DENGUE

INTRODUCTION
Dengue is a viral disease that is transmitted to humans by infected mosquitoes. It is caused by the dengue
virus, which belongs to the family Flaviviridae. Dengue is primarily found in tropical and subtropical
regions, where the Aedes aegypti mosquito that transmits the virus is prevalent. The disease is a
significant public health concern, with an estimated 390 million cases occurring annually in over 100
countries.

DEFINITION
Dengue is a viral disease that is transmitted to humans by infected mosquitoes, primarily the Aedes
aegypti mosquito. It is caused by the dengue virus, which belongs to the family Flaviviridae.

EPIDEMIOLOGY
 Dengue is a major public health concern, particularly in tropical and subtropical regions of the world.
According to the World Health Organization (WHO), an estimated 390 million dengue infections
occur worldwide each year, with about 96 million of those resulting in illness.
 Dengue is endemic in over 100 countries, with the greatest burden of the disease in Southeast Asia,
the Western Pacific, and the Americas. The incidence of dengue has increased dramatically in recent
decades, with a 30-fold increase in global incidence over the past 50 years. This increase is thought to
be due to a combination of factors, including population growth, urbanization, and global travel.
 Dengue is a seasonal disease, with peak transmission occurring during the rainy season in many
endemic areas. The Aedes aegypti mosquito, which is the primary vector for dengue transmission,
thrives in warm, humid environments and is often found in urban and semi-urban areas.
 Dengue can affect people of all ages, but the disease is more severe in certain populations, including
young children, pregnant women, and individuals with underlying health conditions. Additionally,
individuals who have previously been infected with one serotype of the dengue virus are at increased
risk for severe dengue if they are infected with a different serotype.

INCUBATION PERIOD
The incubation period of dengue is typically 4-7 days but can range from 3-14 days after a person is bitten
by an infected mosquito. During this time, the virus replicates in the body and can cause symptoms to
develop.
TRANSMISSION
Through Mosquito Bites
Dengue viruses are spread to people through the bites of infected Aedes species mosquitoes (Ae.
aegypti or Ae. albopictus).  These are the same types of mosquitoes that
spread Zika and chikungunya viruses.

 These mosquitoes typically lay eggs near standing water in containers that hold water, like buckets,
bowls, animal dishes, flower pots, and vases.
 These mosquitoes prefer to bite people, and live both indoors and outdoors near people.
 Mosquitoes that spread dengue, chikungunya, and Zika bite during the day and night.
 Mosquitoes become infected when they bite a person infected with the virus. Infected mosquitoes
can then spread the virus to other people through bites.
From mother to child
 A pregnant woman already infected with dengue can pass the virus to her fetus during pregnancy or
around the time of birth.
 To date, there has been one documented report of dengue spread through breast milk. Because of
the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas with risk of
dengue.
Dengue in pregnancy
Through infected blood, laboratory, or healthcare setting exposures
Rarely, dengue can be spread through blood transfusion, organ transplant, or through a needle stick
injury.

SIGN AND SYMPTOMS OF DENGUE

Dengue can cause a range of symptoms, from mild to severe. The symptoms of dengue typically begin 4-
7 days after a person is bitten by an infected mosquito and can last for up to 10 days.
The symptoms of dengue can include:
 High fever (up to 104°F or 40°C)
 Severe headache
 Pain behind the eyes
 Joint and muscle pain
 Nausea and vomiting
 Rash
 Fatigue
 Mild bleeding from the nose or gums, or easy bruising.
In some cases, dengue can progress to severe dengue, which can be life-threatening. Severe dengue is
characterized by:
Severe abdominal pain,
Persistent vomiting,
Rapid breathing,
Bleeding and a significant decrease in blood pressure.
Shock,
Organ failure and death.

DIAGNOSTIC EVALUATION
The diagnosis of dengue typically involves a combination of clinical evaluation, laboratory tests, and
diagnostic imaging.
 Clinical evaluation: Healthcare providers may ask about the patient's symptoms, travel history, and
exposure to mosquitoes to help identify potential dengue infection. They may also perform a
physical examination to assess for signs of dengue, such as rash, joint pain, and low blood
pressure.
 Laboratory tests: Blood tests are the primary method of confirming a dengue infection. These tests
can detect the presence of the dengue virus or antibodies produced in response to the infection.
The most common blood tests used for dengue diagnosis include enzyme-linked immunosorbent
assay (ELISA), polymerase chain reaction (PCR), and viral isolation.
 Diagnostic imaging: In severe cases of dengue, healthcare providers may use diagnostic imaging,
such as ultrasound or chest X-ray, to assess for signs of internal bleeding or fluid accumulation in
the lungs.

