FOR CME PURPOSE

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3. DENGUE VECTORS
Aedes aegypti Aedes albopictus
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Infected
Person
Susceptible
Person
Mosquito Bite
Infected
Mosquito
Infected Mosquito
Bites next person
Becomes Sick
Mosquito Bite Infected
Mosquito
3 – 14 days
later
Remains viremic
2 to 10 Days
8 – 12
DAYS

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Asymptomatic
Undifferentiated
fever
No h'rage Unusual
hemorrhage
Dengue Fever
DHF I & II DSS
Dengue Hemorrhagic Fever
(plasma leakage)
Symptomatic
Dengue virus
Infection

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6Dengue Perak 5/2010

7. Evidence of plasma leakage:
 Haemoconcentration (20% above baseline)
 A drop in haematocrit following fluid replacement
 Pleural effusion, ascites (not obvious in early stage of critical
phase)
 Circulatory disturbances.
 Hypovolemic shock
PLASMA LEAKAGE
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8. Dengue Shock Syndrome (WHO 1997)
Evidence by :
 rapid and weak pulse
 narrow pulse pressure less than 20mmHg
or hypotension for age
 cold clammy skin and restlessness
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Deferversence
24-48 hours

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Thrombocytopenia

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24. 120
110
100
90
80
70
60
Blood pressure, pulse pressure, heart rate in hypovolemic shock
Time LCS Lum
Compensated shock Decompensated shock
First sign of shock is tachycardia
Followed by increasing diastolic BP
Drop is systolic BP is relatively late event
PR
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INTEPRETATION OF DENGUE SEROLOGY

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