DENGUE

HEMORRHAGIC FEVER
 ALTERNATIVE NAMES
 Hemorrhagic dengue
 Dengue shock syndrome
 Philippine hemorrhagic fever
 Thai hemorrhagic fever
 Singapore hemorrhagic fever
 Dengue Hemorrhagic Fever is an acute
infectious viral disease usually affecting
infants and young children. It is carried by
mosquitoes and caused by any of four related
dengue viruses. This disease used to be called
break-bone fever because it sometimes causes
severe joint and muscle pain that feels like
bones are breaking.
 TRANSMISSION
People get dengue virus infections from the bite
of an infected Aedes mosquito. Mosquitoes
become infected when they bite infected humans,
and later transmit infection to other people they
bite. The two main species of mosquito, Aedes
aegypti and Aedes albopictus, have been
responsible for all cases of dengue transmitted in
this country. Dengue is not contagious from
person to person. The transmitter of the disease
is a day-biting mosquito which lays eggs in clear
water container, such as flower vases, cans, rain
barrels, old rubber tires, etc. The adult
mosquitoes rest in dark places of the house.
 SYMPTOMS
Typical uncomplicated (CLASSIC) DENGUE
usually start with fever within 5 to 6 days after
you have been bitten by an infected mosquito and
includes the following:
 High fever, up to 40 degrees Celsius
 Severe headache
 Retro-orbital (behind the eye) pain
 Severe joint and muscle pain
 Nausea and vomiting
 Rash (The rash may appear over most of your
body 3 to 4 days after the fever begins. A second
rash may appear later in the disease)
Symptoms of DENGUE HEMORRHAGIC FEVER
includes all of the symptoms of classic dengue, plus :
 Marked damage to blood and lymph vessels

 Bleeding from the nose, gums, or under the skin,

causing purplish bruises (This form of dengue

disease causes some deaths)
Symptoms of DENGUE SHOCK SYNDROME (the
most severe form of dengue disease) includes all of
the symptoms of classic dengue and dengue
hemorrhagic fever, plus :
 Fluids leaking outside of blood vessels

 Massive bleeding

 Shock
 SIGNS AND TEST
Physical Examination may reveal the following:
 Low blood pressure

 A weak, rapid pulse

 Rash

 Red eyes

 Red throat

 Swollen glands

 Enlarged Liver (hepatomegaly)

Tests may include the following:
 Hematocrit

 Platelet count

 Electrolytes

 Coagulation studies

 Liver enzymes

 Blood gases

 Tourniquet test (causes petechiae below the tourniquet)

 X-ray of the chest (may demonstrate pleural effusion)

 Serologic studies (demonstrate antibodies to Dengue

viruses)
 Serum studies from samples taken during acute illness

and convalescence (increase in titer to Dengue antigen)

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

Other complications are the following:

 Shock
 Encephalopathy
 Residual brain damage
 Seizures
 Liver damage
 TREATMENT
There is no specific treatment for classic
dengue fever, and like most people you will
recover completely within 2 weeks. To help
with recovery, health care experts
recommends:
 Getting plenty of bed rest
 Drinking lots of fluids
 Taking medicine to reduce fever
 PREVENTION
The best way to prevent dengue fever is to take
special precautions to avoid contact with
mosquitoes. When outdoors in an area where
dengue fever has been found ;
 Use a mosquito repellant
 Dress in protective clothing (long-sleeved shirts,
long pants, socks, and shoes)
 Because Aedes mosquitoes usually bite during the
day, be sure to use precautions especially during
early morning hours before daybreak and in the
late afternoon before dark.
 Other precautions includes;

 Keeping unscreened windows and doors closed

 Keeping window and door screens repaired
 Getting rid of areas where mosquitoes breed, such as
standing water in flower pots, containers, birdbaths,
discarded tires, tin cans, bottles or drain accumulated
water from trees, etc.
 Cover water storage containers to prevent breeding of
mosquitoes
 Clean house gutters to prevent stagnation of rain water
 Isolate patients suffering from Dengue H-Fever for at least
5 days
 Report to the nearest health center any suspected case of
Dengue H-Fever in the neighborhood