitting.

Good Urinary output.

Stable haematocrit.

Convalescent confluent petechiae rash.

Criteria for Discharging Patients

Absence of fever for at least 24 hours without the use of anti fever therapy.

Return of appetite.Visible Clinical improvement.

Good Urine Output.

Minimum of three days after recovery from shock.

No respiratory distress from pleural effussion and no ascites.

Platelet count of more than 50,000 mm3

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