INTRODUCTION

During our one month of stay at Rizal Medical Center,

pay ward 2 for RLE, we handled several cases of
dengue. The seventy five percent of admitted patients
are hospitalized because of dengue febrile syndrome.

DENGUE FEBRILE SYNDROME AND DENGUE

HEMORRHAGIC FEVER are acute infectious disease
manifested initially with fever. Aedes aegypti, the
transmitter of the disease, is a day-biting mosquito
which lays eggs in clear and stagnant water found in
flower vases, cans, rain barrels, old rubber tires, etc. It
is also an acute febrile disease transmitted by
mosquitoes, which occur in the tropics, can be life-
threatening, and are caused by four closely related
virus serotypes of the genus Flavivirus, family
Flaviviridae. It is also known as breakbone fever, since
it can be extremely painful.

It occurs widely in the tropics, including continental

USA, northern Argentina, northern Australia,
Bangladesh, Barbados, Bolivia,Belize, Brazil, Cambodia,
Colombia, Costa Rica, Cuba, Dominican Republic, French
Polynesia, Guadeloupe, El Salvador, Grenada,
Guatemala, Guyana, Haiti, Honduras, India, Indonesia,
Jamaica, Laos, Malaysia, Melanesia, Mexico, Micronesia,
Nicaragua, Pakistan, Panama, Paraguay,The Philippines,
Puerto Rico, Samoa, Western Saudi Arabia, Singapore,
Sri Lanka, Suriname, Taiwan, Thailand, Trinidad and
Tobago, Venezuela and Vietnam, and increasingly in
southern China.

Unlike malaria, dengue is just as prevalent in the

urban districts of its range as in rural areas. Each
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serotype is sufficiently different that there is no cross-
protection and epidemics caused by multiple serotypes
(hyperendemicity) can occur. Dengue is transmitted to
humans by the Aedes (Stegomyia) aegypti or more
rarely the Aedes albopictus mosquito.

The mosquitoes that spread dengue usually bite at

dusk and dawn but may bite at any time during the day,
especially indoors, in shady areas, or when the weather
is cloudy. The adult mosquitoes rest in dark places of
the house. The WHO says some 2.5 billion people, two
fifths of the world's population, are now at risk from
dengue and estimates that there may be 50 million
cases of dengue infection worldwide every year. The
disease is now endemic in more than 100 countries

There are four grades of dengue Grade 1, Fever and

nonspecific constitutional symptoms, positive
tourniquet test is only hemorrhagic manifestation.
Grade 2, grade 1 manifestations plus spontaneous
bleeding. Grade 3, the signs of circulatory failure. Eg:
rapid/weak pulse, narrow pulse pressure, hypotension,
cold/clammy skin. Grade 4, Profound shock
(undetectable pulse and BP).

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GENERAL OBJECTIVES

We, group b, will be able to gain knowledge regarding

the severity of the cases of one of the epidemic infectious
diseases known as dengue febrile syndrome grade 3.