Dengue fever is an acute mosquito-borne infection caused by the dengue viruses. This is found in tropical and sub-tropical regions around the world. For instance, dengue fever is an endemic illness in many countries in South East Asia. The dengue viruses encompass four different stereotypes, each of which can lead to dengue fever and dengue hemorrhagic fever.

Clinical features

Dengue fever is clinically characterized by sudden onset of high fever, severe headache, pain behind the eyes, muscle and joint pains, anorexia, nausea and rash. Young children may exhibit a milder non-specific febrile illness with rash.

Dengue hemorrhagic fever is a severe and potentially fatal complication of dengue fever. Initially, the features include high fever, which lasts two to seven days and can be as high as 40-41 oC, facial flush and other non-specific constitutional symptoms of dengue fever. Later, it may be followed by the manifestation of bleeding tendency such as skin bruises, nose or gum bleeding, and possibly internal bleeding. In severe cases, it may progress to circulatory failure, shock and die.

Immunity is gained against that stereotype after recovery from its infection. However, no effective protection is conferred against subsequent infection by the other three stereotypes.

Mode of transmission

Dengue fever is transmitted to humans through by the bites of female Aedes mosquitoes which are infected with a dengue virus. It cannot be spread directly from human to human. In Hong Kong, the principal vector Aedes aegypti is not found, but the prevailing species Aedes albopictus can also spread the disease.

Incubation period

The incubation period ranges from 3 to 14 days, commonly 4 to 7 days.

Management

There is no specific medication for dengue fever or dengue hemorrhagic fever. Dengue fever is mostly self-limiting. Symptomatic treatment is given to provide relief from fever and pain. Patients with dengue hemorrhagic fever should be treated promptly with supportive management. The mainstay of the treatment is to maintain the circulating fluid volume. With appropriate and timely treatment, mortality rate should be less than 1%.

Prevention

At present, no effective vaccine for dengue fever is available. Therefore, the best preventive measure is to eliminate pockets of stagnant water that serve as sites of mosquito breeding, and to avoid mosquito bites.

Dengue virus infection can lead to leakage of plasma so that the liquid will fill the cavity around the heart, lung, and stomach, resulting in swelling. On the other hand, the body fluid deficiency. Dengue infection that do not cause leakage of plasma called dengue fever. This type of relatively mild and not life-threatening.

The signs of shock to consider is the patient’s anxiety, there was a marked decrease in consciousness with the patient was sleepy and wanted to sleep, no appetite, abdominal pain, no appetite, and rarely urinate.

If the shock occurs without any prolonged medical action could result in death. To prevent shock, DHF patients must given plenty of fluids, either by mouth or infusion.

Dengue fever and dengue hemorrhagic fever (DHF) is a contagious disease caused by dengue virus transmitted by Aedes aegypti mosquitoes. Dengue virus infection spreads quickly and can attack many people in the epidemic. More severe conditions experienced by the children.

DHF is a more severe form of dengue fever because of bleeding and shock may occur which sometimes could be fatal, which is death. Symptoms of dengue fever or DHF is generally quite similar. “In the initial phase, the two diseases couldn’t be distinguished,” he said.

In general, the dengue fever and DHF are typical.

Dengue fever
- Acute fever for 2-7 days, accompanied by headache, sore muscles and joints
- Can be accompanied decrease in platelets.
- The heat will come down on the third or fourth day.
- Better cure rate.

DHF:
- Sudden high fever, accompanied by headache, pain in the back of the eyeball, sometimes abdominal pain.
- There is a sign of rash or red spots on skin
- Not accompanied by a cough or sore in the throat.
- Platelets and leukocytes down (less than 100,000)
- Hematocrit levels  increasing (up 20 percent of normal).
- Bleeding the soft tissues (nose, mouth, or gums).
- There was infiltration of plasma. The more leaks can cause shock.

Added by Alan physician, determination of dengue fever or DHF can only be done on the third day through the clinical symptoms plus the investigation. “The diagnosis of DHF can enforced if it fulfills two clinical criteria and a decrease in platelets and increased hematocrit,” he explained.

DHF caused by dengue virus, distributed by Aedes mosquitoes aegipty or Aedes albopictus female pairs. Mosquito-legged white pinto these human bite during the day. Dengue virus consists of four types (strains), namely dengue type 1,2,3, and 4. However, the dominant type in Indonesia is a type 3.

Dengue disease until now was not unexpected. In general, this disease has features such as high temperature, headache and even vomiting blood. But unfortunately, the same symptoms are often found in other diseases. As a result, until now often the case wrong diagnosis. Therefore, you should more vigilant and recognize other symptoms.

SYMPTOMS:
- Sudden high fever
- Severe headache, especially in the forehead
- Pain in the body and joints
- Nausea or vomiting
- Front redness
- Laboratory tests showed leukocytes and platelets down (less than 100 thousand) and an increase in hematocrit (blood viscosity).

HANDLING
- Monitor patient’s temperature every day
- Bring the patient back to the doctor if the fever lasted 3 days
- Rest and adequate fluid intake are two things that are important in dengue virus infected patients.
- If the patient condition increasingly weak, vomiting, trouble eating or drinking, give intravenous fluids by doctors.
- If the laboratory results showed no sign of decline or increase platelet hematocrit, the patient must hospitalized.
- Patients being watched in shock not to place marked by a sense of weakness, drowsiness, and fainting, while the very cold feet.