Dengue Haemorragic

Fever
DHF

Dengue Haemorragic Fever

Dengue is a viral infection transmitted by mosquitoes,
mainly the Aedes aegypti species.
The virus is not contagious and cannot be spread
directly from person to person. There must be a
person-to-mosquito-to-another-person pathway. The
virus can decrease total human trombosit.

DHF is severe form of dengue . A second

attack by dengue virus of a different
serotype from the first infection.

SYMPTOMS
Sudden high fever (39-41.5C)
for 2 to 7 days
Headache
Pain behind the eyes
Muscle pain, joint pain, bone
pain (break-bone fever)
After 1 to 2 days of fever, the
patient develops initial rash with
discoloured
spots,
often
described as Isles of white in a
sea of red
Second rash may develop to
palms and soles, and skin may
peel off (desquamate) & body
temperature drops

Diagnosis
o Haemorrhagic tendency [spontaneous bruising,
bleeding from mucosa, gingiva, injection sites,
vomiting blood or bloody diarrhea ]
o Fever
o Thrombocytopaenia [<100,000 platelets per mm].
o Evidence of plasma leakage [rise in hematocrit
level > than 20%].

Serology (identification of antibodies in the blood

serum) & polymerase chain reaction (PCR) to
confirm the diagnosis of dengue if clinically
indicated.

TREATMENTS
No specific antiviral treatment, only supportive
treatment is given to such patients.
If the patient is dehydrating, adequate fluids are to
be taken.
Intravenous fluid is administered if the patient is
unable to maintain oral intake.
For severe body ache, painkillers may be needed.
For severe headache and for joint and muscle pain,
acetaminophen/paracetamol and codeine may be
given.
If there is significant bleeding, blood or platelet
transfusion will be carried out.
Note : Aspirin should be avoided as this drug
may worsen the bleeding tendency (because
of its anticoagulant effects & the increased
risk of developing Reye syndrome).

PREVENTIONS
There is currently no vaccine
available
for the dengue fever.
STRATEGIES
Individual roles. People are urged to
empty stagnant water from old tires,
trash cans & flower pots.
Mosquito control. Place larvicide
e.g. Abate or any other suitable
insecticides into any exposed water
container. Use mosquito repellant
sprays that contain NNDB or DEET.
Enforcement. Local authorities from
Ministry of Health conduct on-site
check & destroy larvae at residential
premises & construction sites. Fines
may be imposed on the owner of
properties.

PREVENTIONS
Fogging with insecticide.
Fogging would be carried out by
local authorities in housing area
where 2 or more cases of dengue
fever are reported within one
week.
Information. The Ministry of
Health carried out a major
campaign against Aedes. During
the campaign free packages of
Abate were distributed.
Leaflets & brochures to inform
the public on ways to prevent &
curb Aedes breeding are
distributed.
Awareness campaign. Schools
& local communities are
encouraged to carry out
communal cleaning activities.
Public awareness campaigns
through strategically placed
posters & television
advertisements are also done.

The Way of Executing Mosquito

Breeding Site Eradication Program

Cleaning water containers

Covering water containers
Burying discarded containers
Other activities such as changing water
regularly in flower pots and bird feeding
cups, etc

Typical water containers in Indonesia that

can be potential breeding place for dengue
mosquitoes

REFERENCES
http://ms.wikipedia.org/wiki/Demam_Denggi
http://en.wikipedia.org/wiki/Dengue_fever
http://www.gov.my/MyGov/BI/Directory/Citizen/Citize
nHealth/HealthPersonal/CommonDiseases
http://library.thinkquest.org/07aug/01614/denguemalaysia.html
http://www.dph.gov.my/vektor/eng/kes_dd_tahunan.ht
m
http://www.infosihat.gov.my/isusemasa.php?id=17
http://www.myhealth.gov.my/myhealth/bm/template.js
p?showMe=28&storyid=1231474221719
http://wonder.cdc.gov/wonder/prevguid/p0000373/p00
00373.asp
http://www.who.int/csr/disease/dengue/en/index.html

Thanks for attention

Assalamu alaikum W.W