TREATMENT
Currently, there is no specific antiviral treatment for dengue. However, with prompt medical care and
supportive treatment, most people with dengue can recover fully.
The treatment for dengue typically involves:
 Symptomatic treatment: This includes taking pain relievers such as acetaminophen or
paracetamol to reduce fever and joint pain. Aspirin and nonsteroidal anti-inflammatory drugs
(NSAIDs) should be avoided, as they can increase the risk of bleeding.
 Fluid management: Dengue can cause dehydration and a decrease in blood volume, which can
lead to low blood pressure and shock. Therefore, it is essential to drink plenty of fluids, such as
water, electrolyte solutions, and oral rehydration fluids, to prevent dehydration. In severe cases,
intravenous fluids may be necessary to maintain hydration.
  Monitoring for complications: In severe cases of dengue, patients may require hospitalization for
close monitoring and treatment of complications, such as severe bleeding, organ failure, and shock.
 Prevention of mosquito bites: To prevent further transmission of dengue, patients with the
infection should take steps to prevent mosquito bites, such as using insect repellent, wearing
protective clothing, and using mosquito nets.
In addition to the standard treatment outlined above, some experimental treatments are being studied for
dengue, including antiviral drugs and immunomodulatory therapies.
Antiviral drugs: Several antiviral drugs are being studied for their potential effectiveness against dengue,
including ribavirin, balapiravir, and chloroquine. However, more research is needed to determine their
efficacy in treating dengue.
Immunomodulatory therapies: Immunomodulatory therapies are being studied for their ability to
modulate the immune response to dengue and potentially reduce the risk of severe disease. These
therapies include corticosteroids, intravenous immunoglobulin (IVIG), and monoclonal antibodies.
However, their effectiveness in treating dengue is still being evaluated in clinical trials.

HOME REMEDIES FOR DENGUE

While there is no specific cure for dengue, there are some homes remedies that can help manage the
symptoms and support the immune system during recovery. Here are some home remedies that may help:

Stay hydrated: Drinking plenty of fluids, such as water, coconut water, and electrolyte solutions, can
help prevent dehydration and maintain electrolyte balance.
Papaya leaf juice: Some studies have suggested that drinking papaya leaf juice may help boost platelet
count in people with dengue, although more research is needed to confirm this.
Rest: Getting plenty of rest is essential for recovery and can help reduce symptoms such as fatigue and
muscle aches.
Herbal tea: Drinking herbal tea made with ginger, mint, or chamomile may help soothe nausea and
promote relaxation.
Avoid certain foods: Avoiding spicy, oily, and fatty foods may help ease digestive symptoms such as
nausea and vomiting.

PREVENTION OF DENGUE
Preventing dengue involves measures to control the mosquito population and reduce the risk of mosquito
bites. Here are some steps that can help prevent dengue:
 Eliminate mosquito breeding sites: Mosquitoes breed in stagnant water, so it is important to
eliminate any sources of standing water around your home, such as flowerpots, empty containers,
and gutters.
 Use mosquito repellents: Apply mosquito repellents containing DEET, picaridin, or other
approved ingredients to exposed skin and clothing.
 Wear protective clothing: Wear long-sleeved shirts, long pants, and socks to reduce exposed skin.
 Use mosquito nets: Use mosquito nets over beds and other sleeping areas to protect against bites.
 Keep windows and doors screened: Make sure windows and doors have screens to keep
mosquitoes out.
 Community-wide efforts: Community-wide efforts to control mosquito populations, such as
removing standing water, using larvicides, and spraying insecticides, can be effective in reducing
the overall risk of dengue transmission.
 Vaccination: A dengue vaccine is available in some countries, and vaccination may be
recommended for people living in areas with a high risk of dengue. However, vaccination alone is
not sufficient to prevent dengue and should be used in conjunction with other prevention measures.