At the hospital

At the hospital

Should you fly to a hospital in an industrialized country?

The care for dengue is relatively simple, and hospitals in endemic areas are probably more experienced with dengue than most hospitals in overdeveloped countries.

If the facility is reasonable, the personnel reasonably competent, and the patient reasonably happy, it's probably best to stay put.

An ideal situation might be a local hospital close to an airport.

Adequate follow up in a hospital (or small dengue clinic If there is no alternative):

• 
  
  Frequent (daily or twice daily) platelet count, hematocrit, blood pressure.
• 
  
  Adequate but not excessive hydration, IV If necessary.
• 
  
  Monitoring of patient well-being

Before discharge

• 
  
  Platelet count
• 
  
  Must have stable or increasing platelet count higher than 50,000
• 
  
  (below 50,000 risk of spontaneous bleeding is higher)
• 
  
  Blood pressure
• 
  
  Stable blood pressure (shows good hydration)
• 
  
  Hematocrit
• 
  
  Stable or falling (indicative of no or improvement in capillary leakage)
• 
  
  Pass 48 hours without fever
• 
  
  No vomiting
• 
  
  Doesn't have respiratory distress
• 
  
  From fluid in lungs.
• 
  
  Improved general constitution

Infants exposed to antibodies via pregnancy or mothers milk (Dengue)

Infants exposed to antibodies via pregnancy or mothers milk

• An infant who has been exposed to antibodies through pregnancy or mothers milk and still has them will react exactly the same as somebody who had dengue before. Maternal antibodies usually last up to 6 months or more.
• You can do an IGG test for infant, to determine. If your baby has antibodies or not.
• If a baby tests positive for IGM, they had their own direct infection.
• Not all babies get IGG from breast milk.
• If they test negative for IGG, they will respond to a subsequent dengue infection as an initial infection, not as a more dangerous second infection.
• Retest the baby six months after breastfeeding stops to see If he has own immunity, usually mom's antibodies only last 3-6 months.
• Classic dengue is generally milder in young people. But the risk of DHF increases in infants (less than 1 year) due to the presence of maternal antibodies. Risk of fatality from DHF with adequate treatment is similar across different age groups.
• More children contract dengue, because they have not been exposed to the virus previously and are susceptible.

Serologic testing of dengue

Serologic testing of dengue

Serologic testing is to see if you have develop antibodies against dengue virus. This will let you know your risk factor for subsequent infections.

IGM testing will give let you know if you've had dengue or not, within 30 days of infection.

IGG testing will let you know if you had dengue in the past (long term immunity)

If you think (or know) you've been exposed to dengue years before, IGG testing will show if you still have the antibodies, and thus are at greater risk of contract DHF from a subsequent infection—this is the most critical information.

Criteria for hospitalization

Criteria for hospitalization

Increasing hematocrit

Platelet count --less than 100,000mm3

Any spontaneous bleeding

Any warning sign for shock ( see shock related symptoms)

If not adequately treated, dehydration is what kills people (shock from loss of fluid), not the hemorrhage.

Give a lot of oral fluids and IV fluids without overload

Can hydrate adequately just from drinking in most cases

Precautions for people who've already had dengue

Precautions for people who've already had dengue

If you are returning to a dengue area after already having had dengue, you're at greater risk.

• Avoid getting bit
• Research beforehand a physician, clinic, or hospital which you trust to give you adequate treatment should you develop DHF.
• If you are in endemic areas as part of a development program and you're far from major medical care (as we are), see if you can include part or all of the elements of a "dengue mini-clinic" in your program (see below) so you can monitor your own or other dengue cases locally.

Dengue fever and papaya juice

Dengue fever and papaya juice

 chain letter about juice from papaya leaves as a miracle cure for dengue fever seems to be circulating in India, Indonesia, Philippines, Singapore and other countries

PASS THIS INFORMATION TO AS MANY AS YOU CAN, IT MAY SAVE
LIVES.
Dengue Fever Remedy

