Group 3

DENGUE FEVER
Members:
Bais, Kristia Juanito, Bernadeth
Celendro, Judee Mae Provido, Kylo
Delfin, Aje Marie Sansolis, Kahlyl Patricia
Deslate, Andrea Jane Tingzon, Kezia Faye
Franco, Nisa Bib
 Contents:

I II III
Introduction Diagnostics / Labs Preventive Measures

Etiology Treatment Dental Correlations

Clinical Presentation Prognosis

Celendro ~ Franco ~ Sansolis ~ Delfin Deslate ~ Tingzon ~ Bais Provido ~ Juanito

Introduction 01
Dengue
A viral ailment, otherwise known as
“Break-bone Fever” is transmitted from
mosquitoes to humans. It is more prevalent in
tropical and subtropical climates around the
world.

DENV is a small single-stranded RNA virus

comprising four distinct serotypes (DEN-1 to-4)
that can sporadically result in more serious
instances, including fatalities.
 AEDES
AEGYPTI
- Yellow fever mosquito
- Day biter
 AEDES
ALBOPICTUS
- Asian tiger mosquito
- Day and night biter
Global Dengue Risk
Etiology 02
● A.egypti
- feeds for 21 days on average, however it can last anywhere
from 15 and 65 days. It inhabits areas where people reside.
The mosquito contracts the virus after biting a person who is
infected about 7 days later, and it carries the virus for the
rest of its life.
● DENV
- is a 11 kilobase single-stranded RNA virus
● Icosahedral nucleocapsid and an
envelope made of lipid
● Genus Flavivirus, family Flaviviridae
● A yellow fever virus.
 Life Cycle of Aedes Mosquito

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➢ A dengue-infected individual starts the cycle of
dengue virus transmission through the mosquito
Aedes aegypti.

➢ This person will develop a virus-related condition

called viremia, which lasts for around five days.

➢ After that, the virus multiplies within the

mosquito for a further eight to twelve days of
extrinsic incubation.

➢ The virus is then spread when the mosquito bites

a victim.

➢ The second person then contracts the infection

and develops symptoms.
Clinical
Presentation 03
Phases of Dengue
Febrile Critical Recovery
● Dehydration
● High fever ● Shock from plasma ● Hypervolemia
● Neurological leakage ● Intravenous fluid
disturbances ● Severe hemorrhage therapy is excessive
● Febrile seizures in young ● Organ impairment
children
 Clinical Presentations

Maculopapular Rash Classic Dengue Fever Facial Flushing

Prodrome of chills, erythematous
mottling of the skin, and facial
flushing (a sensitive and specific
indicator of dengue fever). The
prodrome may last for 2-3 days.
Begins with sudden onset of fever,
chills, and severe (termed
breakbone) aching of the head, back,
and extremities, as well as other
symptoms. The fever lasts 2-7 days
and may reach 41°C.
Children younger than 15 years
usually have a nonspecific febrile
syndrome, which may be
accompanied by a maculopapular
rash
 Clinical Presentations

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 Clinical Presentations

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Pan American Health Organization (PAHO)
Acdg. to PAHO the clinical description of dengue fever is:
➢ An acute febrile illness of 2-7 days duration
➢ Severe and generalized headache
➢ Retro-orbital pain
➢ Severe myalgia's, especially of the lower back, arms, and legs
➢ Arthralgia's, usually of the knees and shoulders
➢ Characteristic rash (maculopapular)
➢ Hemorrhagic manifestations(eg, petechiae, bleeding gums, epistaxis, menorrhagia,
hematuria)
➢ Thrombocytopenia
➢ Leukopenia
 DENGUE
HEMORRHAGIC FEVER
WHO Criteria of DHF
➔ Fever
➔ Hemorrhagic manifestations
➔ Low platelet count (100,000/mm3 of
less)
➔ Elevated hematocrit (>20% than
normal or >50% than the baseline)
 DENGUE SHOCK
SYNDROME
WHO Criteria of DSS
➔ Massive bleeding
➔ Death
➔ Dehydration
➔ Febrile convulsion
➔ Circulatory failure
Diagnostics/Labs 04
 DIAGNOSTIC LABORATORY STUDIES
● Living in endemic area
● Full blood count
● Fever over 3 days
● Hematocrit base
● Epigastric pain
● WBC count
● Platelet lower than
● Platelet count
100.000/uL
● Clinical chemistry:
● WBC < 4000/uL
■ LFT
● NS1
■ Glucose
● Serology:
■ Electrolytes
■ Rapidtest
■ RFT
■ ELISA
■ BGA
● Hemaglutination
■ Lactate
● Inhibition Test
■ Cardiac enzymes
● RT-PCR and IgM
 Life Cycle of Aedes Mosquito

