Dengue or Break-Bone Fever

Second Edition
A presentation by
Ahmad Tariq Bhatti
Lahore

Dengue Fever
Dengue fever is a mosquito-borne disease caused by any one of four
closely related Dengue viruses. Thousands of deaths happen because of
Dengue infection around the globe annually.
An estimated 500 million Dengue virus infections occur around the world
every year, with about 100 million resulting in illness.
Dengue fever is most commonly occurring in southeast Asia and western
Pacific islands. The incidence of the disease is rapidly increasing in Latin
America and Caribbean islands.
Most of the people recover within a week or so. In some cases, symptoms
worsen and cause threat to life or cause death.
Blood vessels of the patient are damaged and become leaky in this
disease. The number of clot-forming cells (platelets) in the bloodstream
starts decreasing rapidly which causes a severe form of Dengue fever,
called Dengue Hemorrhagic Fever, severe Dengue, or Dengue Shock
Syndrome.
Dengue - The Killer Mosquito 2

The Killer Mosquito – Dengue.
Aedes Aegypti: Dengue Mosquito
(a close shot of the killer mosquito)
Dengue - The Killer Mosquito
3

Kill Dengue
The Aedes mosquito can be recognized by white markings on legs and thorax.
[Please refer to slide 3 for illustration of Dengue Mosquito]
The male of all mosquito species do not bite humans or animals, they
live on nectar and water only whereas the female mosquitoes take
blood in addition to nectar and water. Dengue virus is transmitted by
female Aedes mosquitoes during sucking blood from human body.

Breeding Places
Barrels, open sewerage holes, drums, jars, pots, buckets,
flower vases, pipes, plant-pots, tanks, discarded bottles, tins,
tyres, stagnant water, tree holes, palm fronds and a lot more
places where rain water accumulates.
Keep your environment
clean from mosquitoes.
Caveat
The mosquito that causes Dengue fever, bites during the day,
particularly in the early morning and in the evening. Their favorite biting
spots are below the elbow and below the knees. So, mosquito repellents
(oils/creams) should be used on these two parts of the body first.

Transmission
Dengue virus is primarily transmitted by Aedes mosquitoes,
particularly by Aedes Aegypti.
Other Aedes species that transmit the virus include:
 Aedes Albopictus,
 Aedes Polynesiensis and
 Aedes Scutellaris.
Humans are the primary host of the virus, but it also circulates in non-
human primates. An infection can be acquired via a single bite of the infected
female mosquito. A female Aedes mosquito that takes a blood meal from a person
who is infected with Dengue virus becomes herself infected with the virus by getting
lining on her gut (stomach/belly), subsequently, the virus spreads to the salivary
glands over a period of 8-12 days. After this incubation period, the virus is
transmitted to humans through biting.
The virus is not contagious and cannot be spread directly from person to
person.

Aedes Polynesiensis
Aedes AlbopictusAedes Aegypti
Aedes Scutellaris

Aedes Aegypti
Sucking Blood & Transmitting
Dengue Virus
into Human Body
Aedes Aegypti is mainly responsible for transmitting Dengue virus – WHO

Classification
World Health Organization has classified
Dengue fever into two groups in 2009:
 Severe and
 Uncomplicated.
Severe Dengue is defined as the one that is
associated with severe bleeding, severe
organ dysfunction, or severe plasma
leakage while all other cases are classified
as uncomplicated.

Symptoms
Dengue fever begins with a sudden high fever, often as high
as 104 - 105 °F (degrees Fahrenheit), within 3 to 14 days
after getting the infection. Normal human body temperature is
considered to be 98.6 °F (i.e. equivalent to 37°C).
A flat, red rash may appear over most of the body within 2 to 5 days
after the fever starts. A second rash, which looks like the measles,
appears later in the disease. Infected people may have severe skin
sensitivity that is highly irritating and becomes unbearable.
Warning signs of Dengue fever include:
 Sudden high fever
 Fatigue/lethargy/exhaustion
 Severe headache (especially behind the eyes)
 Joint & muscle aches
 Nausea & vomiting
 Swollen lymph nodes
 Severe skin rash
 Low BP

Symptoms begin in 3 to 14 days
after getting infection.

Causes & Incidence
Dengue fever is caused by one of four different but
related viruses. It is spread by the bite of female
mosquitoes, most commonly the mosquito, Aedes
Aegypti.
The virus has four different types and the infection with
one type usually gives lifelong immunity to that type,
but only short-term immunity to the others.
Subsequent infection with a different type increases
the risk of severe complications.

