I.

Introduction
Definition: (1) Dengue is a mosquito-borne viral infection causing a severe flu-like illness
and, sometimes causing a potentially lethal complication called severe dengue. Severe
dengue (previously known as dengue haemorrhagic fever) was first recognized in the
1950s during dengue epidemics in the Philippines and Thailand. The Aedes
aegypti mosquito is the main vector that transmits the viruses that cause dengue. The
viruses are passed on to humans through the bites of an infective
female Aedes mosquito, which mainly acquires the virus while feeding on the blood of
an infected person. The dengue virus (DEN) comprises four distinct serotypes (DEN-1,
DEN-2, DEN-3 and DEN-4) which belong to the genus Flavivirus, family Flaviviridae.
Statistics: (1) The incidence of dengue has increased 30-fold over the last 50 years. Up
to 50-100 million infections are now estimated to occur annually in over 100 endemic
countries, putting almost half of the world’s population at risk. Today it affects Asian and
Latin American countries and has become a leading cause of hospitalization and death
among children and adults in these regions.
Risk Factor: (2) Factors at greater risk of developing dengue fever or a more severe
form of the disease include: Living or traveling in tropical areas. Being in tropical and
subtropical areas increases the risk of exposure to the virus that causes dengue fever.
Especially high-risk areas are Southeast Asia, the western Pacific islands, Latin
America and the Caribbean. Prior infection with a dengue fever virus, previous infection
with a dengue fever virus increases the risk of having severe symptoms if you're
infected again.
Signs and Symptoms: (1) Individuals should suspect dengue when a high fever (40°C/
104°F) is accompanied by two of the following symptoms: Severe headache, Pain
behind the eyes, Nausea, Vomiting, Swollen glands, Muscle and joint pains and Rash.
Symptoms usually last for 2-7 days, after an incubation period of 4-10 days after the bite
from an infected mosquito. Severe dengue is a potentially deadly complication due to
plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ
impairment. The warning signs to look out for occur 3-7 days after the first symptoms in
conjunction with a decrease in temperature (below 38°C/ 100°F) include: Severe
abdominal pain, Persistent vomiting, rapid breathing, bleeding gums, blood in vomit,
fatigue and restlessness. The next 24-48 hours of the critical stage can be lethal; proper
medical care is needed to avoid complications and risk of death.
Preventive Measures: (2) Dengue fever vaccine (Dengvaxia), is currently approved for
use in those ages 9 to 45 that lives in areas with a high incidence of dengue fever. The
World Health Organization stresses that the vaccine is not an effective tool, on its own,
to reduce dengue fever in areas where the illness is common. Controlling the mosquito
population and human exposure is still the most critical part of prevention efforts.
Travelling in an area where dengue fever is known to be, the best way to avoid dengue
fever is to avoid being bitten by mosquitoes that carry the disease. Living or travelling in
tropical areas where dengue fever is common, the following may help reduce the risk of
mosquito bites: Stay in air-conditioned or well-screened housing. The mosquitoes that
carry the dengue viruses are most active from dawn to dusk, but they can also bite at
night. Wear protective clothing; wear a long-sleeved shirt, long pants, socks and shoes.
Use of mosquito repellent, Permethrin can be applied to clothing, shoes, camping gear
and bed netting. For skin, use a repellent containing at least a 10 percent concentration
of DEET. Reduce mosquito habitat. The mosquitoes that carry the dengue virus
typically live in and around houses, breeding in standing water that can collect in such
things as used automobile tires. Eliminates habitats where they lay their eggs, at least
once a week, empty and clean containers that hold standing water, such as planting
containers, animal dishes and flower vases. Keep standing water containers covered
between cleanings.
Medical, Pharmacological and Nursing Management: (1) There is no specific
treatment for dengue fever. Patients should seek medical advice, rest and drink plenty
of fluids. Paracetamol can be taken to bring down fever and reduce joint pains.
However, aspirin or ibuprofen should not be taken since they can increase the risk of
bleeding. For severe dengue, medical care by physicians and nurses experienced with
the effects and progression of the disease can frequently save lives. Maintenance of the
patient's circulating fluid volume is the central feature of such care.
Reference:
(1) World Health Organization, 2019 Retrived from
https://www.who.int/denguecontrol/disease/en/
(2) Dengue fever - Symptoms and causes - Mayo Clinic. Retrieved from
https://www.mayoclinic.org/diseases-conditions/dengue-fever/symptoms.../syc-
2035307...