Dengue Hemorrhagic Fever (DHF) Is a serious. life threatening disease that Is extremely prevalent throughout south East Asia. DHF has caused widespread epidemics and has claimed many lives. This paper will focus on educating Individuals in the medical profession and patients that reside in the regions of Thailand, Laos, and Vietnam about this disease. DHF is a viral infection spread by the bite of mosquitoes, more specifically the female Aedes Mosquito (2). DHF is a virus that belongs to the Flaviviridae family (3). Dengue Hemorrhagic Fever, also known as severe dengue and a more serious, deadly ersion of dengue fever of break bone fever.
Although there were diagnosed cases of dengue fever dating back to the 16th century, the first documentation of dengue hemorrhagic fever originated In the Philippians and Thailand during the 195ffs. Since then DHF has spread drastically and is among the top ten leading causes of hospitalization and death In children In at least eight tropical Asian countries (1). Aside from losing loved one, the disease places a deep economical burden. This disease causes an overload of cases In hospitals and clinics thus resulting In overworked medical staff and improper care.
The lack of improper care leads to higher mortality rates and public fear of this disease. A 1995 report estimated that the annual economic burden due to DHF in Thailand ranges from 19 million dollars to 51 million dollars per year, depending on whether low or high levels of transmission occur. (Gen Cons) DHF Is a virus from the genius flavlvlrus. Flavlvlrus are viruses which are arthropod borne consisting of single stranded RNA genome surrounded by an Icosahedral nucleocapsld and covered by a lipid envelope (Gen Cons). Being arthropod borne, it can be spread by an insect which is the vector.
Dengue Hemorrhagic Fever Is a Antibody-Dependent Enhancement (ADE) infection based off the virulence of deungue fever’s ability to trick it’s host immune system via the homology of surface antigens of the four serotypes of dengue virus (Austln. edu). An additional virulence factor is the presence of M proteins which aid in the programmed cell death of target cells. DHF Is a viral infection transmitted by the bite of mosquitoes, more specifically the female Aedes Mosquito (2). A mosquito becomes a carrier of this virus after biting an infected animal or human and then spreads this nfection through her subsequent feedings.
This virus spreads more rapidly in highly populated areas that have very poor living conditions. The reservoir for DHF is found In non human primates. DHF cases occur In subtropical environments. The majority of cases are found In Southeast Asia including, Thailand, Laos and Vietnam. In August 2012 cases in Laos nearly tripled from this time in 2011. DHF has been one of the leading causes of children under the age 10 and has long been among the top five most common transmitted diseases In the Thailand (4).
Any Individual Is capable of being Infected by this virus, but children account for the majority of the cases. Children are more prone to this infection because of their activity and exposure to mosquito bites. This disease infects nearly 100 million people a year and has caused close to 25 thousands deaths. This virus spreads more rapidly in highly populated areas that have very poor living conditions. Improper water control is the key factor in the reproduction of the Aedes mosquito, which is the exclusive vector for DHF, thus increasing the chances of spreading the disease.
To demonstrate the effectiveness of roper water control as the key to controlling the vector and spread of this disease, you can look at Phanboi, Vietnam’s introduction of the copeopod, Mesocyclops . This introduction originally resulted in a 95% reduction of the mosquito population and subsequently resulted in the first occurrence of the local eradication of any mosquito in the world for more than 20 years. The virus enters the human body through the saliva of an infected mosquito, invades immature dendritic cells in the skin, and is carried to lymph nodes where viral antigens activate the host immune response (bbgh).
Early symptoms are those of dengue fever; however, they are followed by more severe shock liked symptoms. In the acute phase, earlier symptoms will increase and a rash may develop. A rash, petachiae or ecchymoss may be present along with fever like symptoms. Clinical symptoms include an enlarged liver, low blood pressure, swollen glands, and increased vascular permeability resulting in the loss of plasma. Diagnosing this disease involves both physical examinations and blood work. Upon a physical examination, if an individual shows the physical signs listed above then blood work ill be done for further diagnosis.
Easily found signs from the blood work show low white blood cell and platelet counts. There are no approved vaccines for this disease at this time. The best form of prevention comes from educating the public on preventative measures and vector control. These measures include better water quality control, medically treated sleep nets, proper clothing to reduce bites, recycling measures and better living conditions. As previously stated, the introduction and maintenance of the copeopod Mesocyclops proved to be extremely effective. Using this for mosquito eradication through overnment control, would be the best hope of resolving this epidemic.
With no foreseeable vaccine for this disease the best defense is a good offense for regions highly affected. Through continual education and awareness, we hope to see a decline in these cases. DHF is a very serious disease that has plagued sub tropical regions for decades now. As areas become more populated we are seeing a rise in the number of cases and the majority of this is due to poor living conditions. Education and awareness of this disease will need to be put into place to combat this endemic in Thailand, Laos and Vietnam.