DOH DENGUE PREVENTION AND CONTROL PROGRAM

https://www.doh.gov.ph/national-dengue-prevention-and-control-program

BACKGROUND

Dengue is the fastest spreading vector-borne disease in the world endemic in 100 countries·

• Dengue virus has four serotypes (DENV1, DENV2, DENV3 and DENV4)
• First infection with one of the four serotypes usually is non-severe or asymptomatic, while second infection with one of other serotypes may cause severe dengue.
• Dengue has no treatment but the disease can be early managed.
•  The five year average cases of dengue is 185,008; five year average deaths is 732; and five year average Case Fatality Rate is 0.39 (2012-2016 data).

TRANSMISSION

Dengue virus is transmitted by day biting Aedes aegypti and Aedes albopictus mosquitoes.

DENGUE CASE CLASSIFICATION AND LEVEL OF SEVERITY

• Dengue illness is categorized according to level of severity as dengue without warning signs, dengue with warning signs and severe dengue.
• Dengue without warning warnings can be further classified according to signs and symptoms and laboratory tests as suspect dengue, probable dengue and confirmed dengue.

1. dengue without warning signs​​

      a.1 suspect dengue

- a previously well individual with acute febrile illness of 1-7 days duration plus two of the following: headache, body malaise, retro-orbital pain, myalgia, arthralgia, anorexia, nausea, vomiting, diarrhea, flushed skin, rash (petechial, Hermann’s sign)

        a.2 probable dengue

-  a suspect dengue case plus laboratory test: Dengue NS1 antigen test and atleast CBC (leukopenia with or without thrombocytopenia) or dengue IgM antibody test (optional) 

       a.3 confirmed dengue

- a suspect or probable dengue case with positive result of viral culture and/or Polymerase Chain Reaction (PCR) and/or Nucleic Acid Amplification Test- Loop Mediated Amplification Assay (NAAT-LAMP) and/ or Plaque Reduction Neutralization Test (PRNT)

b. dengue with warning signs

• a previously well person with acute febrile illness of 1-7 days plus any of the following: abdominial pain or tenderness, persistent vomiting, clinical signs of fluid accumulation (ascites), mucosal bleeding, lethargy or restlessness, liver enlargement, increase in haematocrit and/or decreasing platelet count 

c. severe dengue

severe plasma leakage leading to

• shock (DSS)
• fluid accumulation with respiratory distress

​severe bleeding

• as evaluated by clinician

severe organ impairment

• Liver: AST or ALT ≥ 1000
• CNS: e.g. seizures, impaired consciousness
•  Heart:and other organs (i.e. myocarditis, renal failure)

​PHASES OF DENGUE INFECTION (continue reading...)