I would like to share this interesting discovery from a
classmate's son who has just recovered from dengue fever.
Apparently, his son was in the critical stage at the ICU
when his blood platelet count drops to 15 after 15 liters of
blood transfusion.
His father was so worried that he seeks another friend's
recommendation and his son was saved. He confessed to me
that he gave his son raw juice of the papaya leaves. From a
platelet count of 45 after 20 liters of blood transfusion,
and after drinking the raw papaya leaf juice, his platelet
count jumps instantly to 135. Even the doctors and nurses
were surprised. After the second day he was discharged. So
he asked me to pass this good news around.
Accordingly it is raw papaya leaves, 2pcs just cleaned and
pound and squeeze with filter cloth. You will only get one
tablespoon per leaf. So two tablespoon per serving once a
day. Do not boil or cook or rinse with hot water, it will
loose its strength. Only the leafy part and no stem or sap.
It is very bitter and you have to swallow it like "Won Low
Kat". But it works.
*Papaya Juice - Cure for Dengue*

Dengu Fever Fact Sheet

Dengu Fever Fact Sheet

Introduction

Dengue fever is a disease caused by infection with a type of virus called Flavivirus. There are four different subtypes of this virus producing varying manifestations of the disease.

The disease is spread through the bites of mosquitoes belonging to the Aedes egypti species. The disease is essentially a tropical one and is endemic in large parts of Latin and South America. Of late, its incidence has been on the increase in Asian countries such as India.

Cause and Pathogenesis

Dengue fever is transmitted to humans by the bite of the infected Aedes egypti mosquito. The Aedes mosquito breeds in relatively fresh water, lives close to human habitations and bites during the day. The incubation period between the bite and the onset of symptoms is usually two to seven days. The Aedes mosquito is also responsible for the spread of diseases such as yellow fever and Chikungunya virus fever.

Symptoms and Signs

A large number of infections may be sub-clinical, that is, the patients may not even be aware that they have had the disease. The infection usually manifests itself as fever with severe body pain or myalgia. There may be an associated rash over parts of the body. The body pain is so intense that this disease has been called break-bone fever. Quite often, the disease makes nofurther progress and the patients recover. However, some patients may develop involvement of either of the two dreaded syndromes in Dengue - bleeding (called DHF or Dengue Hemorraghic Fever) or involvement of the brain with altered consciousness (encephalitis). Fatalities are higher among patients in whom these complications are present. Joint pain is another symptom though there may not be true arthritis. Associated symptoms include severe headache, vomiting, and photophobia. Examination of the patient may reveal few findings such as a rash and pain on palpation of the muscles. These symptoms usually last for a period of two to five days and most patients who do not have complications recover completely.

The risk of complications appears to be greater in children, particularly the risk of bleeding and DHF with its high fatality rate. Some patients may also go into shock, a condition known as Dengue Shock Syndrome (DSS). This too carries a higher risk of mortality.

Investigations and Diagnosis

The diagnosis of dengue is based on the clinical presentation, knowledge of the area in which the person lives, and laboratory investigations. Blood tests may show a low white blood cell count, a low platelet count, and elevation of certain enzymes.

The definitive diagnosis is, however, made by isolating the virus in the blood of the individual during the acute phase of the disease or by detecting antibodies to the virus in the blood. Antigen detection is also possible. A rise in the antibody titre is a useful method of diagnosis. Investigations also need to be done to rule out other likely causes of fever such as malaria, and leptospirosis.

Treatment and Prognosis

Treatment is usually supportive and symptomatic. Analgesics, anti-pyretics, and broad-spectrum antibiotics are used during the acute phase to minimise the risk of secondary infection. In cases of bleeding, blood transfusions are required. Shock, if present, needs to be aggressively treated with fluids, oxygen, and close monitoring. Most patients will recover without any sequel. The overall mortality rate with effective treatment is close to 1% but this may be higher in children.

Prevention

Control and elimination of mosquito population is the best method of prevention. A vaccine is in the late stages of development but is still not available for commercial use on a large scale.

Control of the mosquito population reduces the incidence of dengue, yellow fever, and certain other rare fevers that are also transmitted by the same species of mosquito.

Using Weather Data To Predict Outbreaks

Using Weather Data To Predict Outbreaks

Weather has been identified as the main culprit for the spread of the tropical disease dengue fever which used to be restricted to areas in the tropics. Using weather data, one of the most recorded and studied natural phenomenon to predict outbreaks in the future has been seen to be one of the most effective ways to base predictions for as we know, the earth is under the spell of global warming. Like today’s recent weather, the ice caps in the poles are melting and areas that used to be ice-locked are now seeing sub-tropical weather thanks to erratic weather patterns. These weather patterns, though erratic can be predicted and using some of the most-powerful computers to run simulations it may be possible to make accurate predictions on where the disease is more likely to hit next.

