DENGUE FEVER IN MALAYSIA

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DENGUE FEVER IN MALAYSIA

• Prepared by
• Fadhila Binti Mohd Hanapiah
• Nadiah Binti Suffian

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INTRODUCTION

• Dengue is a viral infection transmitted by
  mosquitoes, mainly the Aedes aegypti species.
• The virus is contracted from the bite of a
  striped Aedes aegypti mosquito that has
  previously bitten an infected person. One
  mosquito bite can inflict the disease.
• There are four strains or serotypes of dengue
  virus namely DEN-1, DEN-2, DEN-3 and DEN-4.
• The mosquito flourishes during rainy seasons but
  can breed in water-filled containers, year-round.
  
• The virus is not contagious and cannot be spread
  directly from person to person. There must be a
  person-to-mosquito-to-another-person pathway.
• Dengue haemorrhagic fever ? severe form of
  dengue. A second attack by dengue virus of a
  different serotype from the first infection.
• Approximately 1 of patients with dengue
  infection progress to dengue haemorrhagic fever.

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WORLD-WIDE DENGUE DISTRIBUTION
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EPIDEMIOLOGY

• 1902 - The earliest recorded case of dengue fever
  in Malaysia ? Penang
• 1962 The first major dengue outbreak in
  Malaysia ? Penang
• 1973 A nationwide outbreak ? Kuala Lumpur
• Since then dengue has become a major public
  health problem in the country.
• Dengue cases/deaths mounts parallel
• with the rapid development,
• expansion of urban areas
• population density
• (as of Sept 2008
• 27,730,000 inhabitants).

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INCIDENCE OF DENGUE CASES IN MALAYSIA FROM
1998-2008
P/S 28.12.2008 03.01.2009, 1157 cases were
reported with 4 deaths so far
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DIAGNOSIS

• Classic symptoms high fever, a petechial rash
  with thrombocytopenia relative leukopenia
  (decrease in the number of circulating WBC in the
  blood).
• WHO definition of DHF
• Fever
• Haemorrhagic tendency positive tourniquet test
  (gt than 20 petechiae per square inch),
  spontaneous bruising, bleeding from mucosa,
  gingiva, injection sites, vomiting blood or
  bloody diarrhea.
• Thrombocytopaenia lt100,000 platelets per mm³.
• Evidence of plasma leakage rise in hematocrit
  level gt than 20.
• Serology (identification of antibodies in the
  blood serum) polymerase chain reaction (PCR) ?
  to confirm the diagnosis of dengue if clinically
  indicated.

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SYMPTOMS

• Sudden high fever (39-41.5C)
• for 2 to 7 days
• Headache
• Pain behind the eyes
• Muscle pain, joint pain, bone pain (break-bone
  fever)
• After 1 to 2 days of fever, the patient develops
  initial rash with discoloured spots, often
  described as Isles of white in a sea of red
• Second rash may develop to palms and soles, and
  skin may peel off (desquamate) body temperature
  drops

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TREATMENTS

• No specific antiviral treatment, only supportive
  treatment is given to such patients.
• If the patient is dehydrating, adequate fluids
  are to be taken.
• Intravenous fluid is administered if the patient
  is unable to maintain oral intake.
• For severe body ache, painkillers may be needed.
• For severe headache and for joint and muscle
  pain, acetaminophen/paracetamol and codeine may
  be given.
• If there is significant bleeding, blood or
  platelet transfusion will be carried out.
• Note Aspirin should be avoided as this
  drug
• may worsen the bleeding tendency (because
• of its anticoagulant effects the
  increased
• risk of developing Reye syndrome).

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PREVENTIONS
There is currently no vaccine available for the
dengue fever.

• STRATEGIES
• Individual roles. People are urged to empty
  stagnant water from old tires, trash cans
  flower pots.
• Mosquito control. Place larvicide e.g. Abate or
  any other suitable insecticides into any exposed
  water container. Use mosquito repellant sprays
  that contain NNDB or DEET.
• Enforcement. Local authorities from Ministry of
  Health conduct on-site check destroy larvae at
  residential premises construction sites. Fines
  may be imposed on the owner of properties.

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PREVENTIONS

• Fogging with insecticide. Fogging would be
  carried out by local authorities in housing area
  where 2 or more cases of dengue fever are
  reported within one week.
• Information. In Nov 2007, the Ministry of Health
  carried out a major campaign against Aedes.
  During the campaign free packages of Abate were
  distributed. Leaflets brochures to inform the
  public on ways to prevent curb Aedes breeding
  are distributed.
• Awareness campaign. Schools local communities
  are encouraged to carry out communal cleaning
  activities. Public awareness campaigns through
  strategically placed posters television
  advertisements are also done.

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REFERENCES

• http//ms.wikipedia.org/wiki/Demam_Denggi
• http//en.wikipedia.org/wiki/Dengue_fever
• http//www.gov.my/MyGov/BI/Directory/Citizen/Citiz
  enHealth/HealthPersonal/CommonDiseases
• http//library.thinkquest.org/07aug/01614/dengue-m
  alaysia.html
• http//www.dph.gov.my/vektor/eng/kes_dd_tahunan.ht
  m
• http//www.infosihat.gov.my/isusemasa.php?id17
• http//www.myhealth.gov.my/myhealth/bm/template.js
  p?showMe28storyid1231474221719
• http//wonder.cdc.gov/wonder/prevguid/p0000373/p00
  00373.asp
• http//www.who.int/csr/disease/dengue/en/index.htm
  l