FIK 3042 : ENGLISH COMMUNICATION ( SUMMARY )

What is Dengue Fever?

               Dengue fever is a mosquito-borne diseases are a major international public health problem in recent years. Type a more dangerous dengue is dengue hemorrhagic fever. It was a major cause of child mortality in many countries today ini.Demam carried by the Aedes mosquito of dengue to humans through bites.
How does this disease spread?
            Dengue fever is occurring in urban areas and the surrounding countries of tropical regions. Anyone who is bitten by mosquitoes that carry dengue viruses have a higher risk of getting dengue. Resembles dengue fever, cold and clinical features vary according to patient's age.
Transfer of the disease:
 • Dengue virus is transmitted to humans by the bite of the Aedes mosquito which carries   dengue virus.
• Mosquitoes can spread the disease within 8-12 days after sucking human blood (the host).
• Female mosquitoes infected with dengue virus can transfer the virus to the next generations through transovarial transfer (the ovary).
• People still are the main host for dengue virus multiples in spite of several studies have shown that in certain parts of the world, monkeys can be infected and be a source of virus for mosquitoes are not infected.
• The dengue virus from the first host (the first victim) can only infect / transferred to the second housing body 18 hours before the temperature rises and at least 3 days after onset of symptoms of disease.

How can the occurrence of dengue fever?
Vector of dengue fever is Aedes females.
Infected mosquitoes carrying dengue virus in his body. The virus is then transferred to humans during the process of sucking. Once a person is bitten, the dengue virus to enter and circulate in the blood stream, the beginning of this disease.
What causes dengue fever?
Dengue fever caused by 4 types of dengue virus transmitted to humans by infected Aedes mosquitoes.
Basically, there are four types of dengue virus flavivirus DEN-1, DEN-2, DEN-3 and DEN-4. All Aedes mosquito is able to act as a vector of dengue viruses before transferring to humans. However, the main vector of this virus is the mosquito Aedes Aegypti. Other vectors are Aedes Albopictus which is a vector of dengue viruses in urban areas.

What factors increase the risk of dengue?
Basically, those living in endemic areas are exposed to dengue and Aedes mosquito infected with a fever this risk.
High-risk groups of dengue disease are:
 Residents and visitors§ to endemic areas of dengue.
 Children aged 15 years and below.§ Disease becomes more severe and often fatal to them.
How is the disease?
Incidence rate of dengue fever and dengue haemorrhagic fever in Malaysia are respectively 118.3 and 5.1 per 100,000 population. While the death rate or mortality of dengue fever and dengue haemorrhagic fever in 1998 were respectively 0:22 and 0:23 for each 100,000 people.
Global incidence of dengue has increased dramatically in recent decades. Currently dengue is endemic in over 100 countries in Africa, Americas, Eastern Mediterranean, Southeast Asia and Western Pacific Before 1970, only nine countries had dengue epidemic. The number which is increased 4 times in at least 41 countries in 1995. Other statistics are as follows. A total of 2500 million people - that is 2 / 5 world's population - currently at risk of dengue fever. Without appropriate treatment, mortality from dengue haemorrhagic fever reached 15% or more.

What are the symptoms of dengue?
Dengue fever is a complex arboviral diseases include dengue fever, dengue haemorrhagic fever and dengue shock syndrome.
Dengue Fever
The clinical features of dengue fever vary according to patient's age:
• Infants and children may have fever differentiated difficult along with the appearance of the rash.
• Adults and children older either syndrome may experience mild fever or a sudden high fever, severe headache, rash and pain behind the eyes, muscles and joints.
• bleeding skin are common phenomena.
• The mortality rate is very low.
• The disease usually begins with a sudden increase in body temperature, followed by other symptoms are not specific, such as red face and other symptoms of dengue fever are not specific.
• Discomfort in the troubled (epigastrik), sensitive in the right flank and abdominal pain is a common phenomenon of dengue hemorrhagic fever.
• Fever usually last for 2-7 days and body temperature can rise as high as 40-41oC and may be accompanied by cramps and bleeding.
• In mild cases of severe, often all the signs and symptoms disappear after a fever cure.
• Patients usually recover spontaneously or after a given fluid and electrolyte therapy (individual ions such as sodium, chloride, potassium, bicarbonate, etc.)
Dengue Shock Syndrome
For serious cases, the patient's condition deteriorated sharply after the fever for several days. Signs of circulatory failure can be seen:
The patient's skin becomes cool, black and full of blood collected, sirkumoral cyanosis (circumoral cyanosis), and the patient feels uncomfortable. Next, wander to a critical level of shock.
Shock is characterized by a weak pulse and rapid, low blood pressure (hipotensi) (this condition is not normal decreased), the skin becomes cold and damp and uncomfortable. Patients suffering from shock are in danger and can be life threatening if not given appropriate treatment immediately. Shock is short term. The patient may die within 12-24 hours or heals quickly after being antirenjatan therapy.
What are the complications that may arise?
Complication of dengue fever are:
• Dengue Haemorrhagic Fever.
• Dengue Shock Syndrome.

