1. Dengue fever in Singapore & Pakistan

2. Introduction The most common mosquito-borne viral disease in the world Caused by a virus transmitted by the Aedes mosquito (DENV-1 to 4) Could escalate into Dengue Hemorrhagic fever (Dengue Shock Syndrome - Potentially fatal) Dengue fever is not contagious Does not spread by contact with an infected person Spreads by blood

3. Dengue statistics in Singapore & Pakistan YearSuspected cases Cases laborator y- confirme d Deaths 20064961193141 20072304122618 20082792246917 20091940108513 201015 90111 02440 2011252 93517 057219 Table 1. Denge fever cases reported from Pakistan, 2009–2011

4. The Aedes Mosquito Characteristic black and white stripes Only female mosquito bites Viral incubation period of 7 days Peak biting period is at dawn and dusk Life span of approximately 14 days Lays egg 3 times per lifetime Eggs can remain dormant for a period of up to 9 month

5. Dengue Fever Virus (DENV) A type of RNA virus from the Flaviviridae family Transmitted by anthropods i.e. arboviruses 11,000 nucleotide bases in genome Code for C, prM & E protein molecules 5 strains of virus (DENV-1, DENV-2, DENV-3, DENV-4) Difference is based on their antigenicity Dengue Virus (TEM microscopy)

6. Dengue fever diagnosis In laboratory, detection of specific antibodies in patients’ serum Repeated 2-3 weeks later if necessary Commercial rapid test kits are available Molecular detection (Polymerase Chain Reaction) Dengue antigen testing Blood of patient should be taken as soon as possible after the onset of related symptoms

7. Transmission The virus are transmitted through the bites of infected female mosquitos

8. Symptoms Dengue fever is like a severe flu-like illness that affects infants, young children, but seldom causes death High fever Severe headache Pain behind the eyes Muscle and joint pains Nausea and vomitting Swollen glands or rash

9. Symptoms Usually last 2-7 days, after an incubation period of 4-10 days once bitten by an infected mosquito

10. Treatment Treatment is purely concerned with the relief of the symptoms Rest Fluid intake for adequate hydration Aspirin NSAID Acetoaminophen Codeine

11. Treatment Chemeri Vax Dengue A tetravalent vaccine Uses Yellow Fever Vaccine as a base 20% conversion Still under research

12. Prevention Vector control Use mosquito nets, sprays and repellant oil Drain stagnant water sites Wear full clothes at dusk and dawn Fumigation Public awareness/education

13. Sources http://www.channelnewsasia.com/news/singapore/rise-in-dengue- type-2/1334776.html http://www.channelnewsasia.com/news/singapore/rise-in-dengue- type-2/1334776.html http://www.moh.gov.sg/content/moh_web/home/diseases_and_cond itions/d/dengue.html http://www.moh.gov.sg/content/moh_web/home/diseases_and_cond itions/d/dengue.html http://www.dengue.gov.sg/subject.asp?id=12 http://www.dengue.gov.sg/subject.asp?id=100 http://www.cgh.com.sg/Lists/Health%20Library/Attachments/79/CG H%20AllAbout%20Dengue.pdf http://www.cgh.com.sg/Lists/Health%20Library/Attachments/79/CG H%20AllAbout%20Dengue.pdf http://www.emro.who.int/surveillance-forecasting- response/outbreaks/dengue-fever-in-pakistan.html http://www.emro.who.int/surveillance-forecasting- response/outbreaks/dengue-fever-in-pakistan.html