Dengue Fever, facts and findings.

[Lady Macbeth]

Hello everyone,

As you know scores of people in Pakistan, especially the Punjab province, are getting affected by the dengue virus and few know how to deal with it.

Kindly post anything you find useful in this thread (related to the dengue virus of course) so that we can all benefit from your input.

Thanks

Lady

[Lady Macbeth]

Dengue fever facts



Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes.
Symptoms such as headache, fever, exhaustion, severe joint and muscle pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue fever.

Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and in Paraguay in South America, and Costa Rica in Central America.

Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue fever, the treatment is purely concerned with relief of the symptoms (symptomatic).
The acute phase of the illness with fever and myalgias lasts about one to two weeks.

Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock).
The prevention of dengue fever requires control or eradication of the mosquitoes carrying the virus that causes dengue.

There is currently no vaccine available for dengue fever.

What is dengue fever?

Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles.

Dengue (pronounced DENG-gay) can affect anyone but tends to be more severe in people with compromised immune systems. Because it is caused by one of four serotypes of virus, it is possible to get dengue fever multiple times. However, an attack of dengue produces immunity for a lifetime to that particular serotype to which the patient was exposed.

Dengue goes by other names, including "breakbone" or "dandy fever." Victims of dengue often have contortions due to the intense joint and muscle pain, hence the name breakbone fever. Slaves in the West Indies who contracted dengue were said to have dandy fever because of their postures and gait.

Dengue hemorrhagic fever is a more severe form of the viral illness. Symptoms include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae (small red or purple splotches or blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome.

[Lady Macbeth]

What geographic areas are at high risk for contracting dengue fever?

Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and Central America. Cases have also been imported via tourists returning from areas with widespread dengue, including Tahiti, Singapore, the South Pacific, Southeast Asia, the West Indies, India, and the Middle East (similar in distribution to the areas of the world that harbor malaria and yellow fever). Dengue is now the leading cause of acute febrile illness in U.S. travelers returning from the Caribbean, South America, and Asia.

In 2011, Bolivia, Brazil, Columbia, Costa Rica, El Salvador, Honduras, Mexico, Peru, Puerto Rico, and Venezuela reported a large number of dengue cases. Paraguay reported a dengue fever outbreak in 2011, the worst since 2007. Hospitals were overcrowded, and patients had elective surgeries canceled due to the outbreak.

The U.S. Centers for Disease Control and Prevention (CDC) reports that from 1946 to 1980, no cases of dengue acquired in the continental United States were reported. Since 1980, a few locally acquired U.S. cases have been confirmed along the Texas-Mexico border, temporally associated with large outbreaks in neighboring Mexican cities.

A 2009 outbreak of dengue fever in Key West, Fla., showed that three patients who did not travel outside of the U.S. contracted the virus. Subsequent testing of the population of Key West has shown that up to 55 of the people living in the area have antibodies to dengue. In total, 28 people were diagnosed with dengue fever in this outbreak.

Dengue fever is common, in at least 100 countries in Asia, the Pacific, the Americas, Africa, and the Caribbean. Thailand, Vietnam, Singapore, and Malaysia have all reported an increase in cases.

According to the CDC, there are an estimated 100 million cases of dengue fever with several hundred thousand cases of dengue hemorrhagic fever requiring hospitalization each year. Nearly 40% of the world's population lives in an area endemic with dengue. The World Health Organization (WHO) estimates that 22,000 deaths occur yearly, mostly among children.

How is dengue fever contracted?

The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots, plastic bags, and cans year-round. One mosquito bite can cause the disease.

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.

What are dengue fever symptoms and signs?

After being bitten by a mosquito carrying the virus, the incubation period ranges from three to 15 (usually five to eight) days before the signs and symptoms of dengue appear in stages. Dengue starts with chills, headache, pain upon moving the eyes, and low backache. Painful aching in the legs and joints occurs during the first hours of illness. The temperature rises quickly as high as 104 F (40 C), with relatively low heart rate (bradycardia) and low blood pressure (hypotension). The eyes become reddened. A flushing or pale pink rash comes over the face and then disappears. The glands (lymph nodes) in the neck and groin are often swollen.