What tests can be done to detect the disease?
• Examination of blood were used to assist in the diagnosis of dengue fever. Low platelet cell count (trombositopenia) and the concentration hematokrit (hemokonsentrasi) levels are usually detected.
• serological testing offers the most rapid and simple to confirm the clinical diagnosis of dengue fever. Segregation of viral diagnostic method is most reliable.

What treatments are given for dengue fever?
There is no specific treatment for dengue fever.
• In the case of dengue fever with or without a shock, given by oral fluid enough to replace lost body fluids due to fever, anorexia, and vomiting.
• antipyretic drugs may be used to reduce fever. However, salicylates (compounds containing analgesics to relieve pain, antipyresis - reduce fever by lowering body temperature and anti-inflammatory activities such as aspirin) should be avoided as it is known to cause bleeding. Patients should be monitored closely to detect early signs of shock.
• For patients with dengue shock syndrome, early and immediate replacement of lost plasma with a plasma, plasma enhancer and / or electrolyte solution and the liquid will produce positive effects.

Non-pharmacological treatment
Treatment includes:
• Increase fluid intake.
• Increase the supply of oxygen.
Dengue fever patients should rest and drink more water for your help. Patients who experience shock during a fever should be given fluids intravenously (through a vein). Oxygen should also be given. In patients with dengue haemorrhagic fever, the replacement of lost body fluids may be able to save his life. In some cases, blood transfusions were needed to control bleeding.

Pharmacological treatment
There are no specific drugs to treat dengue fever. Treatment is to eliminate the symptoms that arise.
What kind of monitoring should be done?
When only patients confirmed dengue fever is the responsibility of the treating physician to inform the health authorities on this matter because dengue is a disease that should be reported. This report is essential that further action as below can be carried out:
• The area and the environment in which patients suspected of being infected should be done fumigation (fogging) by the authorities.
• Monitor the area a breeding ground for Aedes mosquitoes so that it does not spread to other places. If the homeowners found breeding will be fine.
• When the patient was discharged from the hospital, he and his family members need to take preventive measures and to act to prevent the disease from recurring.This is because patients who have had dengue if it gets the disease, its impact is very severe.


What is the prognosis of dengue fever?
In general, the prognosis of dengue fever and dengue hemorrhagic fever is good if treatment is given early support.
Is there a particular screening method or an injection for dengue?
Unfortunately, a vaccine for dengue disease is not there. However, some progress was achieved in the process of vaccine that could protect people from the four types of dengue virus. The product may be available on the market in the next few years.


How to prevent dengue?
The following are key preventive measures:
• Protection against mosquito bites.
• Avoid visiting or travel to high risk areas during the day.
• Destroy mosquito breeding places.
• Eliminate mosquito adults.
Protect yourself from mosquito bites
To avoid mosquito bites, a person must know the eating habits of mosquitoes and mosquito deterrent materials on exposed skin when necessary. Wear clothing that covers most parts of the body because it can protect against mosquito bites. Install mosquito nets and screens on windows to prevent mosquitoes from entering homes.
Avoid visiting high risk areas during the day
The best way is to avoid travel to areas at risk (urban areas) in the day. This is because the mosquito is not the insects at night. Feeding peak it was in the early morning and early evening.
Destroy mosquito breeding
Another way to prevent dengue is to destroy mosquito breeding. Aedes mosquitoes breed in places such as tires bad water retention and storage of water. You also need to regularly change water in flower vases and pet drinking water containers to prevent mosquitoes from breeding. What you and your family need to do is:
• Cover tightly all water containers such as buckets, jug of water and the drums or enter larvae-killing drugs into it.
• Copy of water in the vase of flowers every week.
• Dispose of wash water and flower pots lining
Is there a particular screening method or an injection for dengue?
Unfortunately, a vaccine for dengue disease is not there. However, some progress was achieved in the process of vaccine that could protect people from the four types of dengue virus. The product may be available on the market in the next few years.


