Dengue

Question 1

How is dengue spread?

Answer 1

Aedes aegypti and albopictus
Transplacental
Needle stick
Blood transfusion

Question 2

When does aedes bite and where do they breed?

Answer 2

Day biter, early AM and sunset
Urban environment
Breed in containers/ tyres

Question 3

How do you identify an Aedes mosquito?

Answer 3

Black and white pattern
Female- pointed tip, palps shorter than proboscis
Male- palms longer than proboscis

Question 4

How do you differentiate Aedes aegypti from albopictus?

Answer 4

Aegypti- lyre shape on scutum

Question 5

How does dengue present?

Answer 5

90% asymptomatic 
Dengue fever
Dengue haemorrhagic fever
Dengue shock syndrome 
Dengue with CNS

Question 6

What are the features if dengue fever?

Answer 6

Fever and 2 of

• severe HA
• retro-orbital pain
• myalgia/arthralgia
• rash
• leukopenia
• plts <150
• minor bleeding

Question 7

What are the features of dengue haemorrhagic fever?

Answer 7

Fever
Haemorrhage
Plts <100
Plasma leakage

Question 8

What are the features of dengue shock syndrome?

Answer 8

DHF + shock

Question 9

What does the dengue rash look like?

Answer 9

Erythematous maculopapular rash with island sparing

Question 10

What are the dengue warning signs?

Answer 10

Abdo pain
Vomiting
Clinical fluid overload
Mucosal bleeding
Lethargy
Liver enlargement >2cm
High Hct
Low Plts
Dropping fever

Question 11

How do you diagnose dengue?

Answer 11

RT-PCR
RDT: NS1 protein
IgM from 1wk after, IgG from 2wk after

Question 12

How do you manage dengue?

Answer 12

Paracetamol and PO fluids
IVI +/- transfusions
Stop IVI once out of critical stage- fluid overload!

Question 13

How do you prevent dengue?

Answer 13

Vector control
Bite protection
If you have dengue avoid getting bitten for first week
Education
Vaccination- only for endemic people who have had dengue at least once before
Surveillance of vector and virus