Dengue Haemoragic Fever

GROUP 4

ANALIS KESEHATAN
1D

Ade Ikhsanul A
Alsa Salsabila
Aulia Maulida C
Eva Arnika A
Iriani Mutiara C
Maula Kemal A
Putri Rahma W
Siti Rahma Dewi
  Definition
Dengue Hemorrhagic Fever (DHF) is a disease caused by dengue virus that is transmitted
through the bite of Aedes Aegypti and Aedes Albopictus mosquitoes. Dengue is spread by
several species of mosquito of the Aedes type, principally A. aegypti. The virus has five different
types. infection with one type usually gives lifelong immunity to that type, but only short-term
immunity to the others. Subsequent infection with a different type increases the risk of severe
complications. A number of tests are available to confirm the diagnosis including detecting
antibodies to the virus or its RNA.
A novel vaccine for dengue fever has been approved and is commercially available in a number
of countries. Other methods of prevention are by reducing mosquito habitat and limiting
exposure to bites. This may be done by getting rid of or covering standing water and wearing
clothing that covers much of the body. Treatment of acute dengue is supportive and includes
giving fluid either by mouth or intravenously for mild or moderate disease. For more severe
cases blood transfusion may be required. About half a million people require admission to
hospital a year. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen should not be
used.

 History
Dengue Hemorrhagic Fever (DHF) or in medical terms is called Dengue Hemorrhagic Fever.
The disease is caused by dengue virus that is transmitted through the bite of Aedes aegypti
mosquitoes and Aedes albopictus. The disease is found in many tropical regions such as
Southeast Asia, India, Brazil, America, including all over Indonesia, except in places of height
more than 1000 meters above sea level. Doctors and other health workers are often wrong in
diagnosing, because of the tendency of early symptoms to resemble other diseases such as Flu
and Typhus.

The first record of a case of probable dengue fever is in a Chinese medical encyclopedia from the
Jin Dynasty (265–420 AD) which referred to a "water poison" associated with flying insects. The
primary vector, A. aegypti, spread out of Africa in the 15th to 19th centuries due in part to
increased globalization secondary to the slave trade. There have been descriptions of epidemics
in the 17th century, but the most plausible early reports of dengue epidemics are from 1779 and
1780, when an epidemic swept across Asia, Africa and North America. From that time until
1940, epidemics were infrequent.

In 1906, transmission by the Aedes mosquitoes was confirmed, and in 1907 dengue was the
second disease (after yellow fever) that was shown to be caused by a virus. Further investigations
by John Burton Cleland and Joseph Franklin Siler completed the basic understanding of dengue
transmission.
  Prevalency

before 1970, only 9 countries experienced dengue outbreaks, but now DBD is an endemic
disease in more than 100 countries, including Africa, America, Eastern Mediterranean, Southeast
Asia, and Western Fasifics have the highest rates of dengue cases. The number of dengue cases
in the United States, Southeast Asia and the Western Fasific passed 1.2 million cases in 2009 and
more than 2.3 million cases in 2010 in 2013 there were 2.3 million cases in the United States
in France and Croatia in 2013 there were more than 2.0 million cases, most of them children
the number of patients and the area of the spread area is increasing. especially in Southeast Asia
(Indonesia) DHF was first found in Surabaya city as many as 58 people infected and 24 people
died, with mortality rate reached 41.3%.
Since 2015, there are 126,675 dengue fever cases in Indonesia, and 1,229 of them are in the
world. the number is higher than the previous year (2014), ie as many as 100,347 people with
DBD and as many as 9007 died in 2014.
  Mechanism
When a mosquito carrying dengue virus bites a person, the virus enters the skin together with the
mosquito's saliva. It binds to and enters white blood cells, and reproduces inside the cells while
they move throughout the body. The white blood cells respond by producing a number of
signaling proteins, such as cytokines and interferons, which are responsible for many of the
symptoms, such as the fever, the flu-like symptoms, and the severe pains. In severe infection, the
virus production inside the body is greatly increased, and many more organs (such as the liver
and the bone marrow) can be affected. Fluid from the bloodstream leaks through the wall of
small blood vessels into body cavities due to capillary permeability. As a result, less blood
circulates in the blood vessels, and the blood pressure becomes so low that it cannot supply
sufficient blood to vital organs. Furthermore, dysfunction of the bone marrow due to infection of
the stromal cells leads to reduced numbers of platelets, which are necessary for effective blood
clotting; this increases the risk of bleeding, the other major complication of dengue fever.