How to prevent dengue?
The following are key preventive measures:
• Protection against mosquito bites.
• Avoid visiting or travel to high risk areas during the day.
• Destroy mosquito breeding places.
• Eliminate mosquito adults.
Protect yourself from mosquito bites
To avoid mosquito bites, a person must know the eating habits of mosquitoes and mosquito deterrent materials on exposed skin when necessary. Wear clothing that covers most parts of the body because it can protect against mosquito bites. Install mosquito nets and screens on windows to prevent mosquitoes from entering homes.
Avoid visiting high risk areas during the day
The best way is to avoid travel to areas at risk (urban areas) in the day. This is because the mosquito is not the insects at night. Feeding peak it was in the early morning and early evening.
Destroy mosquito breeding
Another way to prevent dengue is to destroy mosquito breeding. Aedes mosquitoes breed in places such as tires bad water retention and storage of water. You also need to regularly change water in flower vases and pet drinking water containers to prevent mosquitoes from breeding. What you and your family need to do is:
• Cover tightly all water containers such as buckets, jug of water and the drums or enter larvae-killing drugs into it.
• Copy of water in the vase of flowers every week.
• Dispose of wash water and flower pots lining each week.
• Check storm water channel (channel roof) each week and remove the leaves or other debris that restricts water flow.
• Clean your home environment. Throw away any container or thing that can hold water such as empty tins and bottles into a plastic bag and place in covered bins.
Eliminate mosquito adults
You can use insect spray to kill adult mosquitoes in the house. Doing thorough spray the house. To be effective, spraying must be done on all parts of the house. You can also use mosquito repellent to prevent you and your family from mosquito bites.

     Summary 1

      Dengue Fever

          Dengue is a seasonal disease that is not only in our country even in the country in other tropical countries. It stems from the bite of aedes mosquito into the human body. Anyone bitten by the female Aedes mosquito will risk this dengue disease.

         Humans infected with dengue virus through mosquito bites. The virus is alive and growing well and accumulating in saliva nyamuk.Ia requires incubation for eight to ten days to breed. Mosquitoes infected with dengue will continue to bring virud all his life. When a female mosquito Ades human or animal bite, it will include all existing dengue virus in the saliva into the blood stream system. When the female Aedes mosquito sucks human blood containing dengue virus it will complete the life cycle of the virus and spreading it to others. 

          Aedies mosquitoes breed in clear water reservoir either inside and outside the home but can not breed in dirty water. The interior of the house it can grow on the plates covering a flower pot, water catchment, such as bathtub, pot or bucket and ant traps.While outside the home as in the bad tires, rain channels, empty tins, construction,rubber cup, tree holes, bamboo stump, axillary leaves such as pandan leaf and pineapple.

          Symptoms of dengue fever depends on the age of the patient. For infants or children, the main feature is a rash accompanied by fever. While adults and adolescents are high fever that appears suddenly which lasted for 2-7 days, headache, pain behind the eyes, muscle and joint pain followed by a rash develop son the third and fourth. Red spots under the skin also available. And results of laboratory tests showing the number of leukocytes and platelets in the blood decreases.
A very hot fever, loss of appetite and vomiting lead to dehydration. Patients are encouraged to drink more water. A very hot fever also increases the risk of seizure ,so the fever should be controlled with antipyretic. In addition, patients will be monitored for symptoms of bleeding and seizures  can be detected early. The most critical time is in the third to the seventh day. So giving intravenous flow to the event count hematokrit reflects the degree of increase for plasma loss.

Therefore, people need to be more sensitive to the vicinity of their homes so thatmosquitoes can not breed by cleaning the house and remove all debris that may become a breeding ground breeding process but also commits the authorities also need to ensure that the premises are free from dengue.