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also known as break bone fever

a mosquito-borne disease which affects the blood
one of the leading causes of illness and death in the tropics and
Originated from monkeys and jumped to humans in Africa, South
and East Asia 100-800 years ago
Dengue Virus types 1-4

Person to person via VECTOR (agent that transmits disease eg.

Animals, insects, microorganism)
VECTOR: Aedes aegypti & Aedes albopictus Mosquitoes

A. aegypti (yellow fever

mosquito) can be recognized by
white markings on its legs and
marking in the form of a lyre on


A. albopictus (Tiger
mosquito) not common in the
A. aegypti

*In order for transmission to occur, the

uninfected mosquito must feed on an
infected person during a 5- day period
when large amounts of virus are in the
blood of that person; this period usually
begins a little before the person become
symptomatic. Some people never have
significant symptoms but can still infect
mosquitoes. After sucking the blood of an
infected person, the virus will require an
additional 8-12 days incubation period on
the body of the infected mosquito before it
can then be transmitted to another human. The mosquito remains
infected/capable to infect other humans for the remainder of its life,
which might be days or a few weeks.

INCUBATION PERIOD (Period between exposure to infection and

appearance of first signs and symptoms):

3-14 Days


Mild to incapacitating high fever
Severe headaches
Pain behind the eyes
Muscle and joint pain
Easy bruising
Positive tourniquet test (not definitive)
Low White cell count (blood test needed)
Low platelet count (blood test needed)
Watch out for DEHYDRATION which usually occurs due to fluid loss
secondary to fever, vomiting, poor oral intake, etc:
Signs and Symptoms of Dehydration:
Decreased urination (observe frequency of trips to the
Highly concentrated urine (Darker than normal colored urine)
Dry mouth, tongue, lips
Sunken eyes
Fast heartbeat
Cold & clammy (unpleasantly damp) fingers and toes
Low blood pressure
Rapid heart rate
No tears when crying
*patient may need fluids through intravenous route (swero) if oral
intake is poor; bring patient to a health care facility.

*Confirm the diagnosis of Dengue Fever (DF) by

undergoing dengue specific blood exam: MAC-Elisa

If the patient is under home/out-patient management watch for

WARNING SIGNS as temperature declines 3-7 days after initial signs
and symptoms began.
if any of the WARNING SIGNS below are present after the fever drops
go immediately to an emergency room or closest health care facility to
prevent or properly manage DENGUE HEMORRHAGIC FEVER (DHFpresence of bleeding together with other signs and symptoms of
Dengue Fever) which may lead to the deadly DENGUE SHOCK
SYNDROME (DSS-circulatory collapse - reduced blood supply to
the body)
Severe Abdominal Pain
Red spots or patches on the skin
Bleeding from nose or gums
Bloody vomitus or spitting of blood
Black tarry stool
Drowsiness, irritability
Pale, Cold & clammy skin
Difficulty of breathing
Low blood pressure
Weak and often fairly rapid pulse
Out-Patient Management for DF
Give paracetamol for fever
Do not give ibuprofen, Aspirin, or aspirin containing drugs
Protect the skin from sharp objects
Use soft bristled toothbrush to prevent gum bleeding
Avoid cutting nails
Use slippers when walking around the house to protect the feet
Do not give iron supplements which may make the color of the
stool darker.
Give plenty of water to prevent Dehydration
Monitor blood. Daily blood exam to a nearest laboratory.
There is no actual cure for dengue; when infected, EARLY
RECOGNITION and prompt supportive treatment can
substantially lower the risk of medical complications and death.
Do not treat infected person at home IF ANY OF THE WARNING
SIGNS ARE PRESENT; bring the patient to a hospital for proper
monitoring and case management.

Vaccines to prevent infection with dengue virus are not yet available and
the most effective protective measures are those that avoid mosquito
The following is the 4S PROGRAM of the DOH against dengue

1. Search and Destroy

throw away, turn over, empty or store under a roof any container
that may accumulate rain water
eliminate stagnant water; change water and clean flower vases
every week
always place a tight lid on container used for water storage
(basket, drums)
check that there are no mosquito / larvae or pupae (kiti-kiti) in
stored water
avoid planting Bromeliads or any plant that could accumulate
rain water
if you have septic tanks, repair cracks and gaps

2. Self-Protection Measures

use screen doors and windows

wear long sleeve shirts, long pants, socks and closed shoes to
avoid mosquito bites at dusk and dawn
use insecticide to kill mosquitoes inside your home etc
when outside, use insecticide such as permethrin (perticide and
repellent) and allethrin (candels and lanterns)
Use repellents containing DEET (N, N-diethyl-m-toluamide) eg.
OFF lotion

3. Seek Early Consultation

If your family member has fever for 2 days duration and rashes
on skin, consult your physician or visit the nearest health

If it is dengue, serious complications of the disease can develop.

If the complications are recognized early, and a doctor is
consulted, it may save the patients life.

4. Say No to Indiscriminate fogging

Fogging operations fail because

mosquitoes to other areas
Yes to fogging only during outbreaks.