Viral Outbreaks Cost Billions

Viral Outbreaks Cost Billions

People as we know it are responsible for spreading diseases and with recent outbreaks of dengue, swine and avian influenza, a very dangerous trend is being observed, they are taking shorter periods to spread. Swine flu pandemic has seen a very rapid spread of the disease throughout the world from the small town in Mexico where it all began. All these recent viral outbreaks is costing billions in losses due to lost business, absenteeism and the fear of the spreading disease that tends to get people out pf the streets fast. The pandemic status of Swine Flu quickly turned to that of damage control for no means of containment was proving effective for the virus was already out on the population. Swine flu has killed thousands but it underlies the more imminent danger from dengue, a far deadlier disease that has yet to get a vaccine out for the general public. And with recent strains of these viruses showing quick immunity to just released anti-viral drugs the job of researchers in finding cures that work is only getting harder by the day.

Dengue scare around the globe

Dengue scare around the globe

Dengue is associated with poorer tropical third world countries. Leaders in Thailand warned his countrymen of the dengue epidemic that took the lives of six Thais and infected 6000 more. the Cambodian government felt it only right to focus on prevention instead of a cure. Cambodia has one of the most numbers of people infected by the Dengue fever. The Dengue prevention organization also believes that educational programs are not prioritized seeing that resources to implement them are not evaluated on a regular basis. , Dengue casualties were reduced significantly with the advent of vaccines and anti-biotic along with deadly viruses such as smallpox, poliomyelitis, and acute rheumatic fever. The World Health Organization stated that since 1998, infectious and parasitic diseases killed one-third of all deaths in the world in 1997.

Dengue diet

Dengue diet

came upon this alternative healing webpage. Interesting enough, there is a section there about what food should be eaten by a dengue patient. It did not state why specific foods are allowed or not. Anyway, it is always best to ask a doctor first.

Dengue patients� main meal should consist of rice gruel and boiled vegetables. Oil is a no-no and so are spices, including salt, although lemon juice may be used to flavor bland dishes. Porridge, baked toasts, or biscuits can be eaten for snacks throughout the day. Tea must be made of fever reducing herbs such as ginger and tulsi. The only fruits that can be eaten are apples and plaintain.

DENGUE PREVENTION BASICS

DENGUE PREVENTION BASICS

The rate of deaths associated with dengue fever is now becoming less. But this does not mean that we should not put concern on it. Many of my friends had dengue and according to them, it is not easy. We should keep in mind that dengue fever is fatal and it must be prevented.
As what people who are associated with the health department say, we must prevent it. And this is prevented by particularly, keeping our homes clean—inside and outside.
Aedes Aegypti, the kind of mosquito that carries the disease, lays their eggs in stagnant water which is found in our homes. Change the water in flower vases every other day to prevent the mosquitoes from laying their egg there. And keep the water containers covered,.
For yourself, see to it that you apply mosquito repellant lotion. Several are available in the market with variations of scents.

Dengue Vaccine – Why the Urgency?

Dengue Vaccine – Why the Urgency?

The outbreaks of many diseases that used to be contained in isolated incidents has become a thing of the past, thanks to modern travel, mostly by air which can reach all corners of the world in less than a day. The recent outbreak of swine flu, a totally different virus more akin to the bird-flu outbreak we had was a first time test of a virus that spread so fast it got out of the containment level before authorities could react. Weaknesses have been exposed and the many gaps of even the best funded government’s health services put to the test. In the end, the world was unprepared for the outbreak which has added to the many problem super-bugs we are now dealing from dengue, avian and swine flu among some of the most recent.

Origins of Dengue

Origins of Dengue

Dengue fever first occurred as a simultaneous epidemic in Africa, Asia, and North America in the late 1700s and was identified and named in 1779. It was in the 1950s and 1970s when another global onslaught happened. It began in Southeast Asia but spread widely soon after. Dengue fever became more common with sporadic outbreaks happening through the years

What is dengue

What is dengue

Dengue Fever: NIAID

WHAT IS DENGUE FEVER?

Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called break-bone fever because it sometimes causes severe joint and muscle pain. Health experts have known about dengue fever for more than 200 years.

Dengue fever is found mostly during and shortly after the rainy season in tropical and subtropical areas of

• Africa
• Southeast Asia and China
• India
• Middle East
• Caribbean and Central and South America
• Australia and the South and Central Pacific

An epidemic in Hawaii in 2001 is a reminder that many states in the United States are susceptible to dengue epidemics because they harbor the particular types of mosquitoes that transmit it.

The World Health Organization estimates 50 million cases of dengue infection occur each year. This includes 100 to 200 cases reported annually to the U.S. Centers for Disease Control and Prevention (CDC), mostly in people who have recently traveled abroad. From 1977 to 1994, U.S. health care workers reported to CDC 2,248 cases of dengue that had been imported into this country. Many more cases probably go unreported because some doctors do not recognize the disease.

During the last part of the 20^th century, cases of dengue began to increase in many tropical regions of the world. Epidemics also began to occur more frequently, and to be more severe. In addition to typical dengue, a severe influenza-like disease-dengue hemorrhagic fever-also has been increasing in many parts of the world.

HOW IS DENGUE FEVER TRANSMITTED?

People get dengue virus infections from the bite of an infected Aedes mosquito. Mosquitoes become infected when they bite infected humans, and later transmit infection to other people they bite. The two main species of mosquito, Aedes aegypti and Aedes albopictus, have been responsible for all cases of dengue transmitted in this country.

WHAT KIND OF VIRUS CAUSES DENGUE FEVER?

Dengue fever can be caused by any one of four types of dengue virus: DEN-1, DEN-2, DEN-3, and DEN-4. A person can be infected by at least two, if not all four types at different times during a life span, but only once by the same type.

WHAT ARE THE SYMPTOMS OF DENGUE FEVER?Symptoms of typical uncomplicated dengue usually start with fever within 5 to 6 days after a person has been bitten by an infected mosquito.

• High fever, up to 105 degrees Fahrenheit
• Severe headache
• Retro-orbital (behind the eye) pain
• Severe joint and muscle pain
• Nausea and vomiting
• Rash

The rash may appear over most of the body 3 to 4 days after the fever begins. A second rash may appear later in the disease.

Interestingly, most children infected with dengue virus never develop typical symptoms.

HOW IS DENGUE FEVER DIAGNOSED?

A doctor or other health care worker can diagnose dengue fever by doing a blood test. The test can show whether the blood sample contains dengue virus or antibodies to the virus. In epidemics, dengue is often clinically diagnosed by typical signs and symptoms.

HOW IS DENGUE FEVER TREATED?

There is no specific treatment for dengue fever, and most people recover completely within 2 weeks. To help with recovery, health care experts recommend

• Getting plenty of bed rest.
• Drinking lots of fluids.
• Taking medicine to reduce fever.

CDC advises people with dengue fever not to take aspirin. Acetaminophen or other over-the-counter pain-reducing medicines are safe for most people.

HOW CAN DENGUE FEVER BE PREVENTED?

The best way to prevent dengue fever is to take special precautions to avoid contact with mosquitoes. Several dengue vaccines are being developed, but none is likely to be licensed by the U.S. Food and Drug Administration in the next few years.

When outdoors in an area where dengue fever has been found,

• Use a mosquito repellant containing DEET.
• Dress in protective clothing—long-sleeved shirts, long pants, socks, and shoes.

Because Aedes mosquitoes usually bite during the day, be sure to use precautions especially during early morning hours before daybreak and in the late afternoon before dark.

Other precautions include

• Keep unscreened windows and doors closed.
• Keep window and door screens repaired.
• Get rid of areas where mosquitoes breed, such as standing water in flower pots or discarded tires.

CAN DENGUE FEVER LEAD TO OTHER HEALTH PROBLEMS?

Most people who develop dengue fever recover completely within two weeks. Some, however, may go through several weeks of feeling tired and/or depressed.

Others develop severe bleeding problems. This complication, dengue hemorrhagic fever, is a very serious illness which can lead to shock (very low blood pressure) and is sometimes fatal, especially in children and young adults.

