DENGUE

&
MALARIA

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XII B
Asan Memorial Senior Secondary
School
 DENGUE
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HISTORY

Dengue virus was isolated in india for the first time in

1945.
The first evidence of dengue fever in india was reported in
1956.

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:

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ABOUT VECTOR
 Bite of the female Aedes aegypti (most urban) and aedes
albopictus.

 Deposit egg singly on damp surface just above waterlines.

 The egg can withstand desiccation for more than a year

and emerge within 24 hour once it comes in contact with
water.

 Life cycle is 30 days.(depends on climate)

 It bites during daytime and can fly up to distance of 400

mt.
HABITATS:

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DENGUE FEVER

An acute febrile illness of 2-7 days duration

with two or more of the following
manifestations:
Headache, retro-orbital pain, joints and muscular pain,
rash, hemorrhagic manifestations.

Dengue hemorrhagic fever is a critical state of dengue

fever.

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 DENGUE SHOCK SYNDROME (DSS)

This condition includes

dengue hemorrhagic fever, rapid and weak
pulse and narrow pulse pressure (≤20 mm Hg) or
hypotension for age,tachycardia, cold and clammy
skin and restlessness.

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LABORATORY DIAGNOSIS:
 Complete Blood Count

 ELISA-based NS1antigen test- used in acute

dengue infection , as early on day 1 of post onset of
symptoms and upto 18th day . Used for differential
diagnosis.

 MAC- ELISA(IgM): based on capturing human IgM

antibodies, day 5th, availble as a kit test.

 IgG-ELISA: It is used to differentiate primary and

secondary infection.
 RT-PCR: To detect viral genome in serum(blood), 90% sensitive
with 95% specific, after 5thday of symptoms.

 Isolation of dengue virus: sample should be taken within 5

days and result take 7-10 days so not very useful.

 PRNT( Plaque Reduction and Neutralization Test): used

to determine infecting serotype in convalescent sera.

 Serological test:
Haemagglutination-Inhibition (HI)
Complement Fixation (CF)
Neutralization test (NT)

 Rapid diagnostic test

rapid NS1 antigen detection test is of comparable sensitivity
and specificity to the NS1 antigen capture ELISA.
 VACCINE FOR DENGUE:

DENGVAXIA(CYD-TDV): (Recombinant ,
live attenuated tetravalent dengue vaccine)

 Completed phase III in 2015.

 Schedule in 3-doses : 0/6/12month.

 Age group 9-45yrs who are living in endemic area.

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 MAJOR CAUSES OF DEATH

 Prolonged shock

 Massive bleeding

 Fluid overload

 Acute hepatic failure and encephalopathy

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MALARIA
 Malaria is suspected clinically on the basis of
fever or a history of fever along with prodromal
symptoms.

o Transmitted by infected female anopheles mosquito.

 Diagnosis based only on clinical features has very low

specificity and results in overtreatment.

 All cases of suspected malaria should have a

parasitological test (microscopy or rapid diagnostic test)
to confirm the diagnosis.
LIFE CYCLE OF PLASMODIUM
 DIAGNOSIS

 Microscopic Examination
-Thick Blood Smear
-Thin Blood Smear

 RDT (rapid diagnostic test)

-PfHRP2 Dipstick
-Plasmodia LDH dipstick

 PCR
 UNCOMPLICATED MALARIA
 A patient who presents with symptoms of malaria and a
positive parasitological test (microscopy or RDT) but
with no features of severe malaria.

 Objective is to cure the infection as rapidly as possible

and to prevent progression to severe disease.
 TREATMENT OF UNCOMPLICATED
FALCIPERUM MALARIA
 ACT( Artemisinin based Combination Therapy) for 3
days.

 ACT-
-ACT is a combination of rapidly acting artemisinin
derivative with a longer acting(more slowly eliminated)
partner drug.

-ACT regimens ensure...

1.Rapid clinical and parasitological cure.
2. Minimize transmission.
3. Retard drug resistance.
 SEVERE FALCIPARUM MALARIA
Defined as one or more of the following occuring in the absence of
an identified alternative cause and in the presence of
P.falciparum asexual parasitemia.

• Impaired consciousness • Jaundice

• Prostration • Pulmonary edema
• Multiple convusions • Significant bleeding
• Acidosis • Shock
•Hyperparasitemia-
• Hypogylcemia
P.falciparum parasitemia
• Severe anemia >10%
• Renal impairment
 MALARIA VACCINE
 The only approved vaccine as of 2015 is RTS,S/AS01 known by
the trade name Mosquirix. Phase 3 trial completed.

 Started in South African Countries- first in Malawi.

Followed by Kenya and Ghana.

 There were two age categories in the trial:

-children aged 5-17 months at first dose; and
-children aged 6-14 weeks at first dose who receive the RTS,S/AS01 vaccine
or a comparator vaccine in co-administration with the pentavalent vaccine
from the routine immunization schedule.

3 doses at 1 month interval . The role of 4thdose 20 months after

the 1stdose is being evaluated.
THE END