What is Dengue Hemorrhagic

Fever?
These are acute febrile
diseases, found in the tropics
and Africa, and caused by
four closely related virus
serotypes of the genus
Flavivirus, family Flaviviridae.

It is known as breakbone
What is Dengue Hemorrhagic
Fever?
The geographical spread is
similar to malaria, but unlike
malaria, dengue is often
found in urban areas of
tropical nations.
Dengue is transmitted to
humans by the Aedes aegypti
or more rarely Aedes
albopictus mosquito, which
What are the signs and symptoms?
Sudden onset of severe
headache

Muscle and joint pains

(myalgiasand arthrarlgias
– sever pain gives it the
name break-bone fever or
bone crusher disease.
What are the signs and symptoms?
Fever

Rash – it is characteristically
bright red petechiae and
usually appears first on the
lower limbs and the chest; in
some patients, it spreads to
cover most of the body.
What are the signs and symptoms?
There may also be gastritis
with some combination of
associated abdominal pain,
nausea, vomiting, or diarrhea

Some cases develop much

milder symptoms which can
be misdiagnosed as influenza
or other viral infection when
What are the signs and symptoms?
The classic dengue fever lasts
about six to seven days, with
a smaller peak of fever at the
trailing end of the disease
( the so-called biphasic
pattern)

Clinically, the platelet count

will drop until the patient’s
What are the signs and symptoms?
A small portion of cases lead
to dengue shock syndrome
(DSS) which has a high
mortality rate

Clinically, the platelet count

will drop until the patient’s
temperature is normal
Treatment of Dengue Fever
The mainstay of treatment is
timely supportive therapy to
tackle shock due to
haemoconcentration and
bleeding

Close monitoring of vital signs

in critical period (between
Treatment of Dengue Fever
Increased oral fluid intake is
recommended to prevent
dehydration

Supplementation with
intravenous fluids may be
necessary to prevent
dehydration and significant
concentration of blood if the
Treatment of Dengue Fever
A platelet transfusion is
indicated in rare cases if the
platelet level drops
significantly or if there is
significant bleeding.

The presence of melena may

indicate internal
gastrointestinal bleeding
Treatment of Dengue Fever
A platelet transfusion is
indicated in rare cases if the
platelet level drops
significantly or if there is
significant bleeding.

The presence of melena may

indicate internal
gastrointestinal bleeding
Treatment of Dengue Fever
Aspirin and non-steroidal anti-
inflammatory drugs should be
avoided as these drugs may
worsen the bleeding tendency
associated with some of these
infections

Patients may receive

What are the emerging
treatments?
Emerging evidence suggests
that mycophenolic acid and
ribavirin inhibit dengue
replication.

Initial experiments showed a

fivefold increase in defective
viral RNA production by cells
What are the emerging
treatments?

Unlike HIV therapy, lack of

adequate global interest and
funding greatly hampers the
development of treatment
regime…
How can we prevent this?

Primary prevention of dengue

mainly resides in mosquito
control

There are two primary

methods; larval control and
adult mosquito control.
 How can we prevent this?
In urban areas, Aedes
mosquitoes breed on water
collections in artificial
containers such as plastic cups,
used tires, broken bottles,
flower pots, etc.

Periodic draining or removal of

artificial containers is the most
 How can we prevent this?
For reducing the adult mosquito
load, fogging with insecticide is
somewhat effective.

Prevention of mosquito bites is

another way of preventing
disease – this can be achieved
by using insect repellant,
 How can we prevent this?
Larvicide treatment is another
effective way to control the
vector larvae but the larvicide
chosen should be long-lasting
and preferable have World
Health Organization clearance
for use in drinking water.

There are some very effective

insect growth regulators (IGR’s)
 How can we prevent this?
In 1998, scientists from the
Queensland Institute of
Research in Australia and
Vietnam’s Ministry of Health
introduced a crustacean
Mesocyclops, in water tanks
and discarded containers where
the Aedes aegypti mosquito
 How can we prevent this?
This method is viewed as being
more cost-effective and more
environmentally friendly than
pesticides, though not as
effective, and requires the
ongoing participation of the
community.

In 2004, scientists from the

Federal University of Minas
How can we prevent this?
The technology, named
Intelligent Monitoring of
Dengue (in Portugal), uses
traps with kairomones that
capture Aedes gravid female,
and upload insect counts with a
combination of cell phone, GPS
and internet technology
How can we prevent this?
The result is a complete map of
the mosquitoes in urban areas,
updated in real time and
accessible remotely, that can
inform control methodologies.
 How can we prevent this?
The technology was recognized
with a Tech Museum Award in
2006.

In 2009, scientists from the

School of Integretive Biology at
The University of Queensland
revealed that by infecting Aedes
mosquitoes with the bacterium
How can we prevent this?

In the study, super-fine needles

were used to inject 10,000
mosquito embryos with the
bacterium.

Once an insect was infected,

the bacterium would spread via
its eggs to the next generation.
How can we prevent this?

A pilot release of infected

mosquitoes could begin in
Vietnam within 3 years.

If no problems are discovered,

a full-scale biological attack
against the insects could be
launched within 5 years.