1. Dengue Fever (Pronounced as Dhen Gey) Facts we all need to know by Dr.R.V.S.N.Sarma., M.D.,

2. Alternative Names l Onyong- Nyang Fever l West Nile Fever l Break Bone Fever l Dengue like Disease

3. Inter play of three factors WE The Virus The Mosquito Interaction

4. The Virus Dengue Virus

5. The Dengue Virus Four types (flavours) l Type 1 to 4 (named very cleverly) l Transmitted by mosquito – Indian national airliner for most germs!

6. Dengue Virus Electron Micrograms

7. The Aircraft for Dengue Difficult name to pronounce? We have to ask its parents (Zoologists) Aedes aegypti (Infected Female Mosquito) mostly females are dangerous anyway – joking!

8. Watch out ! This Mosquito l Day biting – normally catches us unaware l Loves / lives in fresh water in homes l Lays eggs preferentially in jars, discarded containers, coconut shells, old tires etc. l Year round breeding l Tropical regions like our mother India are its favorite zones. l It is an urban mosquito

9. The Aircraft (Aedes aegypti)

10. This special mosquito Transmits Many Dangerous illnesses

11. See our greatness! Prevalent from centuriesHighly prevalent now

12. Dengue Fever l Dengue viruses – 4 flavours cause it l It is transmitted by a mosquito- the Aedes aegypti l It is generally an animal virus l Man is accidentally infected l Other vertebrates are the reservoirs

13. Dengue Transmission Cycle

14. Dengue colourful features! Clinical Features

15. Dengue Presentations l Like any other viral fever- not clear cut l Dengue Fever with Muscle pains this is classical presentation in 90% cases l Dengue Fever with bleeding in 7% l Dengue – the dangerous form in 3%

16. Bleeding from where? l Bleeding into skin l From Gums l From Nose l Into our food passages l Blood in urine

17. What do we experience ? l 2–7 days after the mosquito had its dinner on us we may develop l Sudden onset of fever, chills, headache l Back pain with severe muscle and joint pains l Pain behind the eyes and on moving the eyes l Nick name - Break bone fever- pains so severe l Red patches or spots on the skin l Mild nose bleeds This is the ordinary classical Non dangerous form!

18. What is the end result? l Complete recovery is the rule l Severe weakness many persist for many days after the fever leaves us

19. Skin bleeds

20. Dengue – The bleeding form l Blood vessels are affected l There is severe oozing into tissues l Bleeding into all possible parts of body l Blood clotting mechanism is disrupted l Blood pressure falls and many end in collapse and death l In the best centers 5% of this type of Dengue will reach their forefathers

21. Bleeding into the eye

22. Large bleed into skin

23. Bleeding spots in skin Dengue Normal

24. Rare types of Dengue l Brain fever l Liver damage l Heart damage l Severe bleeding into stomach

25. What are the tests needed? l Routine blood test l Tests to check the clotting process l Special tests to identify the Dengue or its foot marks in our blood l Urine to check protein leak

26. Special Test (ELISA) ELISA PlateIgM-capture ELISA

27. Treatment of Dengue l Supportive measures – Mosquito screen l Avoid Aspirin and pain killers l Steroids should not be used l Plenty of water and salt are required l Children below 12 require careful watch for dangerous form l No antibiotics are of proven value

28. Child with severe form of Dengue Oxygen IV Fluids Special Care See the tubes every where Frightening, isn’t it?

29. Common Misconceptions l Severe Dengue is only a childhood illness – No, All ages may be involved l Sever form is a problem of poor families – No, The effluent do get very sick

30. Can we protect ourselves? l There is no vaccine available as yet l But we can prevent the disease by preventing ourselves from mosquito bite

31. Mosquito Control How to prevent mosquito spread? 1. Do not allow empty vessels, coconut shells, plastic containers, flower pots, tires etc to collect rain water in them 2. Frequently (once in 2-3 days) empty all water storage containers 3. Cover your over tanks to prevent mosquitoes breeding in fresh water

32. How to prevent mosquito bites? l Screen your homes with mosquito screens like Netlon - l Wear full clothing – long sleeves l Apply mosquito repellents like Odomos l Keep Dengue fever patient under mosquito net l True community participation is key

33. l Each person is a Book ! l Each Day is a Learning Opportunity!! l Learning has More Relevance today than ever !!! We need to learn

34. Reach Yours Sincerely @ l Dr.SARMA RVSN l Voice : +91-4116-2309226, 260593 l Mobile : +91- 93805 21221 l E-mail : sarma.rvsn@gmail.com l Web site : http://www.drsarma.inhttp://www.drsarma.in l Snail mail :3, Jayanagar, Tiruvallur Tamilnadu, INDIA Pin : 602 001

35. Thank You !