72

D EM A M B ER DA R A H D EN GU E
Su h e n d ro d Na i n g g o la n ,
, L e o n a r K h ie C h e n , H e r d im a n T . Po h a n

P EN D A H U L U A N
EP I D EM I O LO G I

De m a m d e n g u e ( D F) d a n d e m a
m b e rd a ra h d e n u e D B D
g ( ) De m am b e rd a ra h d e n g u e t e rse b a r d i w ila y a h A s ia
(de n g u e h o e m o r r h o g i c f e v e r ( D H F a d a l a h e n a k i i
) p y t n fe k si Te n g g a ra , P a s i f i k b a r a t d a n K a r i b i a . In d o n e s ia m e r u p a k a n

ya n g d i s e b a b k a n o l e h v i r u s d e n u e d e n g g a n m a n if e st a s i w i la y a h e n d e m is d e n g a n se b a ra n d i se lu ru h w ila y a h
kl i n i s d em am n e r i o t o t / at au ny e ri se n d i a n t a n a h a i r In s i d e
g d is e r t a i
, d a n
y
y . n D BD d i In d o n e sia a n t a ra 6 h in g g a 15
le u k o p e n ia , r u a m l i m f a d e n o
00 0 p e n d
,
p
a t i , t r o m b o s i t o
p
e n i a d a n
pe r 10 0 . u d u k ( 19 8 9 h in g g a 1 9 9 5 ); d a n p e rn ah
d ia t e s i s h e m o r a ik Pa d a D B D t e r a d i e re m b e sa n
g p la sm a m e n in g k a t t aj a m
.

j p sa at k e j a d ia n lu a r b ia sa h in g g a 3 5 p e r
ya n g d it a n d ai d en g an h e m o k o n se n t ra si (p e n in g k a t a n 10 0 000 p e n d
. u d u k p ad a t a h u n 19 9 8 , s e d a n
g
k a n m o r t a l i t a s

he m a t o k r i t ) atau p enu m p u kan c a ir a n d i ro n g g a tu b u h D BD ce n d e ru n g m enu ru n h in g g a m e n ca p a i 2 95 p a d a

.

Si n d r o m r e n j a t a n d e n g u e (d e n u e s h o c k s n d r o m e a d a la h
g y ) ta hu n 19 9 9 ,

de m am b e rd a ra h d e ng u e y a n g d it a n d a i o le h re n a t a n /
j Pe n u la ra n in fe ksi v iru s d e n g u e t e rj a d i m e la lu i

sy o k v e k t o r n y a m u k g e n u s A e d e s (t e r u t a m a A
g yp t i d a n A
.
. o e .

o l b o p i c t u s) . Pe n i n g k a t a n k a s u s s e t i a p t a h u n n y a b e r k a it a n

de n g an s a n it a s i l i n g k u n g a n d e n g an t e r s e d ia n y a te m p at

ET I O LO G I p e r i n d u k a n b a g i n y a m u k b e t i n a y a it u b e j a n a y a n g b e r is i a i r
j e r n ih ( b a k m a n d i, k a l e n
g
b e k a s d a n t e m
p
a t
p
e n a m
p
u n
g
a n

De m am d eng u e d a n d e m am b e r d a ra h d e n g u e d is e b a b k a n a ir la in n y a ) .

o le h v i r u s d e n g u e , y
a n
g
t e r m a s u k d a ta m
g
e n u s F l a v iv i r u s , Be b e ra p a fa k t o r d ik e t a h u i b e r k a it a n d e n g a n

ke l u a r g a F la v iv i r i d a e . Fl a v iv i r u s m e ru p a ka n v ir u s d e n g a n pe n in g k at a n t ra n sm isi b ia k a n v iru s d e n g u e y a it u : 1) .

d ia m e t e r 3 0 n m t e rd ir i d a r i a sa m r i b o n u k le a t r a n t a i t u n g g a l v e kt o r : p e r k e m b a n g b ia k a n v e k t o r, k e b i a s a a n m e n
g g
i
g
i t
,

de n g a n b e r a t m o le k u l 4 10 6 .
ke p a d a t a n v e kt o r d i lin g k u n g a n , t r a n s
po rt a si v e kt o r d a ri

Te r d ap at 4 s e r o t i p e v i ru s y a it u D EN -
1, D E N
-
2 , D E N
-
3 sat u t e m p at ke t e m p at la in ; 2 ) .
pej a m u : t e rd a p a t n y a

da n D EN -
4 ya n g se m u any a d a p a t m e nye b ab kan d em am p e n d e r it a d i l i n g k u n g a n / k e l u a r g a , m o b i l i s a s i d a n
p
a
p
a r a n

de n g ue atau d em am b e rd a ra h d e n g u e . Ke e m p a t se ro t ip e terh ad ap ny am u k , u s i a d a n
j e n is k e la m in ; 3 ) . Ii n g ku n g an :

d it e m u ka n d i In d o n e s ia d e n g a n D EN
-
3 m e ru p a k a n cu ra h h uj a n , s u h u
, s a n it a s i d an ke p ad at an p e nd u d u k .

Te r d a p a t r e a k s i s i l a n g a n t a r a se ro t ip e
se ro t y p e t e r b a n y a k .

a n ese
d e n g u e d e n g a n F l a v i v i r u s l a i n s e p e r t i Ye l l o w / e v e q J a p
PA T O G EN ES I S
e n c e p h o t i t i s d a n W e st N i t e v i r u s .

re p lik a si
Da ta m la b o r a t o r iu m v ir u s d e n g u e d a p a t b e

t ik u s, n
jin g Pa t o g e n e sis t e rj a d i n y a d e m a m b e rd a ra h d en
g u e h in g g a
se p e rt i k e l i n c i , a ,

pa d a h e w a n m a m a lia
h ew an sa a t in i m a sih d ip e rd e b a t k a n
Su r v e i e p i d e m i l o g i p a d a
.

ke l e l a w a r d a n p rim
ata .

d a p v ir u s d e n g u e p a d a
Be r d a sa rka n d at a y ang ad a da p at b u kt i
y a ng
t e r

t e r n a k d id a p a t k a n a n t i b o d i t e r h a
,

it i a n p a d a a r t r o p o d a ku a t b a h w a m e k a n is m e i m u n o p a t o lo i s b e r e r a n d a ta m
h e w a n k u d a , s a p i d a n b a b i Pe n e l .
g p

d a ny am u k te rja d in y a d e m a m b e rd a r a h d e n g u e d a n sin d ro m
a a t b e re p lik a si p a
re n ja t a n
m e n u n j u k k a n v ir u s d e n g u e d p
it e s de n g u e
d a n To x o r h y n c h
.
.
o
g e n u s A e d e s ( St e g o m y i )

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