Dengue Fever

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Dengue hemorrhagic fever (DHF) is acute febrile diseases transmitted by mosquitoes, which occur in the tropics, can be life-threatening, and are caused by four closely related virus serotypes of the genus Flavivirus, family Flaviviridae.
D – Daily monitoring of health status.
E – Encourage fluids like water, juice, oral rehydrating solutions.
N – Note any dengue signs and symptoms (see above)
G – Give paracetamol for fever, NOT aspirin.
U – Use mosquito nets
E – Early consultation if there is bleeding.
Signs & Symptoms: 
6-7 days:
  • High fever
  • Headache
  • Rash 
  • Back and bone pain 
The clinical features of dengue fever vary according to the age of the patient. Infants and young children may have a fever with rash. Older children and adults may have either a mild fever or the classical incapacitating disease with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash.
In moderate DHF cases, all signs and symptoms abate after the fever subsides. In severe cases, the patient’s condition may suddenly deteriorate after a few days of fever; the temperature drops, followed by signs of circulatory failure, and the patient may rapidly go into a critical state of shock and die within 12 to 24 hours, or quickly recover following appropriate medical treatment.
Differential Diagnosis:
Hepatitis
Malaria
Meningitis
Pediatrics: Bacteremia and Sepsis
Pediatrics: Meningitis and Encephalitis
Yellow Fever 
Tick-Borne Diseases, Rocky Mountain Spotted Fever 
Laboratory Studies 
Isolation of virus in serum and detection of immunoglobulins (IgM and IgG) by enzyme-linked immunosorbent assay (ELISA) antibody capture, monoclonal antibody, or hemagglutination
  • Complete blood count
    • Hemoconcentration (hematocrit increased 20%)
    • Thrombocytopenia (platelet count <100 x 109/L)
    • Leukopenia
  • Chemistry panel
    • Electrolyte imbalances
    • Acidemia
    • Elevated BUN
  • Liver function tests
    • Elevated transaminases
    • Hypoproteinemia
  • Guaiac test for occult blood in stool
Treatment:
  • Supportive therapy
    • IV access, O2, and monitoring are helpful.
    • IV crystalloids may be necessary for hypotension; central line may be needed.
    • Correct electrolyte abnormalities and acidemia.
  • Implement therapy for DIC if indicated.
  • Corticosteroids are not helpful.
  • No antiviral therapy is available.
Immunization
There is no vaccine to protect against dengue. Although progress is underway, developing a vaccine against the disease – in either its mild or severe form – is challenging.