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 Life Cycle of Aedes Mosquito

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Treatment 05
 NON PHARMACOLOGICAL PHARMACOLOGICAL
● Bed rest ● Oral rehydration therapy
● Fluid intake ● Antipyretic (Acetaminophen 325-600mg
● Vector control methods Q4hr)
○ Place fish on cotainers to eat larvae ● Dengvaxia vaccine
○ Eliminate larval habitats ● Tepid sponge baths.
○ Chemical control: ● Hematocrit
■ Larvicides ● Blood transfusion
■ Ultra-low volume Fumigation
● Patient education AVOID:

● Maintain hygiene ● Aspirin (acetylsalicylic acid)

● Mosquito repellents ● NSAIDS

● Nonsteroidal anti-inflammatory drugs (such
as ibuprofen) because of their anticoagulant
● Prophylactic platelet transfusions properties
● Corticosteroids
 Life Cycle of Aedes Mosquito

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 Monitoring Parameters

BODY TEMPERATURE RESPIRATORY RATE HEART RATE BLOOD PRESSURE

CAPILLARY REFILL
PULSE PRESSURE ABDOMINAL PAIN BLEEDING
TIME

FLUID SEROLOGICAL
VOMITING BODY INSPECTION
INTAKE/RELEASE STUDIES
Prognosis 06
PROGNOSIS

● For the majority of people, the

people infected with dengue virus
fever the prognosis is excellent
● Although they are likely to feel very
ill during first 1-2 week of acute
illness
● Overall the fatality rate is about 1%
for all dengue fever infection
Classic Dengue

● Classic dengue = full recovery

● Convalescence may take weeks
because of asthenia and depression
full recovery
Dengue Hemorrhagic Fever

● 10-20% mortality rate without

aggressive fluid replacement
● 0.2% with treatment
Dengue Shock Syndrome

● >40% mortality without aggressive

fluid replacement
● <1% mortality with treatment
FACTORS THAT AFFECT PROGNOSIS

● Patient’s age
● Pregnancy
● Nutritional status
● Ethnicity
● Sequence of infection w/ different
dengue serotypes
● Virus genotype
● Quality and extent of available
medical care
Preventive
Measures 07
 Monitoring Parameters

Mucosal involvement Vesicles on the soft

Crust lips Hemorrhagic bullae
with scleral injection palate

Brown color plaques Spontaneous bleeding

with a rough surface on on buccal mucosa, Petechiae Purpura
the buccal mucosa gingiva and tongue

Ecchymoses Inflamed tonsils Xerostomia Tongue coating

 Monitoring Parameters

Mucosal involvement Vesicles on the soft

Crust lips Hemorrhagic bullae
with scleral injection palate

Brown color plaques Spontaneous bleeding

with a rough surface on on buccal mucosa, Petechiae Purpura
the buccal mucosa gingiva and tongue

Ecchymoses Inflamed tonsils Xerostomia Tongue coating

Dental
Correlations 08
 Dental Correlations
1 2 3 4

Mucosal involvement Vesicles on the soft

Crust lips Hemorrhagic bullae
with scleral injection palate

5 6 7 8

Brown color plaques Spontaneous bleeding

with a rough surface on on buccal mucosa, Petechiae Purpura
the buccal mucosa gingiva and tongue

9 10 11 12

Ecchymoses Inflamed tonsils Xerostomia Tongue coating

THANK YOU
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