DENGUE

Symptoms of Dengue fever

Aedes mosquito

•  Dengue is a viral disease.
• It spreads after bite of an infected Aedes mosquito.
•  Aedes is called " Tiger Mosquito" as it has black and white stripes over its body, legs and wings.

Breeding of the mosquito:

Aedes breeds in domestic & peri domestic areas (i.e in and around the houses) especially in

• over head water tanks,
• water storage tanks,
• discarded tyres,
• coolers,
• pitchers,
• discarded and broken buckets,
• coconet shells,
• discarded containers,
• artificial collection of water used as ornamental ponds and water falls,
• water discarded from air conditioners etc. in which water stagnates more than a week.

Habits of the Vector:

Aedes breeds in artificial collection of clean water and rests at cool and shady & dark places.

 Aedes aegypti, the mosquito for dengue transmission bites during the day time.

Dengue can present as:

1. Dengue Fever (DF)
2. Dengue Hemorrhagic Fever (DHF)
3. Dengue Shock Syndrome (DSS)

SIGNS & SYMPTOMS OF DENGUE FEVER

• Abrupt onset of high fever.
• Severe frontal headache.
• Pain behind the eyes which worsens with eye movement.
• Muscle and joint pains.
• Rash over chest and upper limbs.
• Nausea and vomiting.

SIGNS & SYMPTOMS OF DENGUE HAEMORRHAGIC FEVER AND SHOCK SYNDROME

• Symptoms similar to dengue fever.
• Skin becomes pale, cold or clammy.
• Bleeding from nose, mouth & gumsand skin rashes.
• Frequent vomiting with or without blood.
• Restlessness.
• Patient feels thirsty and mouth becomes dry.
• Rapid weak pulse.

In case of any such symptoms, immediately report to nearest Govt. Hospital.

TESTING AND TREATMENT OF DENGUE:

DENGUE TESTING WITH IgM MAC ELISA IS DONE FREE OF COST IN PUNJAB AT -

1. GOVT. MEDICAL COLLEGE, AMRITSAR.
2. GOVT. MEDICAL COLLEGE, PATIALA.
3. CIVIL HOSPITAL, BATHINDA.
4. CIVIL HOSPITAL, JALANDHAR.
5. CIVIL HOSPITAL, LUDHIANA.
6. CIVIL HOSPITAL, SAS NAGAR.

• For treatment of severe cases of Dengue, blod component seperators have been installed at each district headquarters.
• For very severe cases of Dengue suffering from Dengue Hemorrhagic Fever, Aphresis machines have been installed in punjab at -

1. CIVIL HOSPITAL, AMRITSAR.
2. CIVIL HOSPITAL, BATHINDA.
3. CIVIL HOSPITAL, JALANDHAR.
4. CIVIL HOSPITAL, LUDHIANA.
5. CIVIL LHOSPITAL, SANGRUR.
6. CIVIL HOSPITAL, SAS NAGAR.

• PLATELETS can be seperated from Whole Blood at these centres for treatment of DHF (DENGUE HEMORRHAGIC FEVER)

DOs AND DONT'S FOR PUBLIC:

DOs:

1. Remove water from coolers and other small containers and dried thoroughly at least once in a week.
2. Empty/ change water of flower vases once a week.
3. Cover the water filled buckets/ containers tightly.
4. Put oil on the non drinking water that can not be emptied e.g. in water tanks at the construction sites.
5. check the waste tyres at mechanic shops for water collection and mosquito breeding.
6. Tightly cover the over head water tanks.
7. Pet's water bowls need to be emptied daily.
8. Use mosquito killer aerosol during day time to prevent bites of mosquitoes.
9. Wear clothes that fully cover the body parts.
10. Children should be advised to play wearing sleeved clothes and not in short and half sleeved clothes.
11. Use mosquito nets or mosquito repellents during sleep at day time.
12. If you or any of your family member has fever with pain behind eyes, vomiting and rash on the body immediately consult a doctor.

DONT'S:

1. Do not use antibiotics.
2. Do not change the speed of fluid rapidly, i.e., avoid rapidly increasing or rapidly slowing the speed of fluids.
3. Insertion of nasogastric tube to determine concealed bleeding orto stop bleeding (by cold lavage) is not recommended since it is hazardous.

SIGNS OF RECOVERY:

1. Stable pulse, blood pressure and breathing rate.
2. Normal temperature.
3. No evidence of external or internal bleeding.
4. Return of appetite.
5. No Vomiting.
6. Good urine output.
7. Stable haematocrit.

CRITERIA FOR DISCHARGING PATIENTS:

1. Absence of fever for atleast 24 hours without the use of anti-fever therapy.
2. Return of appetite.
3. Visible clinical improvement.
4. Good urine output.
5. Minimum of three days after recovery from shock.
6. No respiratory distress from pleural effusion and no ascitis.
7. Platelet count of more than 50,000/mm3.