Dengue in Pakistan

DENGUE FEVERby

Dr. Zeeshan Ali

Aim

To acquaint you with the Dengue Fever

Seq

• What is Dengue Fever

• World distr of Dengue Fever

• Outbreak in Pakistan

• Mosquito-characteristics and life cycle

• Symptoms of Dengue Fever

• Treatment of Dengue Fever

• Prevention of Dengue Fever

What is Dengue Fever

Dengue Fever also known as the ‘Break Bone Fever’ is an illness caused by infection by a virus (Flavi Virus) transmitted by the mosquito Aedes Aegypti rarely Aedes Albonictus

What is Dengue FeverFlavi Virus

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Global Status of Dengue Fever

• New infections annually -- 50 mn

• Death -- 24,000 annually

• People at risk -- 2.5 to 3 bn

• Hospitalized cases- 50,000 /yr

(90% affected are children)

• Disease burden -- 4,65,000

Disability Adjusted Life Years (DALY)

• Half of the world lives in HOT ZONE

World dist of Dengue Fever

Outbreak in Pakistan

• The first case of Dengue Fever

was detected in Pakistan in

the yr 1994 in Karachi

• The first outbreak of Dengue

Fever was in the yr 2006

• Since then dengue cases

detected per yr are on the rise

Out break in Pakistan 2006

Pak karachi Lahorecases 3232 1836 400death 50 30 4


• Over 4000 cases have been reported all over

Pakistan

• NIH shows 2143 confirmed and 2708 suspected

cases of Dengue Fever

• Max cases have been seen in Punjab Province where

up to 10 deaths have been confirmed

• In GB Province no case have been confirmed


Sr No

Province Confirmed Cases

1. Punjab 2170

2. Sind 176

3. Khyber Pakhtoon Khuwa 08

4. Azad Jammu Kashmir 05

*NIC stats of 9 Sept 11

Out break in Pakistan

Causes • Unplanned urban overpopulation of areas

• Inadequate housing and public health systems

(water, sewerage and waste management)

• Poor vector control, e.g., stagnant pools of water for

mosquito breeding

• Climate change and viral evolution

• Increased intl travel (recreational, business or

military) to endemic areas

Characteristics of Mosquito

Aedes MosquitoOne distinct physical feature – black and white stripes on its body and legs

Bites during the day

Lays its eggs in clean, stagnant water

Characteristics of MosquitoOnly the female Aedes mosquito feeds on blood because they need the protein found in blood to produce eggs

Male mosquitoes feed only on plant nectar

On average, a female Aedes mosquito can lay about 300 eggs during her life span of 14 to 21 days

Characteristics of Mosquito

Anopheles Mosquito Aedes Mosquito

Life cycle of Aedes Mosquito

Stagnant waterStagnant water

1-2 days

EggsLarvaePupae

2-3 days

4-5 days

Transmission of Dengue Fever

Symptoms of Dengue Fever

Manifestation of Dengue Fever Dengue Fever (DF)

Dengue Hemorrhagic Fever

(DHF)

Dengue Shock Syndrome (DSS)


Dengue Fever(DF)• Headaches• High grade fever• Swollen glands• Vomiting• Muscle joints pain• Positive tourniquet test• Basic symptoms in 90% of

patients• Settles in two weeks

DengueTriad


Dengue Hemorrhagic Fever(DHF)

• All prev symptoms of Dengue

Fever

• Spontaneous bleeding

• 9% of patient

• Recover with hospital care


Dengue Shock Syndrome (DSS)

• Rapid pulse

• Clammy cold skin

• Drop in blood pressure

• Abdominal pain

• 1% of patients

• Need ICU care

Treatment of Dengue Fever

Treatment is purely concerned with relief of the symptoms:

• Rest • Fluid intake for adequate hydration • Aspirin• NSAID • Acetoaminophen• Codeine

Treatment of Dengue Fever

Chemeri Vax Dengue

• A tetravalent vaccine

• Uses Yellow Fever vaccine as base

• 20% sero conversion

• Still under research

Prevention of Dengue Fever

Focus on vector control

• Use mosquito nets, spray

and repellent oil

• Drain stagnant water sites

• Use mosquito nets

• Wear full clothes at dusk

and dawn

• Fumigation

Prevention of Dengue FeverPublic Awareness

Facts about Dengue Fever• It is caused by a Virus

• No specific medicine or antibiotic to treat it

• Treatment is purely concerned with relief of the

symptoms

• Illness with fever and myalgias lasts about one to

two weeks

• DHF is a specific syndrome that tends to affect

children under 10 years of age

• Prevention of dengue fever req control or

eradication of the mosquitoes carrying the virus

Thank You

Dengue in Pakistan

Education

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