Review Note

Last Update: 09/03/2024 08:02 PM

Current Deck: Tropical Med::Arboviruses/Rickettsia/Borrelia

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Dengue
70% of cases in {{c1::Asia ::location}}
{{c2::90}}% of cases are asymptomatic
There is a {{c2::20}}% mortality without treatment
Second highest cause of {{c3::fever in returning traveller}} after malaria
Transmitted by {{c4::Aedes mosquito}}
Cases have been increasing due to more reporting but also increased population and climate crisis
Incubation period is {{c5::4-10}} days
Clinical presentation
Mild
{{c6::
Fever
Flu like illness
Retro Orbital pain and headache
Arthralgia
Rash that is white on red
}}
Severe (5%) - more likely if previously infected by a different strain
{{c7::
Shock
Edema
Bleeding
Death
}}
Diagnosis
{{c8::
PCR
Serology for antibodies after 1 week
Rapid diagnostic antigen test
}}
Other bloods
Platelets, haematocrit, WCC
Coag
Liver profile
Renal profile
Management is supportive
Avoid {{c9::NSAIDs}} in Dengue due to increased risk of bleeding
{{c9::Reinfection}} with Dengue is usually much worse than 1st time
Is PLT<100 or HCT >20% treat for shock
Beware of HCT drop not because the treatment is working but because theyre bleeding
Fluid resuscitation and beware of fluid overload
Prevention and control
{{c10::
Vector control of Aedes
Bed nets not too helpful since they feed in the day
Vaccine for those with confirmed previous dengue
There are 4 serotypes and infection gives lifelong immunity to that serotype
}}

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