Dengue Fever (“Kidingapopo” in Kiswahili)

Notes
  • Dengue fever virus (DENV) is an RNA virus of the family Flaviviridae and genus
  • It is transmitted mainly by Aedes eagypti mosquito and to lesser extent via blood transfusion and organ transplant.
  • Recent DENV outbreaks in Kenya were reported in Mandera (2011) and Mombasa (2013)
  • Statistics: Incubation period - 3 to 14 days; number of people infected by dengue globally - 50 to 528 million; global annual mortality rate - 10,000 to 20,000.
Symptoms
  • Mainly asymptomatic (about 80%)
  • Mild cases;

_Symptoms that can be confused with malaria that include severe fever, chills, headache, joint pain, myalgia, diarrhea, nausea and vomiting

_Characteristic  skin rash

_Recovery period of mild cases is ≤ 2 to 7 days.

  • Severe cases;

_Dengue hemorrhagic fever where bleeding (such as nose bleeding as well as bleeding of the gums)  occurs leading to hypotension

_Shock

_Disseminated intravascular coagulation (DIC)

_Ascites

_Pleural effusion

_Seizures (mostly during recovery)

Diagnosis
  • Clinical review (especially history)
  • RT-PCR
  • ELISA (IgG and IgM)
  • Viral isolation and culture
  • Characteristic fingerprint impression when the rashes are pressed with the fingers.
Management
  • Vaccine under trial
  • Use of mosquito nets
  • There is no specific antiviral treatment
  • Symptomatic or supportive treatment

_Blood transfusion

_Fluid replacement

_NSAIDs

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