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Dengue Fever Causes Diagnosis Treatment and Prevention


Causes Diagnosis Treatment Prevention of Dengue fever

Dengue is an acute vector-borne disease caused by dengue virus transmitted through mosquito-borne vectors. Dengue virus infection can cause recessive infection, dengue fever, and dengue hemorrhagic fever. Dengue hemorrhagic fever is rare in Asia. The typical clinical manifestations of dengue fever are rapid onset, high fever, headache, severe pain in muscles, bones and joints, rash, bleeding tendency, lymphadenopathy, decreased white blood cell count, and thrombocytopenia in some patients.

The disease is mainly endemic in tropical and subtropical areas. Guangdong, Hong Kong, Macau and other places in China are endemic areas of dengue fever.
Because the disease is transmitted by Aedes mosquitoes, the epidemic has a certain seasonality, generally in May to November of each year, the peak is in July to September.
In newly endemic areas, the population is generally susceptible, but the incidence is mainly adult. In endemic areas, the incidence is mainly children.

English name:    Dengue



Visiting department:    Infectious Diseases



Common causes:    Dengue virus



Common symptoms: 

  • Severe aches and pains in muscles, bones and joints
  • Rash
  • Bleeding tendency
  • Lymphadenopathy
  • Decreased white blood cell count
  • Thrombocytopenia, etc. in some patients

Contagious:    Yes
Way for spreading:    Mosquito-borne


     What is the Cause of Dengue Fever?

    Causes of Dengue: Dengue virus is a flavivirus genus in the Flaviviridae family. It is a single-stranded positive-strand RNA virus. The virus is resistant to low temperatures. It can survive for 5 years at -20 ° C in human serum. This virus can survive for more than 8 years at -70 ° C, but it is not resistant to Heat. It can be inactivated within 30 minutes at 50 ° C or 2 minutes at 100 ° C. 


    It is not acid resistant. It can be inactivated with detergent, ether, ultraviolet light and 0.65% formaldehyde solution.
    Four serotypes of dengue virus have been isolated, all of which are pathogenic. 


    Aedes mosquitoes (including Aedes aegypti and Aedes albopictus) are its main hosts, and patients and recessive infections are the main sources of infection. 
    The patients were most contagious within 1 day to 3 days after the onset. 
    A small number of patients can also isolate the virus from the blood on the third day after fever regression.

    Dengue virus enters the body through the bite of Aedes mosquito, enters the blood circulation after proliferation of capillary endothelial cells and monocyte-phagocytic system, and forms the first toxemia. It is then re-localized in the monocyte-phagocytic system and in lymphoid tissues, where it is released into the blood again, forming a second toxemia.

    Dengue virus forms an immune complex with anti-dengue virus antibodies produced by the body, activating the complement system, resulting in increased vascular permeability. 
    At the same time, the virus can inhibit the bone marrow, causing leukocytes, thrombocytopenia, and bleeding tendency.

    What is the Clinical Manifestation of Dengue Virus?

    The incubation period is 3 to 14 days, with an average of about 4 to 7 days. 
    Dengue is clinically classified as typical, light and heavy.

    1. What is the conditions under Typical Dengue Fever?

    (1) The onset of fever is mostly sudden, and the body temperature rapidly reaches above 39 ° C, which usually lasts 2 to 7 days. 
    The heat pattern is irregular.

    In some cases, the body temperature drops to normal on the 3rd to 5th days, and then rises again after 1 day,  bimodal or saddle heat. 

    Childhood onset is slower and fever is lower. It is accompanied by systemic symptoms such as headache, back pain, muscle and joint pain, orbital pain, and posterior eyeball pain.

    May have gastrointestinal symptoms such as hypersensitivity, nausea, vomiting, abdominal pain, poor appetite, diarrhea and constipation. 
    Face and conjunctiva congestion, flushing of neck and upper chest skin. 
    Relatively slow pulses can occur during the fever phase.

    (2) The rash appears on the 2nd to 5th days after the onset. The palm, the soles of the feet, the trunk, and the abdomen gradually spread to the neck and limbs. 
    Some patients are seen on the face and may be maculopapular, measles-like rash, scarlet fever-like rash, erythema erythema. 
    There is a slight itch.

    On the last day of fever, or after the heat has subsided, there are fine plaques on the feet, back of legs, ankles, back of wrists, armpits, etc., which subsides within 1 to 3 days, and brown spots remain briefly. Generally, Body temperature subsided at the same time.

