1 / 32

Dengue Fever History, Biology, Pathology, Clinical Management, and Prevention.

Dengue Fever History, Biology, Pathology, Clinical Management, and Prevention. San Estanislao, Paraguay February, 2008 Blair Thedinger. Dengue Fever Hits Paraguay By REUTERS Published: March 4, 2007

ciaran-downs
Télécharger la présentation

Dengue Fever History, Biology, Pathology, Clinical Management, and Prevention.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Dengue Fever History, Biology, Pathology, Clinical Management, and Prevention. San Estanislao, Paraguay February, 2008 Blair Thedinger

  2. Dengue Fever Hits Paraguay By REUTERS Published: March 4, 2007 ASUNCIÓN, Paraguay, March 2 — A Supreme Court justice, soccer players and a senator have come down with dengue in Paraguay, as the worst outbreak in the country’s history hit the well off as well as its usual victims among the poor. On Friday, a nurse who worked with the public health service died after being hospitalized for dengue…

  3. Dengue History

  4. Wilder-Smith A and Schwartz E. N Engl J Med 2005;353:924-932

  5. Geographic distribution of Aedes aegypti in the Americas,

  6. Dengue Worldwide Today

  7. Epidemia No caracterizada año 1988/1989 (40,000) IgM + • Año 2000 DEN-1 24,282 (estimaciones 300,000) • Año 2001 DEN-2 38 • Año 2002 DEN-1,2,3 130 • Año 2003 DEN-1,3 137 • Año 2004 DEN-3 12 • Año 2005 DEN-2 36 • Año 2006 DEN-3 1.889 • Año 2007 DEN 3 6.313

  8. 519 12/31 2/20 5/27

  9. Dengue Microbiology Monath T. N Engl J Med 2007;357:2222-2225

  10. Cycle in Nature Rural – Urban Cycle Urban / semi-urban Epidemic cycle Vector Biology Aedes Species Aedes aegypti Aedes Species Aedes aegypti

  11. Symptoms Fever Headache Retro Orbital Pain Myalgias/Arthralgias Nausea and Vomiting Weakness Rash

  12. Dengue Rash with Sparing of Islands of Skin Wilder-Smith A and Schwartz E. N Engl J Med 2005;353:924-932

  13. Diagnosis

  14. Positive Result on a Tourniquet Test Wilder-Smith A and Schwartz E. N Engl J Med 2005;353:924-932

  15. Laboratory Tests .gif

  16. Viremia IgM IgG(1) IgG(2) Figure 2 Representation of the temporal appearance of virus ,IgM,and IgG antibodies in persons infected with dengue virus.

  17. Wilder-Smith A and Schwartz E. N Engl J Med 2005;353:924-932

  18. Figure 1 Suspected Cases of Dengue Clinical and Epidemiologic Criteria Outpatient Absent Bleeding* Dehydration Little or no oral intake Clinical Edema Comorbidities** Alarming Signs *** Shock Group A Ambulatory care from home Patient or caretaker instructed regarding warning signs and directed to urgently consult medical attention with one or more warning signs. Follow up within 24 hours Inpatient Group C Suspected cases of moderate DHF/DSS (reversible shock) Hospitalize in specialized units Group B Suspected cases of complicated Dengue or Mild DHF (Hematocrit and Platlets) Hospitalize for observation Oral re-hydration or IV if the can not tolerate fluids PO One of more Alarming signs Grupo D Suspected cases of Severe DHF/DSS (Refractory shock or recurrent treatment with cristaloids or prolonged shock) Hospitalizein the ICU * Spontaneous or provoked bleeding ** Comorbidities incluye: Cardiovascular disease, Diabetes, Immunosuppresed, Kidney disease, Malnutrition, Anemia, Asthmatics,etc. *** Clinical signs: Moderate to intense abdominal pain, persistent vomiting, sharp drop in temperature, changesin the level of consciousness, Postural Hypotention, pulse pressure <20 mmHg Labratory signs: Progressive rise in hematrocrit, progressive fall in platelets.

  19. Kaplan-Meier Curves for Time from Study Entry to Initial (Panel A) and Sustained (Panel B) Cardiovascular Stability among Children in Group 1, According to the Resuscitation Fluid Received Wills B et al. N Engl J Med 2005;353:877-889

  20. Prevention and Vector Control • Vaccine • Vector Control • Challenges to Prevention

  21. Monath T. N Engl J Med 2007;357:2222-2225

  22. Challenges

  23. Challenges

  24. Challenges

  25. Looking Ahead

More Related