Fight The Bite

26/09/2020

Monitoring And Treatment Of Dengue In Clinic

Dengue fever is a systemic and dynamic disease, the clinical presentation depending on the different phases of the disease. After a person being bitten by an infected mosquito (usually 2-7 days), the illness begins abruptly and will be followed by 3 phases which is the febrile, critical and recovery phase. Therefore, a patient suspected to have Dengue fever will be assessed in a stepwise manner when he comes to the health clinic.

Stepwise Approach in Outpatient Management

Step 1: Overall Assessment

Patients may arrive in the clinic or emergency department with nonspecific complaints. Most times, the diagnosis will be suspected during the gathering of the history. It is important to ask about recent travel, the constitutional symptoms and if patient live in an outbreak area. The key is to obtain a good history and suspect the diagnosis early. After the history taking and clinical examination completed and the diagnosis of suspected dengue case is established, a confirmation test such as COMBO rapid test kit for NS1, IgM and IgG should be performed.

Step 2: Diagnosis, disease staging and severity assessment

Based on patient’s history, physical examination, and laboratory investigation, the doctor or clinician will determine:

Dengue diagnosis whether provisional or confirmed
The phase of dengue illness.If dengue is suspected whether febrile, critical or recovery phase
The hydration and vital status of patient whether in shock or not
Whether the patient requires admission and referral to hospital or can be treated as outpatient in clinic

Step 3: Plan of management

Any suspected or confirmed dengue case is compulsory to be Notify to nearest district health office via phone followed by disease notification form Health 1 within 24 hours after the diagnosis made.
If admission is indicated, stabilise the patient at primary care before transfer.
If admission is not indicated, daily or more frequent follow up is necessary until the discharge by the doctor
Dengue monitoring record (TABLE 2) will be given to patient and to be used for outpatient care.

26/09/2020

1. When do the dengue causing mosquitoes bite day or night? How to identify them?
Answer: Although mosquitoes causing dengue (Aedes Aegypti mosquito) are known to bite primarily during the day, they can bite during the night as well. You can easily recognise these mosquitoes based on the characteristic stripes on their body.

2. Where do these mosquitoes breed?
Answer: These mosquitoes can breed in clean water (unlike those causing malaria). So right from water logging sites, unused tires, water tanks to trays of potted plants, they can breed anywhere and everywhere in your locality. Also, the warm humid climate and dark and warm places in your house are known to be ideal breeding grounds for these mosquitoes.

3. How does dengue spread?
Answer: Dengue, a viral disease, spreads when an Aedes Aegypti mosquito infected with the dengue virus bites a healthy individual. This causes the virus to enter the bloodstream and multiply, leading to dengue fever.

4. Who is at risk of dengue?
Answer:You might be at a high risk of suffering from dengue if you live in a dengue-prone area or have already suffered from dengue. Also, people who have low immunity, like kids and old people and those suffering from lifestyle conditions like heart disease or diabetes are more prone.

5. Can I get dengue from a person suffering from the disease?
Answer: Dengue is not a contagious disease; i.e. it doesn t spread from one person to other through physical contact. It only spreads when a mosquito infected with the dengue virus bites a person.

6. When do the symptoms of dengue start to appear?
Answer: Once the virus infected mosquito bites, it usually takes around 4 10 days for the symptoms to appear.

7. How to differentiate between viral fever and dengue fever?
Answer: In case of viral fever, you experience high fever coupled with chills and (in some cases headache). However, people suffering from dengue report severe headache, pain behind the eyes, weakness, skin rash and/or severe joint pain along with high fever.

8.Can dengue be diagnosed at home (without a blood test)?
You can diagnose dengue at home based on the symptoms but to confirm it, you need a blood test. Hence, you can t confirm the viral disease unless it is backed by a blood test.

9. How to get tested for dengue?
Dengue can be diagnosed with the help of a blood test complete blood count (CBC) and an antigen/antibody test for dengue. The CBC test tells you about platelet and haemoglobin count whereas NS1 antigen and antibody test for IgM and IgG confirms dengue infection.

10.Does low platelet count always indicate dengue?
Low platelet count is one of the key symptoms of dengue but it doesn t always indicate dengue. It has to be supplemented with a dengue antigen or antibody test to confirm the disease. Clinically known as thrombocytopenia, low platelet count can occur in case of viral fever as well.

26/09/2020

Mint: If the scent of mint relaxes you then this remedy is for you. According to a study published in the Journal of Bioresource Technology {4} found that mint oil and the mint extract is as effective as any other indoor mosquito repellent. You can use mint leaves and essence in various ways. You can choose to use it in a vaporizer to help fill the room with the scent of mint, apply the oil on your body or plant the shrub outside your room s window. Alternatively you could mix a bit of mint-flavoured mouthwash with water and spray it around your home.

Plant trees: If you thought that trees and shrubs led the breeding of more mosquitoes, you are wrong. Planting the right kind of shrubs and trees can go a long way in keeping your home mosquito free. Shrubs of tulsi, mint, marigold, trees of lemon and neem and planting citronella grass are all extremely effective in preventing the breeding of mosquitoes keeping you safe from dreaded vector-borne diseases; naturally.

26/09/2020

1. When do the dengue causing mosquitoes bite day or night? How to identify them?
Answer: Although mosquitoes causing dengue (Aedes Aegypti mosquito) are known to bite primarily during the day, they can bite during the night as well. You can easily recognise these mosquitoes based on the characteristic stripes on their body.

