11 things to know about Dengue fever

Posted date 03/04/2018

1.541 view

Posted date 03/04/2018

1.541 view

Dengue hemorrhagic fever (DHF) is an acute mosquito-borne infection with the dengue virus (DEN) that can cause large epidemics.

Author: MSc. Tran Nhu Phong (Head of Community Medicine Department - Faculty of Nursing).

Dengue hemorrhagic fever (DHF) is an acute mosquito-borne infection with the dengue virus (DEN) that can cause large epidemics.
Dengue fever has become an epidemic in over 100 countries in Africa, the Americas, the Eastern Mediterranean, Southeast Asia and the Western Pacific, with Southeast Asia and the Western Pacific being the most severely affected regions. In 2017, Vietnam had more than 90,626 people with dengue fever, 1.6 times higher than the number of people with dengue fever in 2016 (54,003 people).
1. Pathogen : caused by Dengue virus belonging to the Flavivirus group, Flaviviridae family with 4 serotypes DEN-1, DEN-2, DEN-3 and DEN-4.
2. Vectors: The disease is not transmitted directly from person to person but by mosquitoes that bite infected people carrying the virus and then transmit the virus to healthy people through bites. In Vietnam, the two species of mosquitoes that transmit dengue fever are Aedes aegypti and Aedes albopictus, of which the most important is Aedes aegypti.

(Aedes aegypti mosquito)

3. Incubation period and transmission: The incubation period is from 3 to 14 days, on average from 5 to 7 days. Patients are the source of infection during the fever period, especially the first 5 days of fever, when there is a lot of virus in the blood. Mosquitoes infected with the virus usually 8 to 12 days after sucking blood can transmit the disease and transmit the disease for life.
4. Susceptibility and resistance: Anyone who does not have specific immunity can get the disease, from infants to adults. After recovering from the disease, they will be immune for life to the type of dengue virus that causes the disease, but will not be cross-protected against other types of dengue. If infected a second time with a different type of dengue virus, the patient may have a more severe illness and is more likely to develop dengue shock.
5. Time when dengue fever usually occurs: Dengue fever often increases during the rainy season, when the average temperature is high. In our country, the disease occurs year-round in the southern and central regions, while in the northern and Central Highlands, the disease usually occurs from April to November.
6. Incubation period: The incubation period is from 3 to 14 days, on average from 5 to 7 days. Patients are the source of infection during the fever period, especially the first 5 days of fever, when there is a lot of virus in the blood. Mosquitoes infected with the virus usually 8 to 12 days after sucking blood can transmit the disease and transmit the disease for life [6] .
7. Transmission of dengue fever: Aedes aegypti mosquitoes suck the blood of infected people and then carry the virus. When they bite healthy people, they transmit the dengue virus to healthy people. Dengue fever is not transmitted through direct contact, so taking care of people with dengue fever will not cause infection. However, it is important to avoid mosquito bites because mosquitoes can transmit the disease from sick people to healthy people.

(Dengue fever transmission route)

8. Symptoms of Dengue fever: After being infected with the virus by a mosquito 5-7 days later, the patient may have symptoms that progress through three stages: fever stage, dangerous stage and recovery stage:
- Fever stage: Sudden, continuous high fever. Headache, loss of appetite, nausea. Skin congestion. Muscle pain, joint pain, pain in both eye sockets. Often there are petechiae under the skin, bleeding gums or nosebleeds.
- Dangerous stage: Usually on the 3rd-7th day of the disease. The patient may still have a fever or the fever may have subsided. Symptoms of plasma leakage due to increased vascular permeability (usually lasting 24-48 hours). Pleural effusion, interstitial fluid, peritoneum, eyelid edema, enlarged liver, and possible pain. If there is a lot of plasma leakage, it will lead to shock with symptoms of restlessness, restlessness, or lethargy, cold extremities, cold, clammy skin, rapid, small pulse, stuck blood pressure (difference between maximum and minimum blood pressure ≤ 20 mmHg), hypotension or unmeasurable blood pressure, and oliguria.
Hemorrhage: Subcutaneous hemorrhage: Scattered petechiae or petechiae usually on the front of the two calves and the inside of the two arms, abdomen, thighs, ribs or bruises. Mucosal hemorrhage: Nosebleeds, bleeding gums, blood in urine. Prolonged menstruation or menstruation appearing earlier than the due date. Internal bleeding such as digestive tract, lungs, brain is a serious symptom.
- Recovery phase: After 24-48 hours of the dangerous phase, there is a gradual reabsorption of fluid from the interstitial tissue into the intravascular space. This phase lasts 48-72 hours. The patient's fever subsides, his general condition improves, heaviness increases, hemodynamics stabilize, and heurates frequently. There may be bradycardia and changes in the electrocardiogram. During this phase, excessive fluid infusion can cause pulmonary edema or heart failure.

9. Treatment for dengue fever : During the dengue fever epidemic, if there is a fever or severe headache, the patient should go to a medical facility for examination to detect the disease and promptly treat it if there are signs of severe progression. Stage 2 is the stage that can have many serious complications, so the patient should go to a medical facility for treatment. Dengue fever can be completely treated at primary health facilities. Only cases with severe complications such as dengue shock causing multiple organ failure, thrombocytopenia causing bleeding or threatening severe bleeding need to be treated at higher health facilities.

(Photo collected)

10. Special note when having dengue fever: Severe complications of dengue fever often occur in stage 2. Although the patient's fever has subsided, he/she should not be subjective and should go to a medical facility for examination and daily blood tests. If the patient has signs of danger: fatigue, continuous vomiting or nausea, restlessness, bleeding gums, nosebleeds or prolonged menstruation, in young children there may be lethargy, refusal to breastfeed, little urination, cold hands and feet, it is necessary to take the patient to the hospital immediately for timely emergency care.
11. Prevention of Dengue Fever : The best way to prevent Dengue Fever is to avoid mosquito bites, sleep under mosquito nets, and apply insecticide. Kill Aedes mosquitoes by spraying insecticide to eliminate stagnant water around the house to prevent larvae from developing.

References:
Ministry of Health (4607/QD-BYT), "Plan for integrated surveillance of dengue fever, Zika virus disease and chikungunya in Vietnam, 2017-2020 period".

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