    (3) Bleeding 5 to 8 days after the onset of bleeding, about half of the cases may have bleeding at different locations and to different degrees, such as epistaxis, skin stasis, gastrointestinal bleeding, hemoptysis, hematuria, vaginal bleeding and so on.

    (4) Other systemic lymph nodes may be slightly swollen, with light touch pain. Hepatomegaly and splenomegaly are rare. Individual cases have jaundice. After illness, patients often feel weak and weak, and full recovery often takes several weeks.

    Fever from Dengue Dengi Dengee Mosquito

    2. What are the conditions under Light Dengue Fever?

    Symptoms and signs are milder than typical dengue fever, fever and general body pain are mild, rash is rare or not seen, no tendency to bleeding, superficial lymph nodes are often swollen, and its clinical manifestations are similar to influenza, which can be easily ignored and healed within 1 to 4 days.

    3. What are the conditions under Heavy Dengue Fever?

    The early manifestations of the patient were similar to typical dengue fever. On the 3rd to 5th course of the disease, the condition suddenly worsened, and severe meningitis such as headache, nausea, vomiting, disturbance of consciousness, and neck rigidity appeared.

    Some manifest as major gastrointestinal bleeding and hemorrhagic shock. 
    This type often develops rapidly due to the disease, mostly due to central respiratory failure and hemorrhagic shock within 24 hours.


    What is Routine inspection for Dengue?

    (1) The total number of white blood cells in patients with dengue fever in the surrounding blood is reduced when it starts, especially in the rash period; the percentage of neutrophils is also reduced, and the lymphocytes are relatively high.
    Toxic particles and obvious nuclear left shift are visible. Lymphocytes, and the blood picture returned to normal 1 week after fever. Thrombocytopenia in 1/4 to 3/4 cases can be as low as 13 × 109 / L.
    (2) Urine routine: There may be a small amount of protein, red blood cells, white blood cells, and sometimes casts.

    2. What is Virus isolation for Dengue?

    Blood from early patients was inoculated into Aedes albopictus cell line (C6 / 36), and the virus must be identified by specific neutralization test or hemagglutination inhibition test after virus isolation.

    3. What is Serum immunological examination for Dengue?

    The detection of specific IgM antibodies in patients' serum by ELISA is positive to help the early diagnosis of dengue fever.
    If the dengue virus antigen is detected in the patient's serum, it can also be used as a clear diagnostic basis.

    4. What is Dengue virus nucleic acid detection?

    The detection of dengue virus RNA in patients' serum is more sensitive than virus isolation, and can be used for early rapid diagnosis and serotype identification, but the technical requirements are higher.
    Procedure of Diagnosis of Dengue

    What is the Diagnosis for Dengue?

    According to the epidemiological characteristics of the epidemic area and the onset of the rainy season, the patient has two degrees of high fever, pain in the whole body, obvious weakness, a rash on the first fever or the second fever, a swollen lymph node, and a decrease in the number of white blood cells. It is considered as dengue fever.

    The antibody titer in the recovery phase of the double serum is more than 4 times higher than that in the acute phase, or the antibody titer of the complement test in the acute phase is 1:32 or more, and the diagnosis can be made. 
    Pay attention to identification with influenza, leptospirosis, measles, scarlet fever, typhoid fever, malaria, and yellow fever.

    What is the Treatment for Dengue?

    Dengue Fever Treatment: At present, there is no exact and effective pathogen treatment for this disease, and support and symptomatic treatment measures are mainly adopted.

    1. General Treatment

    The patient lives in an isolation ward with anti-mosquito equipment. In the acute phase, you should rest in bed until your body temperature and platelet count return to normal, and there is no tendency to bleeding before you can move properly.
    Diet should be liquid or semi-liquid rich in nutrient-digestible food. Take care to clean your mouth and skin and keep your stools open.

    2. Reduce body temperature

    For patients with high fever, physical cooling should be used first, such as ice packs, alcohol swabs, and pain relief and antipyretic drugs should be used with caution.
    For those with high fever and severe toxic blood symptoms, a small dose of adrenocortical hormone such as oral prednisone can be used for a short time.

