Presented By

Khushal Khan, Kainat Khan

Tariq Jamil, Saman Bakhtiar
INS-KMU
 Define Dengue Fever
 Explain causes of DF
 Enlist sign and symptoms of DF
 Describe history of dengue
 Identify classification of DF
 Describe Epidemiology of DF
 Discuss the Diagnosis and Treatment of DF
 Elaborate complications of DF
 Evaluate its prevention and control of DF
• Definition:
o Dengue fever is a mosquito-borne tropical
disease caused by the dengue virus
o It is also known as “break bone fever” or
“Dengue Hemorrhagic Fever”
o It is an acute fever producing infectious
disease

Bauman,R.,(2006).Microbiology disease by systems.San Francisco

,CA: Pearson Benjamin Cumming Publisher
 Dengue is caused by Dengue virus.
 Dengue fever virus (DENV) is an RNA virus of
the family Flaviviridae; genus Flavivirus.
 Also referred to as arboviruses (arthropod-
borne viruses).
-because most are transmitted by
arthropods (mosquitoes or ticks).
 Dengue virus genome -11,000 nucleotide
bases,
Code for the three different types of
protein molecules
(C, prM and E) form the virus particle

o Seven other non-structural protein

molecules (NS1, NS2a, NS2b, NS3, NS4a,
NS4b, NS5)
 Five strains of the virus,
called serotypes, of which the first four
are referred to as DENV-1, DENV-2, DENV-3 and
DENV-4.
 Signs and symptoms usually begin
about 4 to 7days after being bitten by
A.aegypti

o High grade Fever 105 F

o Headache
o Backache
o Muscle and Joint pain
o Skin Rash
o Nausea and Vomiting
 Clinical
prescription date as far back as 992
AD in China

 David Bylon in 1779

-“knokkelkoorts” --- joint fever

 Benjamin Rush
-Termed “break bone fever”
 The World Health Organization's 2009
classification divides dengue fever into two
groups:
-Uncomplicated
-Severe

- Severe dengue is defined as that

associated with severe bleeding, severe organ
dysfunction, or severe plasma leakage while all
other cases are uncomplicated
 Most people with dengue recover without any
ongoing problems.
 The fatality rate is 1–5%, and less than 1%
with adequate treatment; however those
who develop significantly low blood pressure
may have a fatality rate of up to 26%.
 Dengue is common in more than 110
countries.
 In 2013 it causes about 60 million
symptomatic infections worldwide, with 18%
admitted to hospital and about 13,600
deaths.
 12 countries in Southeast Asia were
estimated to have about 3 million infections
and 6,000 deaths annually.

 Itis reported in at least 22 countries in

Africa; but is likely present in all of them
with 20% of the population at risk.
Onset ; 3–14 days after exposure

Occurrence: Endemic

Incubation Period:
2–7 days[1]
 Dengue virus is primarily transmitted by
Aedes mosquitoes, particularly A. aegypti.
 Humans are the primary host of the virus,
but it also circulates in nonhuman primates.
 An infection can be acquired via a single
bite
 Also through infected blood products and
through organ donation.
 Vertical transmission (from mother to child)
during pregnancy or at birth
 Detection of antibodies against the virus
-Rapid test IgG/IgM
 Antigen Detection
- NS1 antigen
 RNA Detection
-PCR
 Viral isolation
 Complete blood count

 Platelet count

 Travel history and symptom profile

 The earliest change detectable on laboratory
investigations is a low white blood cell
count, which may then be followed by low
platelets.

 In severe disease, plasma leakage results in

hemoconcentration (as indicated by a rising
hematocrit) and hypoalbuminemia.Pleural
effusions or ascites can be detected by
physical examination
 Nospecific therapeutic agents exists for
Dengue infections

 Supportive care –Bed rest

-Intravenous fluids

 Acetaminophen to control fever

 Aspirin
should be avoided due to its
anticoagulant properties .
 Blood transfusions – in severe dengue
infection
 Monitoring of sign and symptoms for the warning
signs

Price D.D., Wilson S.R.,(2009) dengue fever :differential diagnose

and workout. Medscape. Retrieved APRIL 19,2010 from
http://emedicine .meddscope.com/article/781951-diagnsis
 Bleeding
 Low levels of blood platelets
 Dangerously low blood pressure
 If severe, dengue fever can damage the lungs,
liver or heart. Blood pressure can drop to
dangerous levels, causing shock and, in some
cases, death
 Dengue fever vaccine
 Decreasing mosquito exposure
 Reducing mosquito habitat
 Limiting exposure to bites
 Covering standing water
 Wearing clothing that covers much of the
body
 Using insecticides ,guppy (Poecilia reticulata)
or copepods in standing water to eat the
mosquito larvae).
 Ryan,KJ; Ray CG, eds.(2004). Sherris Medical
Microbiology (4th ed). McGraw Hill.pp396-401.
ISBN 0-8385-8529-9

 John TJ; Cherian T; Steinhoff MC; Simones EA;

etal.(1991 “The global distribution and burden
of dengue”. Rev Infect Dis.13 Suppl 6;s465-9