has a clinical spectrum can range from a specific viral syndrome to a severe and fatal hemorrhagic disease
Dengue Virus
Caused by:
- virus called Flavivirus
- It consists of a single-stranded RNA
- Arbovirus: who are those viruses transmitted by vectors.
- has 4 serotypes
This virus can cause: fever Dengue and Dengue Hemorrhagic
DENGUE IN THE AMERICAS
serotypes in Latin appeared in the following order:
DEN-2: 1970.
DEN-1: 1977.
DEN-4: 1981.
EPIDEMIC DEN-2 DEN -3 CUBA.1981
: 1994. NICARAGUA AND PANAMA - VENEZUELA 2000.
A guy in your life can be 4 times dengue. One serotype does not protect against the other from the immunological point of view.
All serotypes in a given time they can cause dengue hemorrhagic fever, but in order of frequency and severity are: DEN2> DEN3> DEN4> DEN1
TRANSMISSION AND REPLICATION
How soon after exposure?
occurs through the bite of female Aedes aegypti mosquito that has white to the human element, and enter the virus, any organ can be affected as this through the movement produces an initial viremia may affect body. That is why obviously the initial symptoms are general.
CRITERIA FOR DIAGNOSIS OF DENGUE FEVER AND DENGUE HEMORRHAGIC
FEVER DENGUE
is based on:
-
- Clinical Criteria for Clinical Laboratory Standards
- Epidemiologic criteria
- Clinical Criteria:
. Fever 2 to 7 days, occasionally biphasic, with two or more of the following clinical manifestations:
· Headache
· Pain retroocular,
· Decay,
· Myalgia, Arthralgia
·,
· Abdominal pain,
· maculopapular rash, · Hemorrhagic manifestations (mild skin and mucous membranes).
- Laboratory Criteria If
Clinical Laboratory has, consider:
· Leukopenia, with a trend towards lymphocytosis (from 4 to 5 days from the onset of symptoms) , · Platelets decreased or normal. · Hematocrit unchanged, normal coagulation test.
- Epidemiologic criteria
presence in the locality of a laboratory-confirmed case at that time
DHF
Clinical Criteria
· Fever of 2 to 7 days, occasionally biphasic
· Manifestations bleeding, ranging from a "test loop "positive, moderate to severe bleeding skin and mucous membranes, generalized petechiae, ecchymosis, hematomas, epistaxis, gingival bleeding, hematemesis, hematochezia, melena, hematuria, metrorrhagia.
Laboratory Criteria
addition to other clinical criteria Probable Case Dengue Fever.
· Thrombocytopenia (platelet levels 100.000/mm3 or less).
· Hematocrit
• Increased over 20% (from 4 to 5 days after the onset of symptoms), · Decrease by 20% or more in the period of convalescence.
· Hypoproteinemia.
Paraclinical Criteria
• Evidence of plasma leakage (Spills):
· Pleural, Ascites
·,
· thickened bile duct walls,
· Pericardial
· To articulate, evidenced by RX , ultrasonography and / or echocardiogram.
CLASSIFICATION OF SEVERITY dengue hemorrhagic fever
Grade I
• Criteria for clinical laboratory and Dengue Hemorrhagic Case Likely. Single
hemorrhagic manifestation "test loop" or positive tourniquet.
Grade II
• Criteria Grade I.
· spontaneous bleeding:
· epistaxis, gingival
·,
· Generalized petechiae,
· other.
Grade III
• Criteria Grade II.
· Home of shock (DSS)
· Signs warning:
· abdominal pain,
· Vomiting,
· asthenia, hypotension
·,
· sweating, coldness
· distal
· Irritating.
Grade IV
· Signs of profound shock (circulatory failure)
· metabolic acidosis,
· bleeding or not, CID,
· seizure
Eat,
· Death.
unusual presentations. DENGUE
-
- encephalopathy liver damage
- Cardiomyopathy
- severe gastrointestinal hemorrhage
LABORATORY DIAGNOSIS
1 .- hematology
aminotransferases
Urinalysis Albumin
2 .- Specific Test Dengue:
Insulation: Serotypes
Serology: IgM ELISA
Dengue IgM IgG IgM
: 3 to 5 days after onset of fever and persists for 30 to 90 days
only IgG
Primary Infection: Raises 1 to 2 days after onset of infection, with elevated IgM = second infection
DIFFERENTIAL DIAGNOSIS
-
- Influenza Measles Rubella
-
-
- Malaria Typhoid fever Leptospirosis
-
- eningococcemia
- Rickettsiosis
- Bacterial Sepsis
- Other viral hemorrhagic fevers
CLINICAL EVALUATION DENGUE
-Blood Pressure-State-Increase hydration
vascular permeability:
-Stroke ascites, pleural
tourniquet test
TOURNIQUET TEST
- Inflate handle tensiometer at the midpoint of the PS and PD for 5 minutes
- Positive test: 20 or more petechiae per square inch = 6.25 cm square
HOSPITALIZATION CRITERIA
- signs of Alarm
- hemorrhagic manifestations: epistaxis and hematemesis, melena, rectal bleeding. Platelets
TREATMENT
- FLUIDS
- REST
- ANTIPYRETICS
- MONITOR: TA, HTO, PLATELETS, LEVEL OF CONSCIOUSNESS
- bednet use
Remember. - 1. Dengue fever is a potentially fatal disease, but it is preventable and curable in most cases, all depends on your prompt attention.
- 2. Suspecting that this disease may go immediately to your health center to receive medical care.
Prevention
• Regularly clean the yard and inside your home, remove containers that can collect water and can serve as a shelter for the mosquito • Cover water containers permanently.
• Do not litter on the street, and that it can be standing water and to allow the flies from laying their eggs there, favoring the presence of mosquitoes around your home.
Combat mosquito Aedes aegypti is an essential task. She does not require sophisticated equipment but coherent and integrated actions that prioritize efficiency and effectiveness, which requires sustained work over time, which involves all stakeholders. This implies the involvement of the entire population (and that dengue is primarily intradomiciliary sanitation problem), non-governmental organizations (such as binders, collective action), university (where the systematic knowledge and the relationship of research supports the technical-scientific support), and authorities at different levels (contributing to coordination actions).
only way to permanency planning.
"PREVENT DENGUE IT DEPENDS"
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