DR.S.M.

JOSHI
MEDICAL OFFICER
AND
FACULTY MEMBER H.F.W.T.C.THANE
Dengue fever is Caused by Virus spread
by Aedes Egypti mosquitoes .
Globally 2.5-3billion people are estimated
to be at risk of infection with Dengue
Diseases.
It mainly affects children.
The case fatality ranges from <1%-
1%(average5%)
It is characterized by Fever, headache,
muscle and joint pains, rash, nausea ,and
vomiting. some infection results in dengue
heamorraghagic fever can threaten
patients life.
DF and DHF are caused by four dengue
viruses-DEN 1, DEN2, DEN3, DEN4which
are closely related antigenically.
Infection with one serotype provides life
long immunity to that virus but not to
others.
Dengue viruses are maintained in urban
transmission cycle in tropical and
subtropical areas .
Dengue viruses are transmitted from
person to person by Aedes mosquitoes
of the subgenus stegomyia .
Ae. Aegypti breeds entirely in domestic
man made water receptacles found in and
around household, construction sites,
factories, coconut shells, over head tanks
,septic tanks.
Under the optimal conditions the life cycle
of aquatic stage of the Ae. Aegypti can be
short as seven days.
Female of Ae. Aegypti is highly anthrofillic
with two periods of biting activity several
hours after daybreak and in the afternoon
several hours before dusk.
Ae. Aegypti prefer rest in
dark,humid,secluded places inside
houses,or buildings,bedrooms,closets,
bathrooms,kitchen.
Secondary dengue infection is a risk factor
for DHF.
Viremia is usually present at the time of or
just before the onset of symtoms and lasts
on average of five days after the onset of
illness.
Transmission Cycle Female mosquito bite for
meal person with febrile illness mosquito infected
transmission in another person onset of disease .

Pathphysiological changes occur mainly in
following two manners.
1) Plasma Leakage:-Increased vascular permeability
resulting in plasma leakage,hypovolemiaand shock.DHF
appers unique is that selective leakage of plasma into
pleura and peritoneal cavities.The period of leakage is
short-24-48 hours.

2) Heamorrahgic manifestations:-Abnormal heamostasis
due to vasculopathy,thrombocytopenia,
coagulopathy leading to various ) heamorrahgic
manifestations.
Clinical manifestations:- depends on age,immune status
of host,and the virus strain.
In infants it may develop as simple febrile illness
indistiguishable from other viral infections.
DIAGNOSIS:-In acute DF episode

Total WBC-Normal at onset of fever, leucopenia develops
through the febrile period,
Platelet Count:- usually normal
Serum Biochemistry-Normal
Liver Enzymes-may be elevated.

In acute DHF episode:-

Total WBC-leucopenia develops through the febrile period,
Platelet Count:- Thrombocytopenia is constant finding in DHF<
1,00,000/cu/mmof blood is usually found between 5-8day of
ilness.
Heamoconcentration is constant finding in DHF
Transient Albuminurea is sometimes observed.
Occult Blood:- is often found in stools.
Management of DF Fever:-

Is mainly symptomatic and supportive.
1-bed rest in Acute phase.
2-Antipyretics and Analgesics for control of fever and pain
3-.oral fluid and electrolyte therepy for excessive sweating and
vomiting.

Management of DHF Fever:-

Antipyretics and Analgesics for control of fever and pain
simmilar as DF.
oral fluid and electrolyte therapy for excessive sweating and
vomiting.
IV fluid therapy to control plasma loss and impending shock.
like Iv Colloid, Crystalloid, blood transfusion





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