Dengue-Who Treatment Protocols
Dengue-Who Treatment Protocols
Dengue-Who Treatment Protocols
PROTOCOLS
DR.V.USHAPADMINI M.D.,
SENIOR ASSISTANT PROFESSOR
DEPARTMENT OF GENERAL MEDICINE
COIMBATORE MEDICAL COLLEGE AND HOSPITAL
EPIDEMIOLOGY
Most rapidly spreading mosquito borne viral disease in the
world
50 million dengue infections occur annually
Dengue is a public health emergency of international concern
More than 70% of at risk population for dengue live in
southeast Asia and western pacific
DENGUE VIRUS
Small single stranded RNA virus ,4 distinct serotypes 1,2,3,4
of genus flavivirus and family flaviviridae
Asian genotypes 2 and 3 associated with severe disease
DEDDDD
CLASSIFICATION OF DENGUE
Dengue fever(Classical)(DF)
Dengue haemorrhagic fever(DHF)
Dengue shock syndrome(DSS)
3)Severe Dengue
PROBABLE DENGUE
Live in/Travel to endemic ,rash, aches and pains
Leucopenia
DENGUE WITH WARNING SIGNS
Abdominal pain
Restless
liver>2cm
2)severe haemorrhage
3)Ethnicity
Abdomen-Tenderness,Ascites,Hepatomegaly/Rash /Bleeding
manifestations/Tourniquet test +ve
INVESTIGATIONS-BASIC
CBC,BaselineWBC ,Hct,LFT
Bicarbonate ,Lactate
Classified in to 3 groups
GROUP A:patient sent home
5)Blood glucose
GROUP C
Dengue Shock Syndrome-EMERGENCY TREATMENT AND
URGENT REFERRAL
IV fluids 5ml/kg/hrx1-2hrs
3ml/kg/hr2-4hrs
2ml/kg/hr later
If Hct increases then fluids 10ml/kg/hr
If Hct decreases then give blood-packed RBCS or Fresh blood
Cutoff value of Hct<40%in child and women <45%in men
ROLE OF CRYSTALLOIDS
In Hypotensive shock,IV crystalloids 20ml/kg for 15 mins
10ml/kgx1hr
5ml/kgx2hrs
3ml/kgx2-4hrs
continued for 48 hrs
3)Stable Hct
TAKE HOME MESSAGES
1)Clinical suspicion and Early Diagnosis
2)Aware of Warning signs-Abd.pain,Bleed,Restlessness,Hct
and Platelet changes
3)Diagnostic modalities:NS1,IgM and IgG
4)Judicious IV fluids and blood
5)Strict monitoring
6)Know about complications and treatment