Dengue
 

Six dengue fever vaccines are in development, but not yet available. The vaccine that's furthest in development is a three-dose vaccine for children. The results of a phase III trial were published in July 2014. This study showed that the vaccine appears to be safe, and it prevented dengue infections slightly more than half the time.

Those who had the vaccine but still became infected with dengue had a milder course of the disease than did those who weren't vaccinated. Although the vaccine is not as effective as doctors would like, it is safe. The company that makes this vaccine hasn't yet announced any plans to seek approval to market the vaccine.

So for now, if you're living or traveling in an area where dengue fever is known to be, the best way to avoid dengue fever is to avoid being bitten by mosquitoes that carry the disease.



 

If you are living or traveling in tropical areas where dengue fever is common, these tips may help reduce your risk of mosquito bites:

Stay in air-conditioned or well-screened housing. The mosquitoes that carry the dengue viruses are most active from dawn to dusk, but they can also bite at night.
Wear protective clothing. When you go into mosquito-infested areas, wear a long-sleeved shirt, long pants, socks and shoes.
Use mosquito repellent. Permethrin can be applied to your clothing, shoes, camping gear and bed netting. You can also buy clothing made with permethrin already in it. For your skin, use a repellent containing at least a 10 percent concentration of DEET.
Reduce mosquito habitat. The mosquitoes that carry the dengue virus typically live in and around houses, breeding in standing water that can collect in such things as used automobile tires. Reduce the breeding habitat to lower mosquito populations.

Symptoms
 Headache, fever, exhaustion, joint and muslce pain, and rash. Incubation period is 3-14 days, Mostly 4-7 days.
low white count, Nausea vomiting, generalized pain, positive tourniquet test.
 Sudden onset fever occur with headache behind eyes, muscle and joint pains and a rash. Fever often upto 104 lasts upto two to seven days. Rash occur in first or second day in 50-80%

Four grades of hemorrhagic dengue fever
 1. Easy bruising and positive tourniquet test with fever
 2. Spontaneous bleeding on the skin
3. Shock
4. Severe shock and no BP and Pulse. Within five days test for IGM antibody.
Common
 90 percent of malasians have dengue IgG.
Dengue Hemorrrhagic fever. Affects 3% of the infected. IF blood pressure cuff is inflated for five mniutes petechiae occur. Irritability, restlessness and perspiration occur after several days of fever.
Physical Exam
 Physical exam reveals Hepatomegally, Low BP, Rash, red eyes, red throat, swollen glands, weak rapid pulse.
PT, PTT, CBC, Electrolytes, ABG Liver enzymes and Dengue Ab tests are taken.
Tourniquet test, X ray chest (Pleural effusion is common.
Complications
 Complications are
Encephalopathy, Liver damage, Residual brain damage, Seizures, Shock, Rarely viral myocarditis
Dengue Myocarditis
 Dengue myocarditis may present with high troponin levels, Depressed ST in precordial leads. Can be just mild arrhythmia as well. Commoner with serotype 3 found with reverse transcriptase polymerase chain reaction.