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Scarlet Fever
Dengue fever (DB) is an acute febrile disease caused by dengue virus, which enters the human bloodstream through the bite of a mosquito of the genus Aedes, such as Aedes aegypti or Aedes albopictus. There are four types of dengue virus is different, but closely correlated, which can cause dengue fever. Dengue virus is a virus of the genus Flavivirus, family Flaviviridae. Dengue fever are found in tropical and subtropical regions around the world, especially in the humid rainy season. World Health Organization (WHO) estimates that each year there are 50-100 million cases of dengue virus infection worldwide.
Cause
The main cause is a viral disease dengue hemorrhagic fever, which is a virus of the family Flaviviridae. There are four types of dengue virus known to cause dengue fever. The four virus is DEN-1, DEN-2, DEN-3, and DEN-4. Symptoms of dengue emerging as someone who has been infected by one of four types of dengue virus infection by different types of dengue virus. Immune system that has been formed in the body after the first infection would likely result in the emergence of a more severe disease symptoms when infected for a second time. A person can be infected by at least two types of dengue virus during the lifetime, but the same type of virus can only infect one-time due to the body's immune system is formed.
Dengue virus can enter the human body through the bite of the carrier vector, the Aedes mosquito of the genus such as Aedes aegypti and Aedes albopictus females. Aedes aegypti is the vector of the most common cause of this disease. Mosquitoes can carry the dengue virus after sucking the blood of people who have been infected with the virus. After an incubation period of virus in mosquitoes for 8-10 days, an infected mosquito can transmit dengue virus to humans healthy bite. Female mosquitoes can spread the dengue virus is carried to the offspring via the egg (transovarial). Several studies have shown that monkeys can also be infected by dengue virus, and can also serve as a source of infection for other monkeys when bitten by a mosquito vector.Level of risk of contracting dengue fever increased to a person who has antibodies to dengue virus infection due to the first. In addition, the risk of dengue fever were also higher in women, someone who is younger than 12 years, or someone who comes from the Caucasian race.
Clinical ManifestationsDengue virus infection can manifest in several outcomes, including the common cold, dengue fever (classic), dengue hemorrhagic fever (hemorrhagic), and dengue shock syndrome.
Dengue fever (classical)Dengue fever symptoms which generally vary depending on the age of the patient. Symptoms commonly occur in infants and children is fever and the appearance of the rash. Whereas in patients aged adolescents and adults, symptoms that appear are high fever, severe headache, pain behind the eyes, pain in joints and bones, nausea and vomiting, as well as the appearance of the rash on the skin. Decrease in white blood cell count (leukopenia) and a decrease in blood platelets or platelets (thrombocytopenia) can often be observed also in patients with dengue fever. In some epidemics, patients also showed bleeding include nosebleeds, bleeding gums, gastrointestinal bleeding, bloody urine (haematuria), and heavy bleeding during menstruation (menorrhagia).
Dengue hemorrhagic fever (hemorrhagic)Patients suffering from dengue hemorrhagic fever (DHF) patients typically show symptoms such as fever, classic dengue plus the four main symptoms, namely high fever, hemorrhagic phenomena or severe bleeding, which is often followed by an enlarged heart and blood circulatory system failure. The existence of damage to blood vessels, lymph vessels, bleeding under the skin that makes the appearance of bluish bruising, thrombocytopenia and increased number of red blood cells are also frequently found in patients with DHF. One of the characteristics to distinguish the severity of DHF at once distinguishes it from classical dengue fever is the leakage of blood plasma. DHF is a critical phase seteah 2-7 days of high fever, the patient experienced a drastic drop in body temperature. Patients will continue sweating, sleeplessness, and decreased blood pressure. When therapy with electrolyte done quickly and appropriately, patients can recover rapidly after a critical period. But if not, DHF can cause death.
Dengue Shock SyndromeShock syndrome is the most severe dengue virus infection, in which patients will experience most or all of the symptoms that occur in patients with classic dengue and dengue hemorrhagic fever is accompanied by leakage of fluid outside the blood vessels, severe bleeding, and shock (blood pressure resulted in very low), usually after 2-7 days of fever. The body is cold, sleeplessness, and abdominal pain are early signs that the public prior to the shock. Shock syndrome occurs usually in children (sometimes occurs in adults) are experiencing a second dengue infection. It is generally very fatal and can result in death, especially in children, if not handled appropriately and quickly. Duration of the shock itself is very fast. Patients may die during the period 12-24 hours after the shock occurs or recover quickly when the effort to restore body fluid therapy done properly. Within 2-3 days, patients who have successfully passed the shock will heal, marked with the appropriate level of urine output and the return of appetite.
DiagnosisDengue disease is diagnosed by looking at the symptoms that arise, such as high fever and appearance of the rash. However, because the symptoms of dengue fever is sometimes difficult to distinguish from malaria, leptospirosis, and typhoid fever is usually a medical worker or doctor will first check the patient's medical history and travel information to locate the possibility of patients being bitten mosquitoes. In addition to getting a higher accuracy of diagnosis is generally performed various laboratory tests. Several tests are usually performed serological studies to determine whether there is antibody to dengue virus in the patient's body, calculate the titer of antibodies against dengue virus, and complete blood cell counts (red blood cells, white blood cells, and platelets). In addition, other laboratory tests that can be done is hemagglutination inhibition test, ELISA test, and reverse transcriptase polymerase chain reaction to detect antigens, antibodies, or nucleic acid specific to dengue virus. These tests can take several days.
PreventionUntil now, no vaccine or antiviral drugs for this disease. The most effective action to suppress dengue fever epidemic is by controlling the presence and where possible avoiding vector mosquitoes carrying the dengue virus. Mosquito control can be done by using some appropriate method, namely:• EnvironmentPrevention of dengue fever can be done by controlling the mosquito vector, such as by draining bathtub / water reservoirs at least once a week, replace / drain the vase of flowers and birds a place to drink once a week, closed with a meeting of water reservoirs, buried the cans, used batteries and old tires around the house, home design and improvement.• BiologicsBiologically, the vector of dengue virus-carrying mosquitoes can be controlled using larvae-eating fish and bacteria.• ChemicalsFumigation (fogging) can kill adult mosquitoes, while giving abate powder in shelters water can kill mosquito larva. Moreover, it can also be used larvasida.Also because of the Aedes mosquito is active during the day some precautions that can be done is to use anti-mosquito compounds that contain DEET, pikaridin, or oil of lemon eucalyptus, and use clothing can be closed to protect the body from mosquito bites when they are active outside the home. In addition, immediately seek treatment if symptoms appear the disease before it develops into dengue fever is getting worse.
TreatmentUntil now there is no specific cure for dengue fever patients. Many people who recover from this disease within 2 weeks. Treatment measures are generally performed on patients with dengue fever which is not too severe is the gift of body fluids (through drink or electrolyte) to prevent dehydration from fever and vomiting, consumption of drugs containing acetaminophen (eg tilenol) to relieve pain and reduce fever and plenty of rest. Aspirin and other nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen sodium can actually increase the risk of bleeding. For patients with more severe dengue fever, will be advised to undergo inpatient in the hospital, and the infusion of electrolytes to replace body fluids and blood transfusion due to bleeding that occurs.A person affected by dengue fever should also be prevented exposed to mosquito bites, because it feared could transmit dengue virus to other people healthy.
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