Dengue Fever,Dengue Vaccine : DF Prevention,Control,Supportive Measures

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Infectious Diseases in Children

Dengue Fever/DHF/DSS

Infectious Diseases in Children

HIV Infection

Malaria In Children

Tropical Splenomegaly Syndrome

Pneumonias In Children

Chickenpox

Varicella Zoster Virus

Clinical Manifestations Of Congenital Syphilis

H.influenzae - B Prevention Enteric Fever

Hand, Foot and Mouth Disease

Dengue and Dengue Hemorrhagic

H1N1 Influenza Epidemic

Varicella Infection in Pregnancy

Chikungunya - Indian Prespective

Enteric Fever

Otitis Media In Children

Utility of PCR Tests for Diagnosis of HIV in Infants Exposed to HIV Virus

Nonsurgical Treatment of Cystic Echinococcosis

Drug Resistant Tuberculosis in Children in India

Role of Quantiferon Gold Test (Interferon gamma release assay) for Diagnosis of Tuberculosis in Children

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Diagnostic Dilemma

Question of the Day

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VACCINE REMINDER

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SPECIALIST ANSWERS

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Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

DENGUE AND DENGUE HEMORRHAGIC FEVER DENGUE SHOCK SYNDROME

Dengue(Dengue Hemorrhagic) Fever and DSS

Dengue Fever

Related topics

Introduction

Dengue Epidemics Factors

DHF/DSS and Lab Investigations

DHF/DSS Diagnosis Laboratory criteria Complications and Tests

Dr Vishal Dublish, Dr Ira Shah

Continued...

Dengue fever:

Other supportive measures:

Hyponatremia, metabolic acidosis - judicious use of sodium bicarbonate.
Oxygen - for all shock patients.
Sedation - Chloral hydrate (12.5 - 50 ng/kg) Single dose, Avoid hepatotoxic drugs.
Blood transfusion - Reduced hematocrit without clinical improvement suggests hemorrhage and should be replaced with fresh whole blood. There is no role of preventive transfusion in DSS in sustained improvement in coagulation status.
FFP / Platelet transfusion is required only if severe DIC with massive bleeding.
Monitoring should be constant and includes pulse, blood pressure, temperature, hematocrit (2 hourly during 1st 6 hrs and then 4 hourly), input-output chart, IV fluids - type, volume, rate etc.
There is no role of corticosteroids in improving outcome of patients with DHF/DSS.

Prevention and control of dengue fever: At present no specific drug or vaccine is available against dengue virus. So, control primarily is dependent on control of vector.

Environmental changes: Improving water supply, mosquito proofing of overhead tanks, cisterns and underground reservoirs.
Personal protection: Protective clothing, mats, coils aerosols (pyrethrum), repellents e.g., Neem oil, DEET, permethrin impregnated in cloth, insecticide treated mosquito nets and curtains. (OLYSET NET).
Biological control: by
Fish - larvivorous fish: Gambusia affinis and Peorilia reticulata
Bacteria - Bacillus thuringiensis H-14, Bacillus sphaericus - breeds in polluted water.
Chemical control:
- 1% temephos sand granules
- Space sprays - malathion, fenitrothion, pirimiphos (only in major DHF epidemics).
- Insect growth regulators - interfere with development of the immature stages of the mosquito by interference of chitin synthesis during melting process in larvae or disruption of pupal stage.

Dengue Vaccine:

A tetravalent live attenuated DEN vaccine trial has been done in Thailand. After 3rd dose 89% of subjects seroconverted. Trial suggested that this vaccine has moderate but improvable reactogenicity and high seroconversion rates against 4 serotypes of DEN virus after 3rd dose.
A recombinant DEN virus tetravalent vaccine have been developed, which was found to be 92% efficacious in monkeys against all 4 DEN virus serotypes (CHIMERI VAX-DEN).

