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DENGUE FEVER IN MALAYSIA

INTRODUCTION. Dengue is a viral infection transmitted by mosquitoes, mainly the Aedes aegypti species. The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person. One mosquito bite can inflict the disease.There are four strains or serotypes of dengue virus namely DEN-1, DEN-2, DEN-3 and DEN-4.The mosquito flourishes during rainy seasons but can breed in water-filled containers, year-round. The virus is not contagious and cannot be 29876

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DENGUE FEVER IN MALAYSIA

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    1. DENGUE FEVER IN MALAYSIA Prepared by : Fadhila Binti Mohd Hanapiah Nadiah Binti Suffian

    2. INTRODUCTION Dengue is a viral infection transmitted by mosquitoes, mainly the Aedes aegypti species. The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person. One mosquito bite can inflict the disease. There are four strains or serotypes of dengue virus namely DEN-1, DEN-2, DEN-3 and DEN-4. The mosquito flourishes during rainy seasons but can breed in water-filled containers, year-round. 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. Dengue haemorrhagic fever ? severe form of dengue. A second attack by dengue virus of a different serotype from the first infection. Approximately 1% of patients with dengue infection progress to dengue haemorrhagic fever.

    3. WORLD-WIDE DENGUE DISTRIBUTION

    4. EPIDEMIOLOGY 1902 - The earliest recorded case of dengue fever in Malaysia ? Penang 1962 – The first major dengue outbreak in Malaysia ? Penang 1973 – A nationwide outbreak ? Kuala Lumpur Since then dengue has become a major public health problem in the country. Dengue cases/deaths mounts parallel with the rapid development, expansion of urban areas & population density (as of Sept 2008 = 27,730,000 inhabitants).

    5. INCIDENCE OF DENGUE CASES IN MALAYSIA FROM 1998-2008

    6. DIAGNOSIS Classic symptoms : high fever, a petechial rash with thrombocytopenia & relative leukopenia (decrease in the number of circulating WBC in the blood). WHO definition of DHF : Fever Haemorrhagic tendency [positive tourniquet test (> than 20 petechiae per square inch), spontaneous bruising, bleeding from mucosa, gingiva, injection sites, vomiting blood or bloody diarrhea]. Thrombocytopaenia [<100,000 platelets per mm³]. Evidence of plasma leakage [rise in hematocrit level > than 20%]. Serology (identification of antibodies in the blood serum) & polymerase chain reaction (PCR) ? to confirm the diagnosis of dengue if clinically indicated.

    7. SYMPTOMS Sudden high fever (39-41.5°C) for 2 to 7 days Headache Pain behind the eyes Muscle pain, joint pain, bone pain (break-bone fever) After 1 to 2 days of fever, the patient develops initial rash with discoloured spots, often described as “Isles of white in a sea of red” Second rash may develop to palms and soles, and skin may peel off (desquamate) & body temperature drops

    8. TREATMENTS No specific antiviral treatment, only supportive treatment is given to such patients. If the patient is dehydrating, adequate fluids are to be taken. Intravenous fluid is administered if the patient is unable to maintain oral intake. For severe body ache, painkillers may be needed. For severe headache and for joint and muscle pain, acetaminophen/paracetamol and codeine may be given. If there is significant bleeding, blood or platelet transfusion will be carried out. Note : Aspirin should be avoided as this drug may worsen the bleeding tendency (because of its anticoagulant effects & the increased risk of developing Reye syndrome).

    9. PREVENTIONS STRATEGIES Individual roles. People are urged to empty stagnant water from old tires, trash cans & flower pots. Mosquito control. Place larvicide e.g. Abate® or any other suitable insecticides into any exposed water container. Use mosquito repellant sprays that contain NNDB or DEET. Enforcement. Local authorities from Ministry of Health conduct on-site check & destroy larvae at residential premises & construction sites. Fines may be imposed on the owner of properties.

    10. PREVENTIONS Fogging with insecticide. Fogging would be carried out by local authorities in housing area where 2 or more cases of dengue fever are reported within one week. Information. In Nov 2007, the Ministry of Health carried out a major campaign against Aedes. During the campaign free packages of Abate® were distributed. Leaflets & brochures to inform the public on ways to prevent & curb Aedes breeding are distributed. Awareness campaign. Schools & local communities are encouraged to carry out communal cleaning activities. Public awareness campaigns through strategically placed posters & television advertisements are also done.

    11. REFERENCES http://ms.wikipedia.org/wiki/Demam_Denggi http://en.wikipedia.org/wiki/Dengue_fever http://www.gov.my/MyGov/BI/Directory/Citizen/CitizenHealth/HealthPersonal/CommonDiseases http://library.thinkquest.org/07aug/01614/dengue-malaysia.html http://www.dph.gov.my/vektor/eng/kes_dd_tahunan.htm http://www.infosihat.gov.my/isusemasa.php?id=17 http://www.myhealth.gov.my/myhealth/bm/template.jsp?showMe=28&storyid=1231474221719 http://wonder.cdc.gov/wonder/prevguid/p0000373/p0000373.asp http://www.who.int/csr/disease/dengue/en/index.html

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