DENGUE FEVER

Question 1

An acute febrile illness of (BLANK) duration with two or more of the following: headache, retro-orbital (i.e., behind the eye) pain, myalgia (i.e., muscle aches), arthralgia (i.e., joint pain) rash, hemorrhagic manifestations, leucopenia (i.e., low white blood cell count).

Severe manifestations (e.g., dengue hemorrhagic fever or dengue shock syndrome) are rare, but may be fatal.

Answer 1

2-7 days

Dengue Fever

Question 2

transmission usually occurs in tropical or subtropical areas by what primary vector?

Answer 2

Aedes Aegypti Mosquito

Question 3

What are the two types of Dengue Fever?

Answer 3

Dengue Hemorrhagic Fever (DHF)

Dengue Shock Syndrome (DSS)

Question 4

Which one?

• Positive tourniquet test;
• Petechiae (i.e., reddish or purplish spot containing blood as a result of localized hemorrhage), ecchymoses (i.e.,
escape of blood into the tissues from ruptured blood vessels), or purpura (i.e., patches of purplish discoloration
as a result of blood escaping into the skin and mucous);
• Bleeding from mucosa, gastrointestinal tract, injection sites or other sites;
• Hematemesis (i.e., vomiting blood), melena (i.e., black, tar-like stool), and thrombocytopenia (100,000 cells per mm 3 or less) plus evidence of plasma leakage due to increased vascular permeability manifested by one or
more one of the following:
o A ≥20% rise in average hematocrit for age and sex;
o A ≥20% drop in hematocrit following volume replacement treatment compared to baseline; or
o Signs of plasma leakage [i.e., pleural effusion (e.g. shortness of breath, chest pain, gastric discomfort),ascites (i.e., accumulation of fluid in the abdomen), and hypoproteinemia (i.e., low levels of protein in the blood)].

Answer 4

Dengue Hemorrhagic Fever (DHF):

Question 5

If patient presents with all the criteria for DHF plus evidence of circulatory failure manifested by
either:

• Rapid and weak pulse with narrow pulse pressure (≤ 20 mm Hg), or
• Hypotension for age, cold, clammy skin and altered mental status.

They have what?

Answer 5

Dengue Shock Syndrome (DSS)

Question 6

Dengue-specific IgM antibodies present in serum with a P/N ratio ≥2.

Answer 6

Probable

Question 7

Isolation of dengue virus from or demonstration of specific arboviral antigen or genomic sequences in tissue, blood, cerebrospinal fluid (CSF), or other body fluid by polymerase chain reaction (PCR) test, immunofluorescence or immunohistochemistry;
• Seroconversion from negative for dengue virus-specific serum Immunoglobulin M (IgM) antibody in an acute phase (≤ 5 days after symptom onset) specimen to positive for dengue-specific serum IgM antibodies in a convalescent-phase specimen collected ≥5 days after symptom onset;
• Demonstration of a ≥4-fold rise in reciprocal Immunoglobulin G (IgG) antibody titer or Hemagglutination inhibition titer to dengue virus antigens in paired acute and convalescent serum samples;
• Demonstration of a ≥4-fold rise in PRNT (plaque reduction neutralization test) end point titer (as expressed by the reciprocal of the last serum dilution showing a 90% reduction in plaque counts compared to the virus infected control) between dengue viruses and other flaviviruses tested in a convalescent serum sample; or
• Virus-specific immunoglobulin M (IgM) antibodies demonstrated in CSF.

Answer 7

Confirmed