1. Aedes aegypti, the mosquito that spreads Dengue fever.

2. Dengue is a mosquito-borne viral infection that is transmitted to human through the bite of the female Aedes mosquito. Dengue fever is a severe, flu-like illness that affects infants, young children and adults but rarely causes death. This disease used to be called “break-bone” fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking, hence the name. It can be caused by any one of four types of dengue virus: DEN-1, DEN-2, DEN-3, and DEN-4. You can be infected by at least two, if not all four types at different times during your lifetime, but only once by the same type. The 2 most severe forms of dengue are Dengue Haemorraghic Fever (DHF) and Dengue Shock Syndrome (DSS). What is Dengue?

3. Dengue viruses occur in most tropical areas of the world. Dengue is common in Africa, Asia, the Pacific, Australia, and the Americas. It is widespread in the Caribbean basin. Dengue is most common in cities but can be found in rural areas. Dengue Lives in and around human habitations in urban areas. It is rarely found in mountainous areas above 4,000 feet. Where is Dengue found?

4. Breeding grounds for Aedes Aegypti Water storage tanks Buckets, pails & bottles

6. Discarded tires

7. Characteristics of the Aedes Mosquito  One distinct physical feature – black and white stripes on its body and legs.  Bites during the day.  Lays its eggs in clean, stagnant water. Close-up of an Aedes mosquito

8.  Only the female Aedes mosquito feeds on blood. This is because they need the protein found in blood to produce eggs. Male mosquitoes feed only on plant nectar.  On average, a female Aedes mosquito can lay about 300 eggs during her life span of 14 to 21 days. Do you know…….

9. 1-2 days 4-5 days Life cycle of the Aedes Mosquito 2-3 days Adult mosquito Larve Eggs Pupae Once laid, the eggs of a mosquito will take 7-10 days to become adult mosquitoes

10. Symptoms of Dengue will usually appear after 4-6 days. The incubation period for Dengue is 3-4 days. How Do Aedes Mosquitoes Transmit Diseases... A mosquito that has been infected with the Dengue virus is capable of infecting a person throughout its life.

11. Recognition of Dengue fever (DF) - Sudden onset of high fever (up to 105 degrees Fahrenheit) - Severe headache (mostly in the forehead) - Pain behind the eyes which worsens with eye movement - Body aches and joint pains - Nausea or vomiting - Rash The rash may appear over most of your body 3 to 4 days after the fever begins. You may get a second rash later in the disease. Recognition of Dengue Haemorrhagic Fever (DHF) - Symptoms similar to dengue fever plus, any one of the following: - Severe and continuous pain in abdomen - Bleeding from the nose, mouth and gums or skin bruising - Frequent vomiting with or without blood - Black stools, like coal tar - Excessive thirst (dry mouth) - Pale, cold skin - Restlessness, or sleepiness Dengue shock syndrome (DSS) is defined as dengue hemorrhagic fever plus: - Weak rapid pulse - Narrow pulse pressure (less than 20 mm Hg) - Cold, clammy skin and restlessness. - Fluids leaking outside of blood vessels - Massive bleeding - Shock (very low blood pressure) This form of the disease usually occurs in children (sometimes adults) experiencing their second dengue infection. It is sometimes fatal, especially in children and young adults. What are the signs and symptoms of Dengue?

12. What is the treatment? There is no specific treatment for Dengue. Persons with Dengue fever should rest and drink plenty of fluids. They should be kept away from mosquitoes for the protection of others. Dengue hemorrhagic fever is treated by replacing lost fluids. Some patients need transfusions to control bleeding. Aspirin and Brufen should be avoided in dengue fever, as it is known to increase the bleeding tendency and also it increases the stomach pain. Paracetamol can be given on medical advice. If one or more signs of Dengue Haemorrhagic fever are seen, take the patient to the hospital immediately. Give fluids to drink while transferring the patient to the hospital.

13. Dengue Fever Fever Rash

14. NASAL HEMORRHAGING Subcutaneous hemorrhage in child with DHF Dengue Hemorrhagic Fever Hemorrhagic conjunctivitis

15. Dengue Shock Syndrome

16. Dengue Prevention What you need to know…

17. Personal protection against mosquitoes Apply repellent (20-30% DEET) to exposed skin- avoid eyes, mouth, and children’s hands Spray clothing with repellents with DEET or permethrin Use treated mosquito netting over bed Spray insecticide in room before going to bed, follow label instructions Wear long-sleeved shirts and long pants

18. Indoor & Outdoor application with thermal fog or portable ULV unit

19. Mosquito Net

20. Mosquito Repellent Spray Mosquito Repellent Coil

21. This is what you can do to help…

23. Do not litter. Rubbish such as cups and bottles can collect rain water and breed mosquitoes.

24. Dengue fever on the rise in Sultanate BANDAR SERI BEGAWAN Wednesday, March 10, 2010 THERE'S a significant increase in dengue fever cases in the country, said the Ministry of Health's Environmental Health Division. Since January, the division has recorded 35 cases compared to 38 cases for the whole of last year. For the first time, two cases of dengue haemorrhagic fever have been reported, a more virulent form of dengue fever, where a patient bleeds through his skin, nose or eyes. In an interview with The Brunei Times yesterday, Head of Environmental Health Division Dr Muhammad Hussein said the two victims responded well to medical treatment and have since fully recovered. http://www.bt.com.bn/news-national/2010/03/10/dengue-fever-rise-sultanate Practise good hygiene to keep dengue at bay BANDAR SERI BEGAWAN Wednesday, March 10, 2010 http://www.bt.com.bn/science-technology/2010/03/10/practise-good-hygiene-keep-dengue-bay Dengue under control, says MoH Apr 5th, 2010 Bandar Seri Begawan http://news.brunei.fm/2010/04/05/dengue-under-control-says-moh/ Useful link…….