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    A Cross-Sectional Study On Dengue Fever

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    Vern Nuqui
    This document summarizes information about dengue fever, including its transmission, signs and symptoms, diagnosis, prevention and control efforts. It is transmitted by the bites of infected Aedes aegypti and Aedes albopictus mosquitoes. There are four serotypes of the virus. Prevention strategies promoted by the Philippines Department of Health include searching for and destroying mosquito breeding sites, self-protection measures like wearing repellent, early medical consultation for symptoms, and avoiding indiscriminate fogging. Issues include poor surveillance, social impacts like overburdened healthcare systems, and economic impacts on individuals and nationally.

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    A Cross-Sectional Study On Dengue Fever

    Uploaded by

    Vern Nuqui
    49 views39 pages
    This document summarizes information about dengue fever, including its transmission, signs and symptoms, diagnosis, prevention and control efforts. It is transmitted by the bites of infected Aedes aegypti and Aedes albopictus mosquitoes. There are four serotypes of the virus. Prevention strategies promoted by the Philippines Department of Health include searching for and destroying mosquito breeding sites, self-protection measures like wearing repellent, early medical consultation for symptoms, and avoiding indiscriminate fogging. Issues include poor surveillance, social impacts like overburdened healthcare systems, and economic impacts on individuals and nationally.

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    Dengue Fever

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    This document summarizes information about dengue fever, including its transmission, signs and symptoms, diagnosis, prevention and control efforts. It is transmitted by the bites of infected Aedes aegypti and Aedes albopictus mosquitoes. There are four serotypes of the virus. Prevention strategies promoted by the Philippines Department of Health include searching for and destroying mosquito breeding sites, self-protection measures like wearing repellent, early medical consultation for symptoms, and avoiding indiscriminate fogging. Issues include poor surveillance, social impacts like overburdened healthcare systems, and economic impacts on individuals and nationally.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    49 views39 pages

    A Cross-Sectional Study On Dengue Fever

    Uploaded by

    Vern Nuqui
    This document summarizes information about dengue fever, including its transmission, signs and symptoms, diagnosis, prevention and control efforts. It is transmitted by the bites of infected Aedes aegypti and Aedes albopictus mosquitoes. There are four serotypes of the virus. Prevention strategies promoted by the Philippines Department of Health include searching for and destroying mosquito breeding sites, self-protection measures like wearing repellent, early medical consultation for symptoms, and avoiding indiscriminate fogging. Issues include poor surveillance, social impacts like overburdened healthcare systems, and economic impacts on individuals and nationally.

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    A cross-sectional Study on Dengue Fever

    INTRODUCTION

    viral disease transmitted through the bite of an infected female Aedes mosquito 2 major vectors : Aedes aegypti Aedes albopictus Presently exists with four serotype: DENV-1,DENV-2,DENV-3,DENV-4

    Aedes aegypti

    2.5 Billion people are at risk 50-100 Million cases occur each year, worldwide No available vaccines yet
    Aedes albopictus

    History
    WWII brought the dengue pandemic in SE Asia Spread globally due to shifting populations : travel 1st Outbreak in Philippines: 1953 In 1956: DENV-2, DENV-3, & DEN-4 were isolated from patients. 1958: Epidemic in Bangkok Next decades: other Asian countries (China, Vietnam, etc..) The transmission started with sporadic cases of DF followed by DF epidemics the disease become frequent, until it was seen yearly

    Classical Signs and Symptoms


    Sudden onset of fever: 39.5C-41.1C Rashes Severe headache Muscular and joint pains Nausea and vomiting Anorexia In Dengue Hemorrhagic Fever: Bleeding from nose, gums, and mouth Vomits blood Decrease platelet count Bruising from internal bleeding

    Vectors
    Aedes aegypyti Originated in Africa 2 subspecie: Ae. aegypti formosus Ae. aegypti aegypti Ae. aegypti formosus breeds on natural habitat, and feeds on wild animals. Ae. aegypti aegypti is well domesticated and commonly around in human dwellings. Behavior: The mosquito breeds it larva on artificial containers such as jars, discarded cans, flower vase, used tires, and etc

    Prefers and actively feeds blood during daytime


    Prefers indoors, and rural areas.

    Vectors

    Aedes albopictus Said to be originated in the Orient Unlike Ae. aegypyti, Ae. albopictus eggs has the capability to diapause during winter season. Breeds on natural and artificial habitats as well Does not only prefer human as host, but is also known to target other animals -> zoonosis Also prefers rural areas and outdoor areas Usually feeds during dusk and dawn Nighttime feeding is also observed

    Aedes albopictus Aedes aegypti

    EPIDEMIOLOGY

    World Wide Distribution

    South East Asia Distribution

    30000

    Philippine Distribution

    25000

    20000 Number of Cases

    15000

    10000

    5000

    0 2011 2012

    Jan 10710 9205

    Feb 6851 6838

    Mar 5356 6464

    Apr 3795 5776

    May 3701 7905

    Jun 7023 12543

    Jul 15784 2866

    Aug 28549

    Sep 19650

    Oct 9613

    Nov 6670

    Dec 2166

    Source: www.doh.gov.ph/disease-surveillance (2012 Dengue Morbidity Week 28)

    Gender and Age Distribution


    12000 10000

    8000 Number of Cases

    6000

    4000

    2000

    0 Male

    Unspecified
    87 87

    <1
    605 501

    1-10
    10338 10356

    11-20
    10289 8278

    21-30
    3667 2962

    31-40
    1235 1021

    > 40
    1100 1071

    Female

    Source: www.doh.gov.ph/diseasesurveillance (2012 Dengue Morbidity Week 28)