Fever and other signs of dengue last for two to four days, followed by a rapid drop in body temperature (defervescence) with profuse sweating. This precedes a period with normal temperature and a sense of well-being that lasts about a day. A second rapid rise in temperature follows. A characteristic rash appears along with the fever and spreads from the extremities to cover the entire body except the face. The palms and soles may be bright red and swollen.

How is dengue fever diagnosed?

The diagnosis of dengue fever is usually made when a patient exhibits the typical clinical symptoms of headache, fever, eye pain, severe muscle aches and petechial rash and has a history of being in an area where dengue fever is endemic. Dengue fever can be difficult to diagnose because its symptoms overlap with those of many other viral illnesses, such as West Nile virus and chikungunya fever.

In 2011, the U.S. Food and Drug Administration (FDA) approved a blood test to diagnose people with dengue fever, called the DENV Detect IgM Capture ELISA. The FDA notes that the new test may also give a positive result when a person has a closely related virus, such West Nile disease.

[Lady Macbeth]

What is the treatment for dengue fever?

Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the treatment is purely concerned with relief of the symptoms. Rest and fluid intake for adequate hydration is important. Aspirin and nonsteroidal anti-inflammatory drugs should only be taken under a doctor's supervision because of the possibility of worsening bleeding complications. Acetaminophen (Tylenol) and codeine may be given for severe headache and for joint and muscle pain (myalgia).

What is the prognosis for typical dengue fever?

Typical dengue is fatal in less than 1% of cases. The acute phase of the illness with fever and myalgias lasts about one to two weeks. Convalescence is accompanied by a feeling of weakness (asthenia), and full recovery often takes several weeks.

What is dengue hemorrhagic fever?

Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock). DHF is also called Philippine, Thai, or Southeast Asian hemorrhagic fever and dengue shock syndrome.

DHF starts abruptly with high continuous fever and headache. There are respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs two to six days after the start of symptoms with sudden collapse, cool, clammy extremities (the trunk is often warm), weak pulse, and blueness around the mouth (circumoral cyanosis).

In DHF, there is bleeding with easy bruising, blood spots in the skin (petechiae), spitting up blood (hematemesis), blood in the stool (melena), bleeding gums, and nosebleeds (epistaxis). Pneumonia is common, and inflammation of the heart (myocarditis) may be present.

Patients with DHF must be monitored closely for the first few days since shock may occur or recur precipitously (dengue shock syndrome). Cyanotic (bluish) patients are given oxygen. Vascular collapse (shock) requires immediate fluid replacement. Blood transfusions may be needed to control bleeding.

The mortality (death) rate with DHF is significant. With proper treatment, the World Health Organization estimates a 2.5% mortality rate. However, without proper treatment, the mortality rate rises to 20%. Most deaths occur in children. Infants under a year of age are especially at risk of dying from DHF.

How can dengue fever be prevented?

The transmission of the virus to mosquitoes must be interrupted to prevent the illness. To this end, patients are kept under mosquito netting until the second bout of fever is over and they are no longer contagious.

The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue. In nations plagued by dengue fever, people are urged to empty stagnant water from old tires, trash cans, and flower pots. Governmental initiatives to decrease mosquitoes also help to keep the disease in check but have been poorly effective.

To prevent mosquito bites, wear long pants and long sleeves. For personal protection, use mosquito repellant sprays that contain DEET when visiting places where dengue is endemic. There are no specific risk factors for contracting dengue fever, except living in or traveling to an area where the mosquitoes and virus are endemic. Limiting exposure to mosquitoes by avoiding standing water and staying indoors two hours after sunrise and before sunset will help. The Aedes aegypti mosquito is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas.

There is currently no vaccination available for dengue fever. There is a vaccine undergoing clinical trials, but it is too early to tell if it will be safe or effective. Early results of clinical trials show that a vaccine may be available by 2015.

[Lady Macbeth]

How to Make Natural Mosquito Repellent?



As the rainy season come, it invites a few unwelcome guests like mosquitoes, black flies, etc. Mosquitoes are well known for spreading of many diseases like malaria, fever and other contagious diseases. It is very easy to prepare natural mosquito repellent at home. Mosquitoes are attracted by certain odors and they can smell "food” even if they are 50 meters far away from food. By mosquitoes, some people get sting so much more than others. Mosquito repellent creates a smell that is not liked by mosquitoes.


To detect host, mosquitoes have complex methods. Different types of mosquitoes react to different stimuli. During sunrise and sunset, most mosquitoes are active. However, some other mosquitoes seek hosts during the day. By using a repellent and avoiding actions that diminish the effectiveness of the repellent, you can keep away mosquitoes from the body. Natural mosquito repellent is safe and effective, plus it costs much less to make it than to buy it.

Natural Mosquito Repellents:

Mosquitoes will be repelled effectively by natural products but they need more recurrent reapplication (at least every 2 hours) and higher concentrations than other organic products like DEET. Due to the differences between types of mosquitoes, multiple repellents containing products tend to be more effective than those containing a single ingredient. Most of volatile plant oil acts as natural repellents. Such as,

Castor Oil
Citronella Oil
Lemon Eucalyptus Oil
Peppermint Oil
Clove Oil
Lemongrass Oil
Geranium Oil
Cinnamon Oil
Rosemary Oil
Cedar Oil
Probably Oils from Verbena, Pennyroyal, Lavender, Pine, Cajeput, Basil, Thyme, Allspice, Soybean, and Garlic
Natural Mosquito Repellent Preparation:

Natural Mosquito Repellent Recipe: 1
Ingredients:

2 teaspoons citronella essential oil
2 teaspoons tea tree oil
2 cups clear aloe vera gel
1/2 teaspoon rosemary essential oil
1/2 teaspoon honey (ery optional)
1 teaspoon lemonbalm or lemongrass essential oil (optional helpful component and adds to the light fresh scent)
Preparation:

In a bowl or jar, pour aloe vera gel and add the essential oils.
Stir the oils thoroughly until the mixture will turn translucent rather than clear.
Use:

Slather this preparation on arms legs, neck, face and ears for use. You can also use this preparation on cloths if you make sure that it will not be affected by the oils. Possibly, it would irritate the eyes even though it is actually a healing gel.

For storage, pour this preparation into jars like baby food jars. It will last a long time. Honey is a natural healing agent and it also gives creamy moisture to skin which have capacity to the repellent gel.

Natural Mosquito Repellent Recipe: 2
Ingredients:

10-25 drops (total) of essential oils
2 tablespoons of a carrier oil or alcohol
The essential oils that work well against mosquitoes are:

Citronella oil
Cinnamon oil
Lemon eucalyptus oil
Castor oil
Safe carrier oils and alcohols include:

Witch hazel
Olive oil
Any other cooking oil
Sunflower oil
Vodka
Preparation:

Combine the essential oil with the carrier oil or alcohol. You can use this preparation by spraying or rubbing on skin or clothing. Take care while using, to avoid the sensitive eye area. After about an hour or after swimming or exercise, you will be required reapplying of the natural product.

Natural Mosquito Repellent Recipe: 3
Ingredients:

1/3 cup witch hazel (or cheap vodka)
1/3 cup of apple cider vinegar
5 drops of citronella or eucalyptus essential oil
Preparation:

Into the spray bottle, pour all ingredients with the help of funnel.
Then, shake the bottle to mix the liquids.
Now, the preparation is ready for application.

Repellent Effectiveness can be lowered by following things:

Absorption into the Skin
Evaporation from Wind or High Temperatures
Dilution from Rain, Perspiration, or Swimming
Many Sunscreens
Natural mosquito repellents do not automatically means that they are safe. They are not safe especially for the people who are sensitive to plant oils. In reality, some natural insect repellents are toxic and so natural repellents provide an alternative way to synthetic chemicals.