Dengue Serotypes
DENV-1 DENV-2
DENV-3 DENV-4

Dengue Serotypes
Dengue infections are caused by any one of the four closely
related viruses that are named as:
 DENV-1
 DENV-2
 DENV-3
 DENV-4
These four viruses are called serotypes because each type has
different interactions with the antibodies in human blood serum.
These viruses are similar — they share approximately 65% of
their genomes — but even within a single serotype, there is
some genetic variation. Despite these variations, infection with
each of the serotypes results in the same range of clinical
symptoms and disease.

Manifestations
D e n g u e V i r u s I n f e c t i o n
Without Symptoms With Symptoms
Not different from
other types of fever
Dengue Fever
Syndrome (DFS)
Dengue Hemorrhage
Fever (DHF)
Without
Hemorrhage
With Unusual
Hemorrhage
Dengue Shock
Syndrome (DSS)
No Shock

Spread the Awareness
About Dengue Mosquitoes
Let your family, friends and
neighbors know about
the dangers of the breeding of
Dengue mosquitoes around you.

Prevention
Because Dengue fever is spread by a virus, therefore, there
is no specific medicine or antibiotic for its treatment.
For a typical Dengue fever, the treatment is purely concerned with
the relief of symptoms.
Therefore, prevention is sought only by:
 Eliminating the breeding places of mosquitoes
 Keeping the environment clean
 Constant spraying insecticides at open places
 Limiting exposure to bites by using mosquito nets, coils, etc.
 Massaging exposed body parts with a suitable insect repellent and
wear long sleeve shirts and clothing which covers arms and legs.
 Using natural repellents like Lemon Eucalyptus Oil, Lavender, Neem
Oil and Cinnamon Oil to protect against these mosquito bites. Even
herbs like garlic, lemongrass, basil, peppermint, rosemary have
mosquito repellent properties.

Fumigation for Mosquito Control

Vaccination
The vaccine for the patients who have first time incidence of
the disease is not available. Vaccine is available for those
patients who are victim of Dengue virus second time.
According to World Health Organization, it can be
recommended to those patients only who have second
incidence of Dengue fever or populations in which most of
the people have been infected previously.
The application of this vaccine is limited by the fact, it may
worsen symptoms in the cases where patients have not
previously been infected by Dengue virus. Therefore, the
available vaccine is effective for second time victims of
Dengue virus only.

Treatment
There is no specific medicine for the treatment of
Dengue infection. If you think you may have Dengue
fever, you should use pain relievers with
Acetaminophen and avoid medicines with Aspirin,
which can worsen bleeding.
Take rest, drink plenty of fluids, don’t eat spicy
food, consume coconut water, include orange juice in
the daily diet and see a doctor regularly.
If you start to feel worse in the first 24 hours after
your fever goes down, you should rush to a hospital
immediately for a complete check-up for
complications related with this disease.

Controlling Dengue
Fever with Herbal & Other Liquids

1. Barley Grass
Use of Barley (Jau)
grass
helps to increase
platelets.
Drink Barley tea
or eat Barley grass
directly
to see a rapid increase
in platelet count.

2. Goldenseal Roots
Goldenseal is a herb whose dried root is used to make a
medicine. It has the ability to clear up the symptoms of Dengue
fever very quickly and eliminate the virus from the body.

3. Fenugreek Leaves (Maithi)
These leaves are known
to reduce fever and act as
a sedative to ease pain
and promote more restful
sleep for patients.
Soak the leaves in water
and then drink it or you
can use Maithi powder
and mix it with water and
drink it.

4. Papaya Leaves
Papaya leaves are
widely known as natural
treatment of Dengue
fever.
Crush the leaves and
consume or drink
the juice which helps in
flushing out the toxins.

5. Basil Leaves
Chewing 8 to 10 Basil leaves
boosts body immunity and has
been recommended as an
effective treatment for Dengue
fever.
Basil leaves have essential oils
that have natural insecticidal
properties.

6. Neem Leaves
Crush Neem
(Azadirachta Indica)
leaves and drink the
juice to increase platelet
and white blood cell
count.
Properly brewed Neem
leaves also improve the
immune system for the
patients suffering from
Dengue fever.

7. Orange Juice
Oranges are rich
in antioxidants and vitamin C
that help in treating the
secondary symptoms
of Dengue fever.
Orange drink
produces antibodies in the
immune system, increases
urination, thereby, releasing
toxins from the body. Orange
juice also repairs body cells as
it carries vitamin C which is
crucial in creating collagen.

8. Drink Plenty of Pure Water
Drinking plenty of
pure water helps in
keeping the body
hydrated.
Therefore, the
patients feel relaxed
from severe
headache.

Keep your homes clean to avoid
exposure to Dengue mosquitoes.
Good Health!
A presentation by
Ahmad Tariq Bhatti
Lahore

Dengue or Break-Bone Fever

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