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Class notes on dengue

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This document contains pathophysiology of dengue fever, clinical features, diagnosis, investigations and treatment

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Dengue
Dengue is a vector-borne viral disease transmitted to human by bites of infected female
mosquitoes belong to Adese species (About Dengue: What You Need to Know | Dengue | CDC,
no date). The virus causing dengue is flavivirus of flaviviridae family (About Dengue: What You
Need to Know | Dengue | CDC, no date). Most of the tropical and subtropical countries including
Sri Lanka are affected by dengue due to climatic suitability for existence of the vector species
and unplanned rapid urbanization (Dengue and severe dengue, no date). Nearly four billion of
the global population lives in an area at risk of dengue (About Dengue: What You Need to Know |
Dengue | CDC, no date).

Dengue infections might be asymptomatic about three in four people infected (Symptoms and
Treatment | Dengue | CDC, no date). Symptomatic dengue infections lead to a wide range of
complications from dengue fever to potentially fatal dengue hemorrhagic fever and dengue shock
syndrome (Martina, Koraka and Osterhaus, 2009). About one in twenty people who are
symptomatic may develop dengue hemorrhagic fever or dengue shock syndrome (Symptoms and
Treatment | Dengue | CDC, no date).Dengue fever presents with rapid onset of fever, severe
headache, pain in joints and muscles, nausea and rash (Martina, Koraka and Osterhaus, 2009).
Dengue hemorrhagic fever presents with all the symptoms of dengue fever and vascular bleeding
(Martina, Koraka and Osterhaus, 2009). Dengue shock syndrome is associated with hypovolemic
shock resulting bradycardia and hypotension (Martina, Koraka and Osterhaus, 2009). These
severe conditions may even lead to death.

Dengue fever is caused by dengue virus (DENV). There are four serotypes of dengue virus.
Those are DENV -1, DENV -2, DENV -3 and DENV -4 (Transmission | Dengue | CDC, no
date). Therefore, a person can be infected with dengue four times for his lifetime for each
serotype. Adese aegypti and Aedes albopictus are the predominant vectors that transmit dengue
fever from person to person (Transmission | Dengue | CDC, no date). Adese aegypti shows a
larger contribution towards spread of dengue fever and increasing transmission rate while Aedes
albopictus shows relatively a lesser contribution (Transmission | Dengue | CDC, no date).
Dengue fever is transmitted to humans by a mosquito when a person gets bitten by an infected
mosquito. The mosquito gets infected when it bites an infected human (Dengue Transmission |
Learn Science at Scitable, no date). Thereby mosquito transmits dengue fever from infected
human to a healthy human. Dengue fever can also be transmitted from an infected pregnant
woman to the fetus during pregnancy and it is not yet confirmed whether breast milk can
transmit dengue fever from mother to infant (Transmission | Dengue | CDC, no date). Vector
species lay eggs in clear, stagnant, still water sources that are natural or artificial (Dengue
Transmission | Learn Science at Scitable, no date). Then the eggs develop into larva and pupa
stages in the aquatic medium. The mosquitoes bite during the day and night.

The epidemiology of dengue can be studied according to the distribution and determinants of the
disease. The distribution can be studied according to the frequency and pattern of the disease and

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