Dengue fever is one of the most common mosquito-borne viral
diseases of human beings. It has become a major reason for public health
concern internationally over the recent years because of disease morbidity and
mortality. Globally around 2.5 billion people are living in areas where dengue
viruses can be transmitted. Spread of mosquito vectors & viruses in
geographical distribution are two main reasons of rise in incidence and
prevalence of dengue fever & appearance of dengue hemorrhagic cases. Urban
areas of the tropics have been identified to be highly endemic. According to
estimates made by WHO around 50–100 million infections of dengue are prevalent
every year globally. (Deen et al. 2006) In Pakistan first dengue outbreak was reported
in Karachi in 1994 as environmental conditions are conducive to Aedes mosquito
breeding. Economic and security related migration introduced virus to Lahore as
well. According to Punjab Health Department 590339 suspected cases were
reported in Lahore & 21685 confirmed by serology. It has been observed that
5-10% of these cases develop DHF.(Mahmood et al. 2013)
Dengue is mainly transmitted by mosquito vector i.e. Aedesaegypti and can also be transmitted by A. albopictus to a
lesser extent. Virus that causes dengue has four
different types that are closely related to each other. Infected female mosquitoes transmit this virus to human beings through bite.
An infected mosquito can transmit this virus to humans for the rest of its
life. Symptoms of dengue range from very mild fever to very high fever
including intense headache, retro-orbital pain, muscular and joint pain, and
rashes. There is no vaccine or any specific medicine to treat dengue. Patients
having dengue fever are advised to take rest and drink ample fluids. They are
advised to use paracetamol in order to reduce high grade fever or visit the
physician if fever persists. Recovery from infection by one provides
lifelong immunity against that serotype but confers only partial and transient
protection against subsequent infection by the other three. There have been
enough proofs showing that subsequent infection increases the risk of severity
of disease which can result in DHF (WHO).
Leaking of plasma, fluid accumulation,
respiratory distress, and intense bleeding and organ impairment makes severe
dengue a fatal complication. Warning signs includes decrease in temperature
(below 38°C/ 100°F), severe abdominal pain, rapid breathing, bleeding gums,
malaise, and restlessness, continuous vomiting and hematemesis. These can occur
three to seven days after first symptom recognition. In order to prevent
complications and minimize the risk of death adequate and timely health care is
required in next 1-2 critical days.(Halstead 1980)
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