Dengue
Download as PPTX, PDF1 like903 views
Dengue fever is a mosquito-borne viral disease caused by the dengue virus. It is transmitted by the Aedes aegypti mosquito. The disease affects around 100 million people worldwide each year, with cases increasing dramatically in recent decades. Dengue fever causes high fever, severe headache, muscle and joint pains, and a characteristic skin rash. In a small percentage of cases, it can develop into severe dengue hemorrhagic fever or dengue shock syndrome, which can be life-threatening without proper medical treatment. There is no vaccine available for dengue prevention.
Dengue
- 3. INTRODUCTION Dengue fever is a painful debilitating mosquito born disease caused by any one of four closely related dengue virus
- 4. DEFINITION • Dengue fever is also known as breakbone fever is a mosquito born tropical disease caused by the mosquito bite. • The alternative name for dengue, "breakbone fever", comes from the associated muscle and joint pains. • It is caused by the female aedes aegypti mosquito bite, which transmit the dengue virus to human.
- 5. INCIDENCE Each year an estimated 100 millions cases of dengue occur world wide. • The global incidence of dengue has grown dramatically in recent decades. • In INDIA the cases has increase sharply over past five years there have been 38,000 so far in 2013.
- 6. PHASES
- 7. Febrile Phase x 7days High fever 40 °C (104 °F) headache generalized arthalgia myalgia petechiae bleeding from mucus membrane. A rash occurs in 50–80%
- 8. Critical Phase x 2days Leukopenia thrombocytopenia. Increase capillary permeability leading to plasma leakage that lead to metabolic acidosis. In children febrile phase is common carries nausea, vomiting, thrombocytopnea.
- 9. Recovery phase x 2-3 days Stabilize hemodynamic status increase urine output overall clinical improvement. Increase in fluid overload can cause cerebral edema.
- 10. SIGN & SYMPTOMS • Fever ( more than 105 ) • Headache • Muscle, joint pain • skin rash ( appear 4-5 days after fever ) • Pain behind eyes • Nausea • Vomiting • Mild bleeding
- 12. WARNING SIGNS • Severe abdominal pain • Persistent vomiting • Vomit with blood • Drowsiness or irritability • Dyspnoea • Swollen lymph node • Prostration • diarrhea
- 13. DIAGNOSTIC TEST
- 14. WHO-proposed clinical definition of dengue PROBABLE DENGUE • • Exposure in an endemic area • • Fever Two of: • Nausea/vomiting • Rash • Aches/pains • Positive tourniquet test • Leucopenia • Any warning sign • Laboratory confirmation important • Needs regular medical observation and instruction in the warning signs • If there are no warning signs, need for hospitalisation is • influenced by age, comorbidities, pregnancy and social factors
- 15. Dengue with warning signs • Probable dengue plus one of: • Abdominal pain or tenderness • Persistent vomiting • Signs of fluid accumulation, e.g. pleural effusion or • ascites • Mucosal bleed • Lethargy • Hepatomegaly > 2 cm • Rapid increase in haematocrit with fall in platelet • count • Needs medical intervention, e.g. intravenous fluid
- 16. • Severe dengue • • Severe plasma leakage leading to: • Shock (dengue shock syndrome) • Fluid accumulation with respiratory distress • • Severe haemorrhagic manifestations, e.g. GI • haemorrhage • • Severe organ involvement: • Liver AST or ALT ≥ 1000 U/L • CNS: impaired consciousness • Cardiomyopathy • Other organs, e.g. renal impairment • Needs emergency medical treatment and specialist care with
- 18. LABORATORY FEATURES • include leucopenia, neutropenia, thrombocytopenia • elevated alanine aminotransferase (ALT) or aspartate aminotransferase (AST) • serology or detection of dengue viral material in blood by RT-PCR
- 19. • Dengue-specific IgG and IgM ELISA{ positive for IgM antibodies on or after day 5 of the fever} IgM ELISA has a sensitivity of 83.9–98.4% and a specificity of 100% Dengue 2 virus enhancement in asthmatic and non asthmatic individual.Guzman MG, Kouri G, Soler M, Bravo J, Rodríguez de La Vega A, Vazquez S, Mune M
- 20. • Extravasation of fluid due to vascular leakage can be detected radiologically (chest radiography for pleural effusions, echocardiography for pericardial effusions, ultrasonography for ascites).
- 22. MANAGEMENT • Bleeding prevention & control. • Fluid & water replacement. • Symptoms relief & fever control.
- 23. NURSING MANAGEMENT • Increased body temperature related to infection as evidence by vital sign monitoring. • Hypovolemic shock related to hemorrhage. • Fluid volume deficit related to migration of intravascular fluid into extravascular fluid. • Impaired nutrition less than body requirement related to decreased appetite.
- 24. STEPWISE MANAGEMENT STEP 1-Overall Assessment a) History b) Examination c) Investigations STEP 2- Diagnosis,Assessment of disease phase and Severity. STEP 3- Treatment-Group A,B,C
- 26. PROGNOSIS • For the majority of peoples the people infected with dengue virus fever the prognosis is excellent. • Although they are likely to feel very ill during first 1-2 week of acute illness. • Overall the fatality rate is about 1% for all denge fever infection.
- 27. COMPLICATION • A small percentage of individual who have dengue fever can develop a more serious form of disease. • Dengue haemorrhagic fever and disseminated intravascular • coagulation • Dengue shock syndrome • Hepatitis, cerebral haemorrhage or oedema, encephalitis, • cranial nerve palsies, rhabdomyolysis, myocarditis • Vertical transmission if infection within 5 wks of delivery
- 28. MOST OF YOU GET CONFUSED THAT WHAT IS DENGUE HEMMORAHAGIC FEVER AND DENGUE SHOCK SNDROME ALWAYS REMEMBER THEYARE THE COMPLICATION OF DENGUE FEVER
- 29. DENGUE HEMORRHAGIC FEVER – High damage to lymphatic system. – High fever. – Bleeding from nose – Liver enlargement – Damage to blood vessels
- 33. DENGUE SHOCK SYNDROME • It can trigger Dengue Shock Syndrome – Massive bleeding – Death – Dehydration – Febrile convulsion
- 35. MANAGMENT 1.) Supportive measures 2.) Fluid Resuscitation Crystalloids and Colloids 3.) Blood Component Therapy • Packed Red Blood Cells • Fresh Frozen Plasma / Cryoprecipitate • Platelet concentrate 4.) Oxygen therapy 5.) Inotropes - Dopamine,Dobutamine, Epinephrine, Norepinephrine, Milrinone