Dengue Fever; Nightmares and mass death in Aden city
Dengue virus infections are serious cause of morbidity and mortality in most tropical and subtropical areas of the world mainly in southeast and South Asia.
In April 2015 started the civil war in Aden and southern Yemen. During this war most of the hospitals closed with decrease health care.
Manifestations of high fever, headache , skin rash, bleeding ( nasal, gum).
The symptoms progress to massive bleeding, shock and death.
The nightmare was severe and the death was massive.
Dear Prof, my country has been battling dengue fever. In my state (Selangor), dengue has been on the rise, and death due to dengue has increased a lot. I had dengue once, but several of my friends contacted dengue twice. My neighbor, a 50 year old man died of dengue a year ago.
'Dengue fever cases in Selangor continue to rise with 12,427 cases recorded until Feb 21 compared to only 7,507 cases over the corresponding period last year, up by 66 per cent.' Read more: http://www.theborneopost.com/2015/02/26/selangor-dengue-fever-cases-up-by-66-per-cent/#ixzz3fTqUlUyd
"Management of severe dengue requires careful attention to fluid management and proactive treatment of hemorrhage. There is no specific antiviral treatment currently available for dengue fever. Supportive care with analgesics, fluid replacement, and bed rest is usually sufficient. Acetaminophen may be used to treat fever and relieve other symptoms. Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids should be avoided."
http://emedicine.medscape.com/article/215840-treatment
Dear Colleagues,
Good Day,
"Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ~50 million dengue infections and ~500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes. A global strategy aimed at increasing the capacity for surveillance and outbreak response, changing behaviours and reducing the disease burden using integrated vector management in conjunction with early and accurate diagnosis has been advocated. Antiviral drugs and vaccines that are currently under development could also make an important contribution to dengue control in the future."
please, see the first website for more detail, and see the article on "
Guidelines on Clinical Management of Dengue Fever/ Dengue Haemorrhagic Fever", on the second website.
http://www.nature.com/nrmicro/journal/v8/n12_supp/full/nrmicro2460.html
http://www.slideshare.net/alshafipdk/guidelines-on-clinical-management-of-dengue-fever-dengue-hemorrhagic-syndrome
https://en.wikipedia.org/wiki/Dengue_fever
http://www.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-dengue
Dengue fever has been classified as Dengue , Dengue with warning signs & severe Dengue . The decision to be taken is whether to admit the patient or treat them as outpatients . The treatment is to give a) paracetamol to control fever & body pain & b) give adequate fluids to treat hypotension .
If the patient has fever , with no vomiting or abdominal pain , he can be treated as mild dengue with instructions to take adequate oral fluids . If he has warning signs such as vomiting , abdominal pain , cold peripheries & thrombocytopenia , he should be admitted & given IV fluids , as per guidelines . If he is in shock due to severe dengue , he should be resuscitated with iv fluids immediately .
Dengue fever has emerged as the most important cause of acute febrile illness in tropical developing countries . The 2009 WHO guidelines has simplified the management & is valuable for primary care doctors . The role of adequate fluid therapy is the cornerstone of treatment in improving survival .
Dengue is a febrile illness caused by a flavivirus transmitted by Aedes aegypti or Aedes albopictus mosquitoes while taking a blood meal. There is four dengue virus (DENV) types (DENV-1, DENV-2, DENV-3, and DENV-4), all of which are capable of inducing severe disease (dengue hemorrhagic fever [DHF]/dengue shock syndrome [DSS]). The likelihood for the development of severe dengue is highest among individuals who are infected a second time by a different DENV type from the first infection (known as secondary or heterotypic infection). DENV transmission occurs when susceptible hosts, DENVs, and mosquitoes capable of transmission are co-located in space and time. Infection risk exists for anyone living in or traveling in a dengue-endemic region, especially in tropical Asia, Central, and South America, and the Caribbean. In most of these regions, DENV transmission occurs year-round. However, the greatest risk of infection tends to be seasonal or during a recognized outbreak. For more information kindly check:
https://www.uptodate.com/contents/dengue-virus-infection-prevention-and-treatment
Also, kindly check:
https://www.epid.gov.lk/web/images/pdf/Publication/guidelines_for_the_management_of_df_and_dhf_in_adults.pdf
https://www.cdc.gov/dengue/resources/dengue-clinician-guide_508.pdf
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