Dengue

Question 1

What are the 5 clinical presentations of dengue?

Answer 1

1. Abrupt onset of fever
2. Severe headache
3. Pain behind the eyes
4. Muscle & joint pains
5. Rash

Question 2

How many serotypes of dengue are there?

Answer 2

4

Question 3

What are the 4 clinical criteria of DSS/DHF?

Answer 3

1. Fever
2. Haemorrhagic manifestations
3. Enlargement of liver
4. Rapid & weak pulse with narrowing of pulse pressure or hypotension + cold clammy skin & restlessness

Question 4

What are the 2 lab criteria for DSS/DHF?

Answer 4

1. Thrombocytopenia < 100,000/mm3
2. Increased haematocrit > 20% increase

Question 5

What are the 5 warning signs of shock in DSS?

Answer 5

1. Restlessness and/or lethary
2. Acute abdominal pain
3. Cold extremeties
4. Skin congestion
5. Oliguria

Question 6

When does DSS happen?

Answer 6

Occurs at time or, or shortly after, fall in temperature between days 3-7 of disease

Question 7

What is the main cause of death in DSS/DHF?

Answer 7

Increase in vascular permeability that leads to leakage of plasma, causing hypotension

Question 8

How to manage DSS/DHF?

Answer 8

Infuse plasma or electrolyte solution

Question 9

Why is the second dengue infection worse than the first?

Answer 9

Non-neutralizing antibodies form immune complexes with replicating virus and attach to Fc receptors on mononuclear phagocytes, internalizing the viruses.

Viruses continue to replicate in infected cells, activating the mononuclear phagocytes causing the release of factors responsible for increased vascular permeability.