INDEX

• Acknowledgement
• Introduction
• Causes
• Mechanism
• Signs and Symptoms
• Diagnosis
• Treatment
• Prevention
• Bibliography
Introduction
Dengue fever, also known as breakbone fever, is a mosquito-
borne infection that can lead to a severe flu-like illness. It is
caused by four different viruses and spread by Aedes
mosquitoes. This may include fever, headache, muscle and joint
pains, and a characteristic skin rash that is similar to measles. In
a small proportion of cases, the disease develops into life-
threatening dengue hemorrhagic fever, which results in
bleeding, thrombocytopenia, and leakage of blood plasma, or
into dengue shock syndrome, in which dangerously low blood
pressure occurs.
Facts on dengue fever
Here are some key points about dengue fever. More detail is in
the main article.
• Dengue is transmitted by the mosquitoes Aedes aegypti and
Aedes albopictus, which are found throughout the world.
• Around 2.5 billion people, or 40 percent of the world's
population, live in areas where there is a risk of dengue
transmission.
• Dengue is endemic in at least 100 countries in Asia, the
Pacific, the Americas, Africa, and the Caribbean.
• Symptoms usually begin 4 to 7 days after the mosquito bite
and typically last 3 to 10 days.
Causes
There are four dengue viruses (DENV) that cause dengue fever.
common dengue causing virus is flavivirus. They are all spread
by a species of mosquito known as Aedes aegypti, and more
rarely by the Aedes albopictus mosquito.
The viruses jumped from monkeys to humans between 100 and
800 years ago, according to the CDC, but dengue remained a
minor problem until the middle of the twentieth century.

Mechanism
When a mosquito carrying dengue virus bites a person, the virus
enters the skin together with the mosquito's saliva. It binds to
and enters white blood cells and reproduces inside the cells
while they move throughout the body. The white blood cells
respond by producing a number of signaling proteins, such as
cytokine and interferon, which are responsible for many of the
symptoms, such as the fever, the flu-like symptoms, and the
severe pains.
In severe infection, the virus production inside the body is
greatly increased, and many more organs (such as the liver and
the bone marrow) can be affected. Fluid from the bloodstream
leaks through the wall of small blood vessels into body cavities
due to capillary permeability. As a result, less blood circulates in
the blood vessels, and the blood pressure becomes so low that it
cannot supply sufficient blood to vital organs.
Furthermore, dysfunction of the bone marrow due to infection of
the cells leads to reduced numbers of platelets, which are
necessary for effective blood clotting; this increases the risk of
bleeding, the other major complication of dengue fever.

Signs and symptoms

Symptoms vary depending on the severity of the disease.

Mild dengue
Symptoms can appear up to 7 days after being bitten by the
mosquito that carries the virus. They include:
• fever
• aching muscles and joints
• body rash that can disappear and then reappear
• high fever
• intense headache
• pain behind the eyes
• vomiting and feeling nauseous
Symptoms usually disappear after a week, and mild dengue
rarely involves serious or fatal complications.

Dengue hemorrhagic fever

At first, symptoms of DHF may be mild, but they gradually
worsen within a few days. As well as mild dengue symptoms,
there may be signs of internal bleeding. A person with Dengue
hemorrhagic fever may experience:
• bleeding from the mouth, gums, or nose
• clammy skin
• damage to lymph and blood vessels internal bleeding,
which can lead to black vomit and feaces, or stools
• a lower number of platelets in the blood
• small blood spots under the skin
• weak pulse.
Without prompt treatment, DHF can be fatal.
Dengue shock syndrome
DSS is a severe form of dengue. It can be fatal. Apart from
symptoms of mild dengue fever, the person may experience:
• intense stomach pain
• disorientation
• sudden hypotension, or a fast drop in blood pressure
• heavy bleeding
• regular vomiting
• blood vessels leaking fluid Without treatment, this can
result in death.

Diagnosis
The signs and symptoms of dengue fever are like some other
diseases, such as typhoid fever and malaria. This can sometimes
delay an accurate diagnosis. The doctor will assess the
symptoms and the person's medical and travel history, and they
may order some blood tests to confirm the diagnosis.
The diagnosis of dengue fever may be confirmed by
microbiological laboratory testing. This can be done by virus
isolation in cell cultures, nucleic acid detection by PCR, viral
antigen detection or specific antibodies. Virus isolation and
nucleic acid detection are more accurate than antigen detection,
but these tests are not widely available due to their greater cost.
All tests may be negative in the early stages of the disease. PCR
and viral antigen detection are more accurate in the first seven
days.
These laboratory tests are only of diagnostic value during the
acute phase of the illness with the exception of serology. Tests
for dengue virus-specific antibodies, types of IgG and IgM, can
be useful in confirming a diagnosis in the later stages of the
infection. Both IgG and IgM are produced after 5-7 days. The
highest levels of IgM are detected following a primary infection,
but IgM is also produced in re-infection. After a primary
infection, IgG reaches peak levels in the blood after 14-21 days.

Treatment
Dengue is a virus, so there is no specific treatment or cure.
However, intervention can help, depending on how severe the
disease is.
For milder forms, treatment includes:
• Preventing dehydration: A high fever and vomiting can
dehydrate the body. The person should drink clean water,
ideally bottled rather than tap water. Rehydration salts can
also help replace fluids and minerals.
• Painkillers, such as Tylenol or paracetamol: These can help
lower fever and ease pain.
More severe forms of dengue fever may need:
• intravenous (IV) fluid supplementation, or drip, if the
person cannot take fluids by mouth
• blood transfusion, for patients with severe dehydration
Hospitalization will allow the individual to be properly
monitored, in case symptoms get worse.

Prevention
No vaccine can protect against dengue fever. Only avoiding
mosquito bites can prevent it.
Anyone who lives in or travels to an at-risk area can use a
number of ways to avoid being bitten.
• Clothing: Reduce the amount of skin exposed by wearing
long pants, long-sleeved shirts, and socks, tucking pant legs
into shoes or socks, and wearing a hat.
• Mosquito repellents: Use a repellent with at least 10
percent concentration of diethyltoluamide (DEET), or a
higher concentration for longer lengths of exposure. Avoid
using DEET on young children.
• Mosquito traps and nets: Nets treated with insecticide are
more effective, otherwise the mosquito can bite through the
net if the person is standing next to it. Insecticide will kill
mosquitoes and other insects, and it will repel insects from
entering the room.
• Door and window screens: Structural barriers, such as
screens or netting, can keep mosquitoes out.
• Timing: Try to avoid being outside at dawn, dusk, and
early evening.
• Stagnant water: The Aedes mosquito breeds in clean,
stagnant water. Checking for and removing stagnant water
can help reduce the risk.

To reduce the risk of mosquitoes breeding in stagnant

water:
✓ turn buckets and watering cans over and store them under
shelter so that water cannot accumulate.
✓ remove excess water from plant pot plates.
✓ scrub containers to remove mosquito eggs.
✓ loosen soil from potted plants, to prevent puddles forming
on the surface.
✓ make sure scupper drains are not blocked and do not place
potted plants and other objects over them.
✓ use non-perforated gully traps, install anti-mosquito valves,
and cover any traps that are rarely used.
✓ do not place receptacles under an air-conditioning unit.
✓ change the water in flower vases every second day and
scrub and rinse the inside of the vase.
✓ prevent leaves from blocking king anything that may result
in the accumulation of puddles or stagnant water.