Also See Article On "DENGUE FEVER" For More Information
See Expertise Views For Questions On"Dengue"
See Frequently Asked Questions On"Dengue"

References:

Souza LJ, Alves JG, Nogueira RM, Gicovate Neto C et al. Aminotransferase changes and acute hepatitis in patients with dengue fever: analysis of 1,585 cases. Braz J Infect Dis. 2004 Apr;8(2):156-63. Epub 2004 Sep 08
Wills BA, Oragui EE, Dung NM, Loan HT, Chau NV, Farrar JJ, Levin M. Size and charge characteristics of the protein leak in dengue shock syndrome. J Infect Dis. 2004 Aug 15;190(4):810-8. Epub 2004 Jul 19.
Davis JS, Bourke P. Rhabdomyolysis associated with dengue virus infection. Clin Infect Dis. 2004 May 15;38(10):e109-11. Epub 2004 Apr 28.
De Paula SO, de Melo Lima C, Torres MP, Pereira MR, Lopes da Fonseca BA. One-Step RT-PCR protocols improve the rate of dengue diagnosis compared to Two-Step RT-PCR approaches. J Clin Virol. 2004 Aug;30(4):297-301.
Santos NQ, Azoubel AC, Lopes AA, Costa G, Bacellar A. Guillain-Barre syndrome in the course of dengue: case report. Arq Neuropsiquiatr. 2004 Mar;62(1):144-6. Epub 2004 Apr 28
Ahmed S. Vertical transmission of dengue: first case report from Bangladesh. Southeast Asian J Trop Med Public Health. 2003 Dec;34(4):800-3.
Witayathawornwong P. Parturient and perinatal dengue hemorrhagic fever. Southeast Asian J Trop Med Public Health. 2003 Dec;34(4):797-9.
Janjindamai W, Pruekprasert P. Perinatal dengue infection: a case report and review of literature. Southeast Asian J Trop Med Public Health. 2003 Dec;34(4):793-6.
Guirakhoo F, Pugachev K, Zhang Z, Myers G, Levenbook I, Draper K, Lang J et al. Safety and efficacy of chimeric yellow Fever-dengue virus tetravalent vaccine formulations in nonhuman primates. J Virol. 2004 May;78(9):4761-75.
Shepard DS, Suaya JA, Halstead SB, Nathan MB, Gubler DJ, Mahoney RT, Wang DN, Meltzer MI. Cost-effectiveness of a pediatric dengue vaccine. Vaccine. 2004 Mar 12;22(9-10):1275-80.
Chakravarti A, Parthasarathy P, Chakravarti A. Evaluation of a rapid immunochromatographic test in the diagnosis of dengue fever. Indian J Pathol Microbiol. 2003 Jan;46(1):127-8.
Sabchareon A, Lang J, Chanthavanich P, Yoksan S, Forrat R, Attanath P et al. Safety and immunogenicity of a three dose regimen of two tetravalent live-attenuated dengue vaccines in five- to twelve-year-old Thai children. Pediatr Infect Dis J. 2004 Feb;23(2):99-109.
Shivbalan S, Anandnathan K, Balasubramanian S, Datta M, Amalraj E. Predictors of spontaneous bleeding in Dengue. Indian J Pediatr. 2004 Jan;71(1):33-6.
Donoso Mantke O, Lemmer K, Biel SS, Groen J, Schmitz H, Durand JP, Zeller H, Niedrig M. Quality control assessment for the serological diagnosis of dengue virus infections. J Clin Virol. 2004 Feb;29(2):105-12
Nguyen TH, Lei HY, Nguyen TL, Lin YS, Huang KJ et al. Dengue hemorrhagic fever in infants: a study of clinical and cytokine profiles. Infect Dis. 2004 Jan 15;189(2):221-32. Epub 2004 Jan 09
Miranda LE, Miranda SJ, Rolland M. Case report: spontaneous rupture of the spleen due to dengue fever. Braz J Infect Dis. 2003 Dec;7(6):423-5. Epub 2004 Mar 01.
Lum LC, Abdel-Latif Mel-A, Goh AY, Chan PW, Lam SK. Preventive transfusion in Dengue shock syndrome-is it necessary? J Pediatr. 2003 Nov;143(5):682-4.
Vazquez S, Lemos G, Pupo M, Ganzon O, Palenzuela D, Indart A, Guzman MG. Diagnosis of dengue virus infection by the visual and simple AuBioDOT immunoglobulin M capture system. Clin Diagn Lab Immunol. 2003 Nov;10(6):1074-7.

Last updated on 01-08-2005 Vol 2 Issue 8 Art # 38

How to cite this url

Dublish V,Shah I.Dengue And Dengue Hemorrhagic Fever Dengue Shock Syndrome.Pediatric Oncall [serial online] 2005 [cited 2005 August 1];2. Art # 38. Available from: