Dengue should be considered as the possible etiology. Dengue is a febrile illness caused by infection with one of four dengue viruses denv transmitted by aedes aegypti or aedes albopictus mosquitoes during the taking of a blood meal. Perubatan ud54 slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Texas has the highest number of cases of dengue fever in the united states.
Viral hemorrhagic fevers vhfs are a diverse group of animal and human illnesses in which fever and hemorrhage are caused by a viral infection. Guerdan, md, mph abstract in september 2009 the first documented, locally acquired cases of dengue fever in eighty years were diagnosed in individuals living in or visiting key west, florida. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Dengue initially is inoculated into the skin by the aedes mosquito, where it infects skin dendritic cells.
Dengue infection is caused by 4 antigenically distinct dengue virus serotypes. Among these, there are 200,000 to 500,000 cases of potential lifethreatening dengue hemorrhagic fever dhfdengue shock syndrome dss, characterized by thrombocytopenia and increased vascular permeability. Dengue virus produces a mild acute febrile illness, dengue fever df and a severe illness, dengue hemorrhagic fever dhf. Globally, it is estimated that approximate 50 to 100 million new dengue virus infections occur annually. Dengue fever dengue hemorrhagic fever dengue fever dengue hemorrhagic fever bruce r. Histologic, viral, and molecular correlates of dengue fever liver histopathology and biological correlates in five cases of fatal dengue fever in vietnamese children. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Pathophysiology dengue hemorrhagic fever is a severe, potentially deadly infection spread by some mosquitos. The pathophysiology of the severe forms of dengue may be related to sequential infection with different serotypes, variations in virus virulence, interaction of the virus with environmental and host factors or a combination of these factors. Dengue virus infection has been counted among emerging and reemerging diseases because of 1 the increasing number of patients, 2 the expansion of epidemic areas, and 3 the appearance of severe clinical manifestation of dengue hemorrhagic fever dhfdengue shock syndrome dss, which is often fatal if not properly treated. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a. Although dengue is a very old disease but recently an alarming increase has been seen in the geographic range, along with the severity of.
The initial, and currently only, outbreak of lujo virus in septemberoctober 2008 left 45 patients dead. Symptoms of dengue hemorrhagic fever are fever that lasts from 2 to 7 days, vomiting blood, drowsiness, bleeding from nose or gums. A viral hemorrhagic fever is a possible cause of the plague of athens during the peloponnesian war. Some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and. Dengue fever is an acute infectious disease caused by four serotypes of dengue virus. Pathogenesis people bitten by aedes aegypti mosquito are diagnosed with high fever and severe joint pain that are the common symptoms of dengue fever 16. Department of health and human services centers for. Burke, evidence that maternal dengue antibodies are important in the development of dengue hemorrhagic fever in infants, american journal of tropical medicine and hygiene, vol.
Pathophysiology and management of dengue hemorrhagic fever. Pathophysiology plasma leakage denvinfected cells release inflammatory mediators, immune complexes are formed, and the complement cascade is activated resulting in increased vascular permeability and hemorrhagic manifestations that characterize severe dengue. Summary dengue infection is caused by any of four dengue virus serotypes. Impact of dengue virus infection and its control pathogens. Dengue fever virus denv is an rna virus of the family flaviviridae. Infection may be asymptomatic or present with a broad range of clinical manifestations including a mild febrile illness to a lifethreatening shock syndrome. As the mosquito feeds on the human host, it injects the dengue virus denv into the bloodstream. Acute reversible hypokinesia and reduction in left ventricular ejection fraction was also reported by wali. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Plasma leakage and intrinsic coagulopathy are the pathological hall marks in dengue haemorrhagic fever dhf.
If left untreated, dengue fever can develop into the fatal dengue hemorrhagic fever dhf. Summary dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity the cocirculation of multiple serotypes, and the emergence of dengue hemorrhagic fever in new geographic regions. Pathophysiology dengue hemorrhagic fever free download as word doc. Other members of the same genus include yellow fever virus, west nile virus, zika virus, st.