2. Where do these mosquitoes breed?
Answer: These mosquitoes can breed in clean water (unlike those causing malaria). So right from water logging sites, unused tires, water tanks to trays of potted plants, they can breed anywhere and everywhere in your locality. Also, the warm humid climate and dark and warm places in your house are known to be ideal breeding grounds for these mosquitoes.

3. How does dengue spread?
Answer: Dengue, a viral disease, spreads when an Aedes Aegypti mosquito infected with the dengue virus bites a healthy individual. This causes the virus to enter the bloodstream and multiply, leading to dengue fever.

4. Who is at risk of dengue?
Answer:You might be at a high risk of suffering from dengue if you live in a dengue-prone area or have already suffered from dengue. Also, people who have low immunity, like kids and old people and those suffering from lifestyle conditions like heart disease or diabetes are more prone.

5. Can I get dengue from a person suffering from the disease?
Answer: Dengue is not a contagious disease; i.e. it doesn t spread from one person to other through physical contact. It only spreads when a mosquito infected with the dengue virus bites a person.

6. When do the symptoms of dengue start to appear?
Answer: Once the virus infected mosquito bites, it usually takes around 4 10 days for the symptoms to appear.

7. How to differentiate between viral fever and dengue fever?
Answer: In case of viral fever, you experience high fever coupled with chills and (in some cases headache). However, people suffering from dengue report severe headache, pain behind the eyes, weakness, skin rash and/or severe joint pain along with high fever.

8.Can dengue be diagnosed at home (without a blood test)?
You can diagnose dengue at home based on the symptoms but to confirm it, you need a blood test. Hence, you can t confirm the viral disease unless it is backed by a blood test.

9. How to get tested for dengue?
Dengue can be diagnosed with the help of a blood test complete blood count (CBC) and an antigen/antibody test for dengue. The CBC test tells you about platelet and haemoglobin count whereas NS1 antigen and antibody test for IgM and IgG confirms dengue infection.

10.Does low platelet count always indicate dengue?
Low platelet count is one of the key symptoms of dengue but it doesn t always indicate dengue. It has to be supplemented with a dengue antigen or antibody test to confirm the disease. Clinically known as thrombocytopenia, low platelet count can occur in case of viral fever as well.

26/09/2020

As Malaysia celebrates the decline of Covid-19 cases in the nation, the Health Ministry has released a warning for the second wave of another deadly virus infection – dengue.
A second wave of dengue cases is expected to hit the nation early June and carry on until September 2020, based on the trend of dengue cases in the nation over the last 5 years.
From January to 6 June 2020, 48,584 cases of dengue fever were reported, with a total of 84 deaths this year.
While the total figure is an 11% drop from last year’s 54,524 cases in the same time frame, the numbers climbed over the last 6 weeks with an average of 8% each week.

Moreover, the Health Ministry notes that 11% of this year’s dengue fever deaths were due to late treatment.
Health director-general Datuk Dr Noor Hisham Abdullah hypothesised that premises closed during the Movement Control order (MCO) period had inadvertently become breeding grounds for the virus-carrying Aedes mosquito.
Just like the novel coronavirus, there is no vaccine available for the dengue virus.
As such, the Health Ministry urges the public to increase the level of cleanliness and hygiene in their surroundings, especially in places that collect water which are a potential breeding ground for mosquitoes.

26/09/2020

Prevention is always better than cure. In most instances, our unclean environment is the leading cause of breeding of aedes mosquitoes. It is vital to keep our environment clean to prevent dengue fever.

As Monsoon season approaches Malaysia, it is recommended that we spend at least 10 minutes a day to clean our surroundings. Be sure to check and tidy up any possible eades breeding spots.

The below post shows ways to prevent mosquitoes breeding sites. If there aren't any mosquitoes breeding sites, we'll be able to prevent dengue fever.

Let us all fight the bite together!

26/09/2020

26/09/2020

If you are suspected of having or diagnosed with dengue fever, minimize the risk of transmission :

1.Reduce the number of adult mosquitoes in your house:
• Wear full sleeves clothes and long dresses to cover as much of your body as possible

2.Clean your environment:

3.Prevent further mosquito bites:
• You could apply insect repellants to exposed body parts or use a mosquito net

4.Inform your neighbours and friends who are suspected of having or diagnosed with dengue fever to do the same.

26/09/2020

Sign and symptoms of dengue fever :

• Aching muscles and joints
• Body rash that can disappear and then reappear
• High fever (40°C) for up to a week
• Intense headache
• Pain behind the eyes
• Vomiting and feeling nauseous

26/09/2020

Many people, especially children and teens, may experience no signs or symptoms during a mild case of dengue fever. When symptoms do occur, they usually begin four to seven days after you are bitten by an infected mosquito.

Sign and symptoms of dengue fever :

• Aching muscles and joints
• Body rash that can disappear and then reappear
• High fever (40°C) for up to a week
• Intense headache
• Pain behind the eyes
• Vomiting and feeling nauseous

Sign and symptoms of dengue hemorrhagic fever :

• Bleeding from your mouth/gums/nose
• Clammy skin
• Internal bleeding, which can result in black vomit and faeces (stools)
• Abdominal pain
• Small blood spots under your skin
• Weak puls

26/09/2020

Dengue is one of the most important arthropod-borne viral diseases in terms of human morbidity and mortality in Malaysia. Dengue has become an important public health problem. It affects tropical and subtropical regions around the world, predominantly in urban and semi urban areas. Dengue viruses are transmitted to humans through the bites of a striped Aedes aegypti mosquito that has previously bitten an infected person. Dengue does not spread directly from person to person. It is only spread through the bite of an infected mosquito.