[Neo]

Dengue epidemic

The latest figures of dengue patients diagnosed with the disease and the number of deaths in Lahore are 6,666 and 44 respectively, and rising. This of course is a fraction of the numbers crowding the hospitals for fear of having contracted the disease, even if on examination, only about 16 percent of those are found to have actually been struck by dengue. Because of a lack of public awareness and accurate information about the disease, a sense of panic has gripped people. Fear of the unknown is the root of this apprehension. In the vast majority of even confirmed dengue fever cases, although modern medicine still has no cure for viruses like dengue, conservative treatment yields positive results and recovery is probable. Only if a person contracts dengue haemorrhagic fever (DHF), a different virus, is the likelihood of fatality greater. Because the epidemic is a new and unknown development, a public awareness campaign with expert input should have been mounted earlier. However, better late than never, as the Punjab and federal governments have benefited from the advice of the Sri Lankan dengue experts team operating in Lahore now and are gearing up for such a campaign through the media.

While the media was being briefed by the Sri Lankan team in Lahore on Monday, Prime Minister Yousaf Raza Gilani also held a national dengue conference in the city to help coordinate the fight against the epidemic. To this end, the federal government has offered all help and assistance to the Punjab government in an all too rare show of solidarity transcending partisan politics. A national coordination mechanism in the shape of a Coordination and Strategy Cell at federal level has been announced. The Cell will coordinate amongst the federal and provincial governments and facilitate coordination and aid from international donors and health organisations for the provinces. Since dengue is no respecter of provincial boundaries or provincial autonomy (Raza Rabbani’s objections to the federal government ‘interfering’ in health matters, devolved to the provinces under the 18th Amendment, notwithstanding), it is rational and positive that the federal and provincial governments, not only Punjab but all the provinces, should be coming together to coordinate their efforts against an epidemic that is showing signs of emerging all over the country.

Meanwhile in Lahore the Punjab government has, in an excess of late zeal, used Section 144 to seal 69 diagnostic laboratories accused of charging more for the dengue blood test than the maximum of Rs 90 fixed by the Punjab government. Their owners and employees have also been taken into custody. Car service stations have been shut. While this end of the Punjab government’s activity smacks of trying to shut the stable door after the horse has bolted, since if the public awareness campaign had been conducted before such draconian actions in the name of public health and safety, any following strict actions would have earned more public support. As it is, that objective may not have been achieved, while the closure of laboratories has exacerbated the overcrowding in the remaining laboratories and hospitals. Closing schools and higher education institutions for 10 days too seems misplaced zeal. The Punjab government needs to reach out to the citizen and institutions in a rational manner to educate everyone on the need for the entire community to pull together if the epidemic is to be combated. For a start, the preventive end of the campaign requires each householder, workplace owner and authority responsible for public spaces to ensure all potential breeding grounds for the dengue mosquito, i.e. stagnant pools of water, both clean and sullied, are either drained or filled up with sand to prevent the female laying its eggs and the larvae hatching to maturity. Spraying to kill the mosquitos and larvae must accompany these measures.

The dengue epidemic has alarmingly exposed the cracks in our public health regime. In today’s interconnected world, countries have to be even more vigilant since mass health hazards have plenty of opportunity to travel. Pakistan must gear up its public health awareness and preventive regimens, while also being prepared to manage the curative side if an epidemic does strike.

Daily Times - Leading News Resource of Pakistan

[Neo]

The dengue scare

There has been an exponential rise in dengue cases in the country in recent years. Currently, Punjab is the worst hit and the highest toll is borne by Lahore. This is an omen that the coming years may see escalation in number, severity and death toll.

The authorities are totally clueless and people have started pondering whether it is because of carelessness, negligence and inefficiency or is an outcome of biological infringement jump-started by some aliens. Belated surge in various steps taken by the authorities concerned like spraying, importing medicines, establishment of help-centers, provision of help-lines, use of media etc, clearly betrays a knee-jerk reaction. It is understandable that the High Court has taken notice lately and is expected to award exemplary punishment to the government functionaries responsible. On the other hand, the epidemic is spreading southward where floods are wreaking havoc, complicating the situation further.

