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)

Marked damage to blood and lymph vessels 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