NIAID RESEARCH

Scientists supported by the National Institute of Allergy and Infectious Diseases (NIAID) are trying to develop a vaccine against dengue by modifying an existing vaccine for yellow fever. Researchers in NIAID laboratories in Bethesda, Maryland, are using weakened and harmless versions of dengue viruses as potential vaccine candidates against dengue and related viruses.

Other researchers supported by NIAID are investigating ways to prevent dengue viruses from reproducing inside mosquitoes.

Because dengue virus has only recently emerged as a growing global threat, scientists know little about how the virus infects cells and causes disease. New research is beginning to shed light on how the virus interacts with humans — how it damages cells and how the human immune system responds to dengue virus invasion.

Dengue fever: Introduction

Dengue fever: Introduction

Dengue fever, also called dengue, is a potentially serious disease caused by a virus. There are four types of dengue virus that can cause illness in humans. Dengue viruses are transmitted between humans by the bite of an infected Aedes mosquito.

Dengue is rare in the U.S., but is common and a serious public health threat in warm sub-tropical and tropical areas of the world. These include areas of Central and South America, Africa, Southeast Asia, China, India, the Middle East, Australia, the Caribbean and the South and Central Pacific. Dengue fever is most common in urban areas and outbreaks occur commonly during the rainy season when mosquitoes breed heavily in standing water. The incidence of dengue fever is on the rise worldwide, and in some areas of Asia, complications of the disease are a leading cause of serious illness and death in children.

Mosquitoes pick up a dengue virus when they bite a human who is already infected with the virus. The mosquito then carries it in its own blood and spreads it when it bites other humans.

After a dengue virus enters the human bloodstream, it spreads throughout the body. Symptoms appear in about eight to ten days after a bite from an infected mosquito. Symptoms are flu-like and can include high fever, nausea, vomiting, body aches, and headache

Treatments for Dengue fever:

Treatments for Dengue fever:

The first step in treating dengue fever is prevention. Prevention measures include controlling mosquito populations in warm sub-tropical and tropical areas of the world. This includes draining areas and objects that can hold standing water and become a breeding ground for mosquitoes, such as old tires, puddles, and bird baths. Wearing insect repellent that contains DEET, picaridin, or oil of lemon eucalyptus and wearing protective clothing that covers the whole body are also important preventive measures.

There is no definite treatment for or vaccine to prevent dengue fever. Most people who get dengue fever will recover in about 2 weeks to a month by getting plenty of rest, increasing fluid intake and taking acetaminophen (Tylenol) for fever and body aches. People with dengue fever should not take aspirin or medications that contain aspirin because it increases the risk for severe bleeding.

Hospitalization and intensive care is required for people who develop the life-threatening complications of dengue hemorrhagic fever and dengue shock syndrome These complications can occur in anyone but happen most often in children.

Dengue Fever At A Glance

Dengue Fever At A Glance

• Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes.
• Symptoms such as headache, fever, exhaustion, severe joint and muscle pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue fever.
• Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and Central America.
• Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue fever, the treatment is purely concerned with relief of the symptoms (symptomatic).
• The acute phase of the illness with fever and myalgias lasts about one to two weeks.
• Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock).
• The prevention of dengue fever requires control or eradication of the mosquitoes carrying the virus that causes dengue.
• There is currently no vaccine available for dengue fever.

Dengue Fever (cont.)

How can dengue fever be prevented?

The transmission of the virus to mosquitoes must be interrupted to prevent the illness. To this end, patients are kept under mosquito netting until the second bout of fever is over and they are no longer contagious.

The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue. In nations plagued by dengue fever, people are urged to empty stagnant water from old tires, trash cans, and flower pots. Governmental initiatives to decrease mosquitoes also help to keep the disease in check but have been poorly effective.

To prevent mosquito bites, wear long pants and long sleeves. For personal protection, use mosquito repellant sprays that contain DEET when visiting places where dengue is endemic. Limiting exposure to mosquitoes by avoiding standing water and staying indoors two hours after sunrise and before sunset will help. The Aedes aegypti mosquito is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas.

There is currently no vaccine available for dengue fever. There is a vaccine undergoing clinical trials, but it is too early to tell if it will be safe or effective. Early results of clinical trials show that a vaccine may be available by 2012.