Dengue Fever: Texts Text A Text B Dengue: virus, fever and mosquitoes Dengue fever is a viral disease spread only by certain mosquitoes – mostly Aedes aegypti or “dengue mosquitoes” which are common in tropical areas around the world. There are four types of the dengue virus that cause dengue fever – Dengue Type 1, 2, 3 and 4. People become immune to a particular type of dengue virus once they’ve had it, but can still get sick from the risk of developing severe dengue. Severe dengue causes bleeding and shock, and can be life threatening. Dengue mosquitoes only live and breed around humans and buildings, and not in bush or rural areas. They bite during the day – mainly mornings and evenings. Dengue mosquitoes are not born with dengue virus in them, but if one bites a sick person having the virus in their blood, that mosquito can pass it on to another human after about a week. This time gap for the virus to multiply in the mosquito means that only elderly female mosquitoes transmit dengue fever. The mosquitoes remain infectious for life, and can infect several people. Dengue does not spread directly from person to person. Signs and Symptoms Classic dengue fever, or “break bone fever,” is characterised by acute onset of high fever 3–14 days after the bite of an infected mosquito. Symptoms include frontal headache, retro-orbital pain, myalgias, arthralgias, hemorrhagic manifestations, rash, and low white blood cell count. The patient also may complain of weight loss and nausea. Acute symptoms, when present, usually last about 1 week, but weakness, malaise, and weight loss may persist for several weeks. A high proportion of dengue infections produce no symptoms or minimal symptoms, especially in children and those with no previous history of having a dengue infection.
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Dengue Fever: Texts
Text A
Text B
Dengue: virus, fever and mosquitoes
Dengue fever is a viral disease spread only by certain mosquitoes – mostly Aedes aegypti or“dengue mosquitoes” which are common in tropical areas around the world.
There are four types of the dengue virus that cause dengue fever – Dengue Type 1, 2, 3 and 4. People become immune to a particular type of dengue virus once they’ve had it, but can still get sick from the
risk of developing severe dengue. Severe dengue causes bleeding and shock, and can be life threatening.
Dengue mosquitoes only live and breed around humans and buildings, and not in bush or rural areas.They bite during the day – mainly mornings and evenings. Dengue mosquitoes are not born with dengue virus in them, but if one bites a sick person having the virus in their blood, that mosquito can pass it on to another human after about a week. This time gap for the virus to multiply in the mosquito means that only elderly female mosquitoes transmit dengue fever. The mosquitoes remain infectious for life, and can infect several people. Dengue does not spread directly from person to person.
Signs and Symptoms Classic dengue fever, or “break bone fever,” is characterised by acute onset of high fever 3–14 days after the bite of an infected mosquito. Symptoms include frontal headache, retro-orbital pain, myalgias, arthralgias, hemorrhagic manifestations, rash, and low white blood cell count. The patient also may complain of weight loss and nausea. Acute symptoms, when present, usually last about 1 week, but weakness, malaise, and weight loss may persist for several weeks. A high proportion of dengue infections produce no symptoms or minimal symptoms, especially in children and those with no previous history of having a dengue infection.
Dengue Fever: Texts
Text C
Steps to take when seeing a suspected case of dengue fever Step 1: Notify your nearest Public Health Unit immediately upon clinical suspicion. Step 2: Take a comprehensive travel history and determine whether the case was acquired overseas or locally. Step 3: Note the date of onset of symptoms to identify the correct diagnostic test, as suitable laboratory tests depend on when the blood sample is collected during the illness. • Another useful test is full blood count. Cases often have leukopenia and/or thrombocytopenia. The table below shows which test to order at which stage of illness:
TEST TYPE PCR IgM IgGNSIELISA
Days after onset of symptoms
0-5 days 0-9 days From day 5onwards
From day 8onwards
Step 4: Provide personal protection advice. • The patient should stay in screened accommodation and have someone stay home to look after them.
• The patient should use personal insect repellent particularly during daylight hours to avoid mosquito bites.
• All household members should use personal insect repellent during daylight hours.
• Advise family members or associates of the case who develop a fever to present immediately for diagnosis.
Dengue Fever: Texts
Text D
END OF PART A
Prior to discharge:
• Tell patients to take antipyretics to control their temperature. Children with dengue are at risk for febrile seizures during the febrile phase of illness.
haemorrhage.
• Monitor your patients’ hydration status during the febrile phase of illness. Educate patients and parents about the signs of dehydration and have them monitor their urine output.
• Perform hemodynamic assessments, baseline hematocrit testing, and platelet counts.
• Continue to monitor your patients closely during defervescence. The critical phase of dengue begins with defervescence and lasts 24–48 hours.
Dengue Fever
Questions 1 - 7
For each of the questions, 1 - 7, decide which text (A, B, C, or D) the information comes