Dengue Fever

Today is the last day of my survey about dengue fever in Balung General hospitals. I get the data that 200 more childrens who are patients suffering from dengue fever, dengue fever and dengue dengue shock syndrome, in a period of three years. 5 childrens died because of dengue shock syndrome. Are they dangerous?

What is dengue fever, DHF and DSS?

Dengue fever is febril acute fever caused by one of four closely related, but antigenically distinct, virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4), of the genus Flavivirus ,with clinical signs fever, muscle pain, joint pain that accompanied leukopenia, rash, headache, also trombocyteopenia. Dengue haemorrhagic fever is dengue fever is accompanied by the signs of bleeding, such as Tourniquet test positive, ptechiae, echimosis, epistaksis, gum bleeding and melena. Dengue shock Syndrome that dengue fever is accompanied by signs of shock. Shock on the dengue fever patient is hipovolemic shock.

SIGNS AND SYMPTOMS

Clinical picture varies greatly, from very mild (silent dengue infection) to the medium such as dengue fever, to the DHF with the manifestation of acute fever, and bleeding tendency occurred shock that could result in fatal. Incubation period of dengue between 5-8 days.

Classical form of DHF are marked with high fever, sudden 2-7 days, accompanied with a reddish face. Complaints such as anoreksia, headache, muscle pain, bone, joints, nausea, and vomiting are often found. In addition, gastritis can also appear with a combination of pain in the stomach, feeling of nausea, vomiting or diarrhea. Some patients complain of painful swallow faring hiperemis found on inspection, but rarely found a cold cough. Usually found also felt pain in stomach and epigastrium below the rib bones.

Pain is often prominent on the abdomen of a child suffering from DSS. Found this on the symptoms of DSS, is marked danger because of the likely occurrence of gastrointestinal bleeding. Between 3 -5 days, symptoms develop bleeding rash, petechie, echimosis, epistaksis going to hematemesis and melena. Scarlet fever rash discrete red light, petekiae spread to cover up almost the entire body. Petekie spontaneous skin bleeding is most often found, then the symptom is always sought when the suspected case of DHF, while epistaksis bleeding is the second most. Hematemesis is the vomiting of black blood from the top of the channel indigestion, where the blood come out mixed with stomach acid and melena is constipate black blood from the top of the channel digested. Bleeding digested this channel is of serious bleeding.

In the DHF, there are plasma leakage due to increased capillary permeability, with a marked increase in PCV by hematocryt or ≥ 20%, efusi pleura, ascites even arise. In the adult male, hematocryt increased> 45% percent, whereas in women hematocrit increased> 40%, and> 38% in children aged less than 12 years .

Decrease in the number of trombocyte (trombocytopeni) <100.000/pl>

During the initial infection, leukosit polimorfonuklear increased leukositosis so visible, but at the end of a critical phase and the early stage of shock, so that decreased the number of leukosit obtained leukopenia.

Critical period of the disease occurred in the late phases of fever (day 3 and day-to-7), at the time of this decrease in temperature that suddenly the often accompanied by disturbances in the circulation of various heavy or light. In the case of interference with the circulation of light changes, and at least temporarily, in the case of patients may experience a shock.