Nutritional status of children with dengue hemorrhagic fever. The who estimates that 50100 million cases of dengue infection occur annually, with approximately 500,000 of those cases resulting in dengue hemorrhagic fever dhf, with an estimated 22,000 deaths per year, mostly in children. Dengue virus dv is transmitted through mosquito bite and is prevalent in over 100 tropical and subtropical countries with about 2 000 000 000 people at risk. This video aims to describe the mode of replication of dengue virus and the pathophysiology of dengue. Viral hemorrhagic fevers vhfs are a group of febrile illnesses caused by rna viruses from several viral families. Request pdf pathophysiology and management of dengue hemorrhagic fever dengue infection is caused by any of four dengue virus serotypes. Dengue fever has emerged as a global public health problem in the recent decades. Summary much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. If left untreated, dengue fever can develop into the fatal dengue. Pdf pathogenesis and pathophysiology of dengue hemorrhagic. Jan 17, 2016 the supportive care in dengue includes fluid replacement and close monitoring of platelet and hct c.
Infection by any one of the four serotypes of dengue virus denv remains asymptomatic in the vast majority. In a small proportion of cases, the virus causes increased vascular permeability that leads to a bleeding diathesis or disseminated intravascular coagulation dic known as dengue hemorrhagic fever dhf. All types of vhf are characterized by fever and bleeding disorders and all can progress to high fever. Sep 17, 2010 aetiology, pathophysiology and diagnosis of dengue infection dr lee oi wah peg. Pathogenesis of dengue haemorrhagic fever and its impact. It is a vasculopathy that consists in endothelial lesions which allow plasma leakage and hemorrhages. The clinical manifestations of dengue are the expression of a constellation of host and viral factors, some acquired, others intrinsic to the individual. Alternate hypothesis on the pathogenesis of dengue. Dhf starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Pathogenesis of dengue haemorrhagic fever and its impact on. Dengue hemorrhagic fever and dengue shock syndrome some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and sometimes fatal form of the disease. Dengue hemorrhagic fever is a fatal manifestation of dengue virus that manifest with bleeding diathesis and hypovolemic shock. Pathophysiology and management of dengue hemorrhagic fever chuansumrit 2006 transfusion alternatives in transfusion medicine wiley online library.
The first infection with dengue often causes mild to moderate disease, whereas the second infection can create a lifethreatening hemorrhagic fever. Dengue fever is common in tropical areas, so take extra precautions if you travel somewhere with this type of climate. These highly infectious viruses lead to a potentially lethal disease syndrome characterized by fever, malaise, vomiting, mucosal and gastrointestinal gi bleeding, edema, and hypotension. Bleeding diathesis in dengue hemorrhagic fever dhf is caused by a combination of plasma leakage, vasculopathy, thrombocytopenia, platelet dysfunction, and coagulopathy. The clinical manifestations range from asymptomatic infection to undifferentiated. Dec 07, 2018 dengue is also known as breakbone fever, hemorrhagic fever, dandy fever, infectious thrombocytopenic purpura. Dengue infection is caused by any of four dengue virus serotypes. The pathology of dengue hemorrhagic fever request pdf.
Dengue hemorrhagic fever nursing care management and study guide. High circulating levels of the dengue virus nonstructural protein ns1 early in dengue illness correlate with the development of dengue hemorrhagic fever. Around the time the fever begins to subside usually 37 days after symptom onset, the patient may develop warning signs of severe disease. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of. Jul 11, 2018 why cant your body handle a punch to the liver.
Since the second edition of dengue haemorrhagic fever. A viral hemorrhagic fever is an alternate theory of the cause of the black death and the plague of justinian. All can cause syndromes that are selflimited or severe. Dengue virus infection has been counted among emerging and reemerging diseases because of 1 the increasing number of patients, 2 the expansion of epidemic areas, and 3 the appearance of severe clinical manifestation of dengue hemorrhagic fever dhf dengue shock syndrome dss, which is often fatal if not properly treated. In a small proportion of cases, the disease develops into severe dengue, also known as dengue. Dhf is characterized by sustained high fever for 27 days. The four dengue viruses are transmitted in tropical countries that circle the globe. Aetiology,pathophysiology and diagnosis of dengue infection. These viruses are related to the viruses that cause the west nile infection and yellow fever. World health organization, regional office for southeast asia.
Dengue fever may adversely affect cardiac function. Pathology of dengue virus infection and dengue hemorrhagic. Dengue hemorrhagic fever may arise from repeated infection with different serotypes of the dengue virus. It is felt that competent mosquito vectors are located in twentyeight of the fifty states.
Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever vii dengue fever is the fastest emerging arboviral infection spread by aedes mosquitoes with major public health consequences in over 100 tropical and subtropical countries in southeast asia, the western pacific and south and central america. A syndrome due to the dengue virus that tends to affect children under 10, causing abdominal pain, hemorrhage bleeding and circulatory collapse. May 03, 2019 dengue fever is a benign, acute febrile syndrome occurring in tropical regions. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever dhf, and eventually dengue shock syndrome dss. Pathophysiology dengue hemorrhagic fever virus veterinary. A prospective nested casecontrol study of dengue in infants. It is characterized by biphasic fever, myalgia, headache, pain in various parts of the body, rash, lymphadenopathy, and leucopenia1,2. They are rna viruses that belong to the flavivirus genusflaviviridae family, which also includes the yellow fever virus, west nile virus, japanese encephalitis virus, zika virus, and the st louis encephalitis virus. Who, comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever, 2011. The pathology of dengue hemorrhagic fever sciencedirect.
Defined by the presence of fever and 2 or more of the following but not meeting the case definition of dengue haemorrhagic fever. The clinical manifestations range from asymptomatic infection to. Dengue vaccine is given to new born babies as preventive method g. The common severe syndromedengue haemorrhagic feverdengue shock syndrome dhfdssis characterised by sudden vascular permeability generated by cytokines released when t cells attack dengueinfected cells. The traditional classification is divided into dengue fever, dengue haemorrhagic fever, and dengue shock syndrome. These highly infectious viruses lead to a potentially lethal disease syndrome characterized by fever, malaise, vomiting, mucosal and gastrointestinal gi. The most common hemorrhagic manifestations are mild and include a positive tourniquet test, skin hemorrhages petechiae, hematomas, epistaxis nose bleed, gingival bleeding gum bleed, and microscopic hematuria. Dengue fever is a mosquitoborne viral illness found throughout the. Pathogenesis and pathophysiology of dengue hemorrhagic fever. Vhfs may be caused by five distinct families of rna viruses. Mar 16, 2017 viral hemorrhagic fevers vhfs are a group of febrile illnesses caused by rna viruses from several viral families. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis.
Coagulopathy in dengue infection and the role of interleukin6. Viral hemorrhagic fever dengue fever presented by jega subramaniam, student guided by ap. Dengue hemorrhagic fever can occur when someone is bitten by a mosquito or exposed to blood infected with the dengue virus. Apr 03, 2016 this video aims to describe the mode of replication of dengue virus and the pathophysiology of dengue. The characteristic feature of dhf is increased capillary permeability leading to extensive plasma leakage in serous cavities resulting in shock. Jan 09, 2008 dengue fever is an acute infectious disease caused by four serotypes of dengue virus. The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagic fever dhf. Thrombocytopenia, preventitive, arbovirus, bleeding, hemorrhage introduction dengue fever df is the most common mosquitoborne human viral illness worldwide, and has rapidly spread to reach hyperendemic proportions in the urban tropics over the last quarter of a century. The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagi. Df is selflimited, but, it will progress to dengue hemorrhagic fever dhf or dengue shock syndrome.
As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a critical need for adequate tropism assays, animal models, and human autopsy data. The cause of thrombocytopenia in dengue is thought to be an immunerelated process. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Secondary infection by a different dengue virus serotype has been confirmed as an important risk factor for the development of dhf. Louis encephalitis virus, japanese encephalitis virus, tickborne encephalitis virus, kyasanur forest disease virus, and omsk hemorrhagic fever virus. Today, dengue is the most frequent arbovirus infection with more than 100 million cases annually throughout the world, including up to 0. Dv infection is mostly asymptomatic or produces a mild selflimiting acute febrile illness, dengue fever df.
Dengue hemorrhagic fever india pdf ppt case reports. Todays topics arboviruses general concept dengue fever and dengue hemorrhagic fever mcqs and case studies 3. Symptoms typically begin three to fourteen days after infection. Dengue vaccine is used in all the endemic countries currently f. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. Dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity the cocirculation of multiple serotypes, and the emergence of dengue hemorrhagic fever in new geographic regions. Pathophysiology and pathogenesis of dengue haemorrhagic fever. Clinical spectrum among symptomatic infection ranges from undifferentiated fever viral syndrome, dengue fever df, and dengue haemorrhagic fever dhf to the expanded dengue syndrome with isolated organopathy unusual manifestations. Dengue is an important cause of childhood and adult morbidity in asian and latin american countries and its geographic footprint is growing.
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