June 17, 2008
Dengue Fever:  There are 4 different dengue serotypes, or viruses, conveniently named dengue 1, 2, 3 and 4. There is even the possibility of being infected with more than 1 dengue virus at a team. This is known as Dengue HF (hemorrhagic fever) and can result in severe shock. The principal vector, or transmitting organism, is the Aedes aegypti mosquito that is pictured above. Infection with Dengue can occur year round between latitudes 25°N and 25°S although infections as far North as Philadelphia have been documented. The spread of Dengue is limited to the spread of the vector, although as cases become more common in the Southern United States, this limitation seems to be minimal. This isn’t helped any by the globalized economy and the travel of humans and mosquitos, which may be infected, all over the world. Dengue fever is endemic to Central America, and there has been a recent outbreak in El Salvador.  2-7 days after the initial infection, or bite, the patient experiences sudden onset of fever, headache, retroorbital pain, and back pain along with the severe muscle aches that gave rise to the colloquial designation of “break-bone fever.” There is often a macular rash on the first day as well as adenopathy, palatal vesicles, and scleral injection. The illness may last a week, with additional symptoms usually including anorexia, nausea, vomiting, nose bleeds, and a maculopapular rash beginning on the trunk and spreading to the extremities and the face.  Laboratory findings of Dengue Fever include leukopenia (low white blod cells), thrombocytopenia (low platelets), and, in many cases, serum aminotransferase (liver enzymes) elevations. The diagnosis is made by IgM ELISA or paired serology during recovery or by antigen-detection ELISA or RT-PCR during the acute phase. These are tests that check for either the human made antibodies to the virus or to a part the virus’s genetic code. The virus itself can be isolated from blood in the acute phase of the disease. There is no immunization or vaccination for Dengue Fever although research is under way. Also, there are no anti-viral medication that treat Dengue available. There is no antiviral drug therapy. Dengue hemorrhagic fever can be treated by fluid replacement therapy. Control depends mostly upon antimosquito measures, eg, elimination of breeding places and the use of insecticides. Screened windows and doors can reduce exposure to the vectors. www.accessmedicine.com - Harrison’s Online

Dengue Fever: 

There are 4 different dengue serotypes, or viruses, conveniently named dengue 1, 2, 3 and 4. There is even the possibility of being infected with more than 1 dengue virus at a team. This is known as Dengue HF (hemorrhagic fever) and can result in severe shock. The principal vector, or transmitting organism, is the Aedes aegypti mosquito that is pictured above. Infection with Dengue can occur year round between latitudes 25°N and 25°S although infections as far North as Philadelphia have been documented. The spread of Dengue is limited to the spread of the vector, although as cases become more common in the Southern United States, this limitation seems to be minimal. This isn’t helped any by the globalized economy and the travel of humans and mosquitos, which may be infected, all over the world. Dengue fever is endemic to Central America, and there has been a recent outbreak in El Salvador. 

2-7 days after the initial infection, or bite, the patient experiences sudden onset of fever, headache, retroorbital pain, and back pain along with the severe muscle aches that gave rise to the colloquial designation of “break-bone fever.” There is often a macular rash on the first day as well as adenopathy, palatal vesicles, and scleral injection. The illness may last a week, with additional symptoms usually including anorexia, nausea, vomiting, nose bleeds, and a maculopapular rash beginning on the trunk and spreading to the extremities and the face. 

Laboratory findings of Dengue Fever include leukopenia (low white blod cells), thrombocytopenia (low platelets), and, in many cases, serum aminotransferase (liver enzymes) elevations. The diagnosis is made by IgM ELISA or paired serology during recovery or by antigen-detection ELISA or RT-PCR during the acute phase. These are tests that check for either the human made antibodies to the virus or to a part the virus’s genetic code. The virus itself can be isolated from blood in the acute phase of the disease.

There is no immunization or vaccination for Dengue Fever although research is under way. Also, there are no anti-viral medication that treat Dengue available. There is no antiviral drug therapy. Dengue hemorrhagic fever can be treated by fluid replacement therapy. Control depends mostly upon antimosquito measures, eg, elimination of breeding places and the use of insecticides. Screened windows and doors can reduce exposure to the vectors.

www.accessmedicine.com - Harrison’s Online

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