One thing is quite clear; the dengue horror is not Pakistan-specific. Nearly 40 per cent of the world’s population is in the grip of the epidemic. According to WHO, over 100 countries are affected; mainly South America, north-eastern Africa, Middle East, Indian sub-continent and a large part of eastern Asia are badly hit. Malaria was an endemic some decades back in Pakistan but has been fairly under control. The current swelling of dengue cases raises alarm regarding malarial recurrence.

Furthermore, the mosquito which spreads dengue virus, i.e., Aedes Aegypti, is also responsible for spreading Yellow fever. Under normal conditions, the law of uncertainty and chaos theory increase the probability of multiplying the miseries! Pakistan already is in the grip of multi-dimensional problems. Bad governance, ill-preparedness, inconsideration and corruption have all added up to torment the people.

There is a difference of opinion in categorising the patients; many cases including a few deaths caused by dengue have vehemently been denied and labeled otherwise. This has unwittingly exacerbated the situation and panic-stricken authorities have resorted to fiddling with the record, as observed by patients and their relatives. The course taken by the fever varies from patient to patient which adds uncertainty, although the pattern is more or less the same. Temperature stays between 100 and 102 degF and rarely comes to normal for at least a week. In some cases it continues for another four to five days. Patient grows very weak day by day with diminishing platelets in cases where the attack is severe or the immunity is poor. Vomiting and headache cause loss of fluid and patient tends to lose appetite. In such a situation, the patient’s platelets drop so fast that some times doctors are unable to stop the downslide. Platelets falling below 40,000 are extremely dangerous and may result in death (due to hemorrhage) but quite a few hospitals have brought the figure to dangerously low level of 20,000 (and even 10,000) as a condition for indoor treatment relying on the increased gluing efficiency of platelets as the number goes down.

In view of the poor statistical picture of this grossly under-estimated menace, it is felt necessary to share the concern especially for the coming years through this article. Futuristically, it is important to reduce the ratio of patients who have suffered because of wrong treatment, inattention, panic or lack of information. Moreover, the situation turns grave for patients not being able to control vomiting causing acute dehydration. It is to be emphatically explained that in case of a viral disease, the fever has to be kept low with the help of Paracetamol; primarily, it is to be fought through diet, fluid intake and rest.

Many viruses have a tendency to lay dormant in small colonies within the human body replicating at low rate depending on the subject’s immunity. Malaria is one of them which stays in liver for years together waiting for the individual’s immunity to go down a certain level. Although it has been claimed that dengue spreads through Aedes-bite only, yet there is a need to study from the above aspect. The present virus is detectable only after about six days of incubation period (range is between 3 to 14 days). In nearly 80 per cent of cases, patients could only guess that they suffered a dengue attack. Even hospital authorities are not sure and fever pattern and symptoms are the leading indicators to suggest that patient is suffering from dengue. There are basically four known types of dengue virus but the information lacks perspicuity.

Personally, I believe that this virus may not be originally dengue but mutates very quickly based on individual immunity level and its depletion-gradient after the virus starts appearing stronger and stronger through its growing number, in some cases it has even been lying dormant (although a study does lead to negative findings and is attributed to environmental variations). There is therefore a need to study in detail what form of various strings of this particular virus in the country appear in the chain, what are their isolated effects viz a viz the individual’s immunity level and how could a common man possibly be educated on a preventive basis in our variegated demographic milieu. The subcontinent’s weather pattern is definitely changing and the study must also include this impact on mutation taking place in the virus at all stages.

Proper information regarding relapsing, in the true sense, is not available even on the internet; that can also be included in the research by medical experts and students although it has been opined that the period may vary between 3 months to one year. Herbal treatment such as extract of papaya leaves has been recommended; dengue-specific home-grown medicines can be tested and suggested.

Thus, besides all the necessary measures being taken according to local “Prevention and Control of Dengue Fever and Dengue Hemorrhage Fever” and WHO instructions, it is an opportunity for our researchers and multi-national companies to turn the tide in the next rainy season and manage a steep decline in dengue cases. Underlying commonality of human experience requires that all these efforts should also appear on internet; it is a wellspring of information and would assist the authorities and the common man alike to fight this menace.

The dengue scare | Blog | DAWN.COM

[talhablog123]

Very Important and good knowledge ..