    3. Rehydration

    For those who sweat more and have diarrhea, first take oral rehydration, pay attention to water, electrolytes and acid-base balance. 
    Intravenous rehydration should be used when necessary to correct dehydration, hypokalemia, and metabolic acidosis, but the possibility of inducing cerebral edema, intracranial hypertension, and cerebral hernia should always be watched.

    4. Reduce intracranial pressure

    In cases of severe headache and intracranial hypertension, a rapid intravenous drip of 20% mannitol injection should be applied in time.
    At the same time, intravenous infusion of dexamethasone can help reduce cerebral edema and reduce intracranial pressure
    For patients whose respiratory center is inhibited, an artificial respirator should be applied in time.

    5. Hemostasis

    Those who have bleeding tendency, give carbachol, vitamin K and other general hemostatic drugs. 
    When the amount of bleeding is large, whole blood or platelets can be transfused.

    Prognosis

    Dengue fever is an infectious disease with a self-limiting tendency. The duration of uncomplicated patients is about 10 days. 
    The disease usually has a good prognosis. 
    Most of the deaths were severe patients.

    How can we Prevent Dengue Fever?

    Prevention of Dengue Fever:

    1. Manage the source of infection

    Endemic or probable endemic areas should do a good job of monitoring and forecasting the dengue epidemic, early detection, early diagnosis, and timely isolation and treatment. 
    Specific laboratory tests should be performed as soon as possible to identify light patients.

    Medical observation should be performed on suspicious patients. Patients should be isolated in wards with screens and screens. 
    The isolation time should be no less than 5 days. Strengthen border health quarantine.

    2. Cut off the transmission route

    Anti-mosquito and anti-mosquito is the fundamental measure to prevent this disease. Improve the sanitary environment, eliminate the breeding ground of Aedes mosquitoes, and clear up the accumulated water. Spray insecticides to eliminate adult mosquitoes.

    3. Protect vulnerable people

    Improve the population's disease resistance, pay attention to a balanced diet, work and rest, exercise appropriately, and enhance physical fitness. 
    Apply insect repellents to susceptible people during epidemics to prevent mosquito bites.

    How to Detect Dengue Virus infection?

    Detection of Dengue Infection: In March 2019, the University of Bath announced that researchers at the school are developing a small device to detect dengue virus infections earlier in order to treat patients more efficiently and avoid deterioration.

    The team believes that better understanding of how these cells behave after being infected will lead to more precise ways to detect dengue virus.

    Overview symptoms etiology treatment prevention of Dengue Fever

    Dengue fever is a common disease in the Department of Infectious Diseases. It is caused by acute mosquito-borne infectious diseases caused by the bite of Aedes mosquitoes carrying dengue virus. 
    It is highly infectious. Because mosquitoes spread quickly and many sources, dengue fever spreads rapidly.

    In addition, symptoms such as high fever, high fever, dizziness, headache, severe swelling and pain in the joints, rash, bleeding tendency, and thrombocytopenia will occur during the onset of the disease. Those who do not treat in time are prone to life danger.

    Prevention and treatment should be done to avoid the source of infection. So as not to be threatened by disease.

    Must see when going to the hospital
    1.     What department to link: Infectious Diseases
    2.     What symptoms: fever chills, headache, low back pain, joint pain, nausea, vomiting, abdominal pain, diarrhea, bleeding
    3.     Vulnerable groups: all groups
    4.     Examinations required: blood routine, complement test, blood biochemistry, blood culture, liver and kidney function

    Good Dengue Medicine Tips

    Common Drugs: Prednisone, Vitamin C, Vitamin K1, Anluoxue, Hemostatic, Plasma, Low Molecular Dextran, Glucose Saline, Aluminum Hydroxide Gel, Mannitol, Dexamethasone, Potassium Citrate, Cimetidine Ranitidine.

        Treatment cost: According to different hospitals, the charging standards are not the same. The city's top three hospitals charge about $ 1,000-3,000 on admission.

        Caused by disease: acute intravascular hemolysis, mental disorders, myocarditis, liver function impairment, uremia, acute respiratory distress syndrome


    Author's Bio

    Doctor Shawna Reason, Virologist
    Dr. Shawna Reason
    Name: Shawna Reason

    Education: MBBS, MD

    Occupation: Medical Doctor / Virologist 

    Specialization: Medical Science, Micro Biology / Virology, Natural Treatment

    Experience: 15 Years as a Medical Practitioner

    About Me | Linkedin | Quora Profile | Medium Profile | Twitter


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