Dengue
Dengue
Dengue
Paul R. Earl
1) elimination of mosquito
breeding places,
2) prevention of mosquito bites
and
3) vaccination of all persons
against all 4 serotypes, DEN 1-4.
Annually, over 100 million cases of
primary dengue fever and over
450,000 cases of dengue
hemorrhagic fever (DHF) and shock
syndrome (DSS) occur DHF/DSS
many fatal) is the leading cause of
hospitalization of children in Asia.
A sick person needs to be
diagnosed and treated early,
and a rise in vector population
must be controled early. Much
of the essential knowledge on
dengue fever has now been
presented. Health education is
the crucial aspect.
Symptoms.
As soon as the public understands the
mosquito transmission of dengue, they
should learn the symptoms. Dengue fever
has 1) sudden high fever, 2) severe frontal
headache, 3) pain behind the eyes that
worsens with eye movements, 4) muscle
and joint pains, 5) loss of sense of taste and
appetite, 6) measles-like rash over the
chest and upper arms, and 7) nausea and
vomiting. Breakbone fever is one name for
dengue.
DHF/DSS has 1) severe and
continuous stomach pains, 2) pale,
cold or clammy skin, 3) Bleeding
from the nose, mouth and gums ±
skin bruising, 4) vomiting often ±
blood, 5) sleepiness and restlessness,
6) constant crying, 7) excessive thirst,
8) rapid weak pulse, 9) difficulty in
breathing, and 10) fainting.
DHF is the most fever form of
dengue with hemorrhage and the
tendency to develop shock. DHF
presents a high continuous fever
of 2-7 days after 5-8 days of
incubation, hemorrhagic diathesis,
hepatomegaly and circulatory
disturbance as shock.
Live attenuated vaccines have been
developed for yellow fever (strain 17D)
and Japanese encephalitis (JE; strain
SA14-14-2) viruses, and inactivated
vaccines have been developed for JE and
tick-borne encephalitis viruses. YF live
attenuated 17D vaccine are efficacious
and safe current vaccines been used to
immunize more than 300 million people.
Tetravalent live attenuated dengue
vaccines are undergoing clinical trials.
Flaviviridae viruses.
This family contains about 70 RNA viruses,
the most important of which might be yellow
fever (YF). or dengue. Flaviviruses are
among the most important emerging viruses.
Most are arboviruses (arthropod-borne)
being transmitted by mosquitoes or ticks.
Many are spreading to new geographical
areas and causing increased numbers of
infections. Many RNA viruses have these
essential genes: pol, env and gag that are
major protein coding regions.
Viremia and immune responses.
Dengue virus is present in the blood of
infected patients for about 6 days after
which it is cleared by antibodies. Many
parts of the world do not have the
laboratory facilities required for virus
diagnosis or even the equipment and skill
for proper diagnosis of bacteria.
Nonetheless in some communities, the
political will to protect the public is not
evinced.
IgM antibody rises during acute illness.
Serological tests become positive by day 6.
IgM lasts 60-90 days, thus indicates recent
infection. However, IgM antibodies may
crossreact with other flaviviruses. In
primary dengue. IgG develops a few days
later than IgM antibody. Tests measuring
IgG antibody generally depend on paired
sera that show a difference in the course
of the infection, e. i., acute and
convalescent sera are compared.
Although secondary antibody
responses are broadly crossreactive,
there can be a higher response to
the primary infecting agent.
Distressing allergic reactions are
caused by crossreactions among the
4 dengue serotypes. Still, other
flaviviruses might be involved.
Cultivation of the virus.