 Symptoms general
1. A sudden high fever.
2. Severe headache (especially on the forehead).
3. Pain behind the eyes that worsens with eye movements.
4. Whole body pain and joint pain. Nausea or vomiting.

 Symptoms specific
1. Having a fever with high temperatures can reach 40 ° C
2. Shivering.
3. Severe headache.
4. Pain behind the eyeball.
5. Back pain.
6. Pain in the legs and joints.
7. Reddish rash on the skin.
8. Rash in the form of spots of bleeding under the skin (ptekie) is blackish red.
9. There may also be gastritis with a combination of abdominal pain accompanied by
nausea, vomiting, or diarrhea.
10. In some cases dengue fever presents milder symptoms that can be misdiagnosed as
influenza, chikungunya, or other viral infections when there is no rash.
  Methode & equipment
The primary method of controlling Aedes Aegypti is by eliminating its habitats. This is done by
getting rid of open sources of water, or if this is not possible, by adding insecticides or biological
control agents to these areas. Generalized spraying with organophosphate or pyrethroid
insecticides, while sometimes done, is not thought to be effective. Reducing open collections of
water through environmental modification is the preferred method of control, given the concerns
of negative health effects from insecticides and greater logistical difficulties with control agents.
People can prevent mosquito bites by wearing clothing that fully covers the skin, using mosquito
netting while resting, and/or the application of insect repellent (DEET being the most effective).
However, these methods appear not to be sufficiently effective, as the frequency of outbreaks
appears to be increasing in some areas, probably due to urbanization increasing the habitat of
Aedes Aegypti. The range of the disease appears to be expanding possibly due to climate change.
1. Haemoglobin (haemometer Sahli)

a. input 5 drops HCl 0.1 to red mark

b. Enter 20 ml of blood using a pipette and hose sahli
c. Let stand 3 minutes
d. add aquades drop by drop, until they are colored to standard
e. Read the HB level by looking at the volume in the sahli reaction tube
2. Hematocrit (Mikrometode)

a. Fill a microcapillary tube specially made for the determination of microhematocrit

with blood
b. Cover one end with a flame or with a special cover material
c. Insert the capillary tube into a special centrifuge that reaches a massive speed, which
is more than 16,000 rpm (centrifuge microhematocrit).
d. Spin for 3-5 minutes.
e. Read the value of hematocrit by using a graph or special tool

3. Leukocytes

a. suction the blood with a leucocyte thoma pipette until the 0.5 dot marks markedly
b. remove excess blood attached to the outside of the pipette
c. Sauce suction turk samapai solution to the mark 11 (be careful not to happen air
bubbles)
d. then both ends of the pipette in the lid using fingers and shake until the blood and turk
solution homogeneous
e. place the improved neubaure and the glass of the enclosure / cover glass (so that the
cover glass is easy to stick on the second part of the stump in moisture with a little
water)
f. then take the thoma pipette and shake it back, then throw away about 3-4 drops
g. subsequent droplets inserted into the calculated room (improved neubaure) and let
stand briefly
h. then the leucocytes are counted in 4 large areas with 10x and 40x objective lens
magnifications to clarify
 4. Trombocytes / Platelet

a. pipette 2000 μl ammonium oxalate reagent 1% and insert in the test tube
b. Added to the 20 μl tube of blood specimen, mix to homogeneous
c. The liquid (reagent + blood) is piped with a dropper pipette, then touch the tip of the
pipette with a 300 angle on the surface of the counting chamber and touch the edge of
the cover glass. Let the room count filled with liquid is capillarity power.
d. Place the count room into a petri dish in which there is wetted tissue paper,
incubation for 15 minutes.
e. Check under objective lens microscope 40X
f. Count platelets. Calculations are done in an erythrocyte box that is in 10 medium
squares.