    Pattern, Severity, and Occurrence


    1.4 1.2 1 Case Fatality Ratio 0.8 0.6 0.4 5000 30000 25000

    Number of Cases

    20000

    15000

    10000

    0.2 0
    0 <1 1-10 11-20 Age Group 21-30 31-40 > 40 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

    2011 1071 6851 5356 3795 3701 7023 1578 2854 1965 9613 6670 2166 2012 9205 6838 6464 5776 7905 1254 2866

    UPDATES ON DIAGNOSIS

    Classical Diagnosis
    Classic dengue fever is characterized by Fever: Sudden and abrupt onset May go up to 39.5-41.4C Lasts for about 1-7 days, then fades away for 1-2 days

    It soon recurs with secondary rashes which is usually not as severe as before

    Classical Diagnosis
    Headaches:

    Fever is usually accompanied by headache in front portion of head or behind the eyes
    Muscular (Myalgia) or bone pain: - Occurs after onset of fever - Affects legs, joints, and lumbar spine - Usually the pain gets severe after its onset - The pain may last for several weeks even after the fever has subsided - Pain is usually absent in DHF/DSS

    Classical Diagnosis
    Other symptoms: Nausea and vomiting Loss of appetite Increased sensation to touch Change in taste sensation Symptoms maybe milder in children than in adults The acute phase of illness can last for 1 week followed by a 1 to 2 week period of recovery period that is characterized by weakness, malaise and loss of appetite.

    Recent Diagnosis
    1. Virus isolation 2. Serological testing (including IgM antibody capture ELISA, IgG ELISA, neutralization assays, and lateral flow device for NS1-specific antibodies) 3. Nucleic acid amplification (RT-PCR, real time RT-PCR, and nucleic acid-sequence based amplification assays) 4. Antigen detection (NS1 antigen detected by antigen capture ELISA)

    Recent Diagnosis
    Other Dengue test Diagnosis

    Serological Tests MAC-ELISA Haemagglutination inhibition (HI) test Complement fixation (CF) test Dengue Virus Isolation

    Advanced Diagnosis
    Biotek-M Dengue Kit
    The UP scientists developed the Biotek-M Dengue Kit that can detect the dengue virus in nucleic acid extracted from a patient's blood. The resulting fluid will turn either of two colors: a green-colored mixture indicates the presence of the virus, while an orange color shows its absence

    New Technologies
    CDC DENV-1-4 Real Time RT PCR Assay
    This assay can identify all four dengue viruses within the first seven days after symptoms appear to the patient. It also detects a certain type of antibody to the virus

    PREVENTION AND CONTROL

    1993: National Dengue Prevention and Control Program: initiated


    by the Department of Health (DOH)

    1998: program was implemented nationwide

    -To establish a Dengue Risk-Free Philippines


    -To improve the quality of health of Filipinos

    -To reduce morbidity and mortality from dengue infection

    Objectives of the Program


    (1) Establish a Dengue Reference Laboratory capable of performing

    IgM capture ELISA for Dengue Surveillance


    (2) Increase the percentage of 1 and 2 government hospitals with laboratory capable of platelet count and hematocrit (3) Ensure surveillance and investigation of all epidemics

    2010: Las Pias government, in collaboration with the Department of Health (DoH), launched an anti-dengue campaign 4S Laban sa Dengue.

    4S Laban sa Dengue Search and destroy Self-protection measures Seek early consultation Say no to indiscriminate fogging

    Search and destroy possible breeding places of dengue-causing mosquitoes.


    flower pots vases Do your part in keeping the discarded plastic bags environment clean. bottles Change water in vases frequently old tires cans Make sure all water containers earthen jars are kept covered. coconut husks roof gutters water drums other containers that might hold clean stagnant water

    Self-protection measures
    Wear long sleeves or long pants Apply mosquito repellant Can also use mosquito coils, electric vapour mats and mosquito sprays Use mosquito nets and screens

    Seek early consultation

    See a doctor immediately if early signs and symptoms of dengue shown up.

    Say no to indiscriminate fogging


    Fogging is only advisable and recommended when outbreaks and epidemics are positively determined in a particular area. Fogging can only kill the adult infected mosquito; it cannot get rid of the larvae, locally known as kiti-kiti. Indiscriminate fogging will only drive away other mosquitoes to other places to find new breeding grounds.

    INTERVENTION STRATEGIES

    Intervention Strategies
    February 2011 The Department of Science and Technology (DOST) introduced the Ovicidal/Larvicidal (OL) Trap System to the Philippines

    OL traps consist of: - Black plastic container - Water - Sawdust pellets - Wooden stick

    Solution attracts mosquitos, who lay eggs in the wood DOST has hopes to reduce the population of female Aedes aegypto and Aedes albopictus, which carry the dengue virus

    ISSUES AND PROBLEMS

    Issues and Problems


    1) Public health impact 2) Social impact 3) Economic impact

    Public Health Impact


    Surveillance is poor Early stages of transmission not detected until epidemic is recognized as dengue Emergency control initiated but often times too late to make an impact on the epidemic

    **Public awareness is key. People should be more aware of early symptoms of Dengue Fever.

    Social Impact
    Many Filipinos are poor; cannot afford expensive medical care Clinics become overloaded with patients, leads to:
    Overworked medical staff Mediocre care for patients Increased mortality

    Economic Impact
    As a nation:
    Lost work and productivity Social disruption Tourism

    As individuals:
    Absences from school and/or work Missing work results in not getting paid; cannot support ones family

    THANK YOU FOR LISTENING!

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