Method: Blood Routine (H2tl)

No Method Equipment
1. Haemoglobin 1. Pippete Hb sahli
2. Haemoglobinometer
3. Stems stirrer
4. A Tube dilluent hemometer

2. Haematocryt 1. Of a centrifuge mikrohematokrit

2. Capillary tube in which with heparin
3. Scale haematocryt
4. A ruler

3. Leukocytes 1. Pippete thoma leukocytes

2. Room count (Improved Naubauer)
3. Deck glass & cover glass
4. Microscope
4. Platelet test/ 1. pippete thoma trombocyte
Trombocytes 2. room count (Improved Naubauer)
3. deck glass & cover glass
4. microscope
  Lab result

 Management care
There are no specific antiviral drugs for dengue, however maintaining proper fluid balance is
important. Treatment depends on the symptoms. Those who are able to drink, are passing urine,
have no "warning signs" and are otherwise healthy can be managed at home with daily follow up
and oral rehydration therapy. Those who have other health problems, have "warning signs", or
who cannot manage regular follow-up should be cared for in hospital. In those with severe
dengue care should be provided in an area where there is access to an intensive care unit.

Intravenous hydration, if required, is typically only needed for one or two days. In children with
shock due to dengue a rapid dose of 20mL/kg is reasonable. The rate of fluid administration is
than titrated to a urinary output of 0.5–1 mL/kg/h, stable vital signs and normalization of
hematocrit. The smallest amount of fluid required to achieve this is recommended.
Prevention

Prevention depends on control of and protection from the bites of the mosquito that transmits it.
The World Health Organization recommends an Integrated Vector Control program consisting of
five elements:

1. Drain the tub at least once a week

2. Closely sealed the water reservoir
3. Discard or stash of useless objects that can hold water
4. Sprinkle the ABT powder on the bath and other water reservoirs, also on the gutter
around the house
5. Do not get used to hanging clothes

 Conclusion
Dengue Haemoragic Fever is a disease caused by dengue virus is classified arboviruses and enter
the body through the bite of the female Aedes Aegypti mosqito. The main cause is the Arbovirus
through the bit of Aedes Aegypti mosquito. Whose main vector is the Aedes Aegypti. Their
proficiency level vector related to :
- Habbits community to accommodate clean 6water everyday
- Poor environmental sanitation
- Clean water is scare

Daftar Pustaka
https://en.wikipedia.org/wiki/Dengue_fever#Management
http://tutorialkuliah.blogspot.co.id/2010/03/definisipengertian-dengue-haemorrhagic.html
https://id.123dok.com/document/4zpnj87y-prevalensi-demam-berdarah-dengue-dbd-pada-
pasien-anak-di-rsup-h-adam-malik-medan-dari-januari-hingga-desember-2009.html
http://aceh-laboratorium.blogspot.co.id/2012/01/pemeriksaan-trombosit.html
https://www.bing.com/images/search?q=hematokrit%20reader&qs=n&form=QBIR&sp=-
1&pq=hematokrit%20reader&sc=8-
17&sk=&cvid=E780A4DFF4FC477A838B15BCEE3F2C4D
http://kuliahanaliskesehatan.blogspot.co.id/2013/05/pemeriksaan-hitung-jumlah-leukosit.html
https://imamri.wordpress.com/2013/10/14/praktikum-biokima-penentuan-kadar-hemoglobin-hb/