Dengue Fever in Pakistan

Dengue Mosquito usually have black and white Stripe Markings

Introduction:

Dengue fever (DF) is a disease caused by a virus, of the family Flaviviridae. It is spread through the mosquito, Aedes Aegypti.

This mosquito is a daytime feeder and normally remains indoors and other dark places. Otherwise, cool and shady areas are its likely habitations. After an incubation period of 2-8 days after an infective mosquito bite, the disease usually begins with sudden onset of fever (sever flu-like infection and fever) and headache. In this infection, platelet count is decreased to about 100,000/ cubic mm or less.

Prevalence:

According to World Health Organization (WHO), dengue is more widespread in South-Asia. According to WHO, estimations there may be more than 50 million world wide cases of dengue infection every year.

Now DF is considered as the world’s emerging infectious diseases. About 24,000 deaths were reported annually due to dengue infection.

First reported case of DF in Pakistan was in 1994. Peak incidence period of dengue infection in Pakistan is post monsoon period. Dengue Surveillance Cell Sind province of Pakistan reports 1,809 suspected Dengue out of which 881 confirmed till 11th October 2010 with 5 deaths while 16 confirmed cases reported in Islamabad without any mortality.

Till now 563 confirmed cases were reported at the institution of Agha Khan University Hospital,  since January 2010. Reported cases are usually complicated or with hemorrhagic manifestation.

Recent outbreaks have shown significant mortality and morbidity in Pakistan.

Attributed Risks:

Due to following reasons any country can be at high risk of dengue infection and same to the Pakistan:

1. Over crowded cities

2. Unsafe drinking water

3. Inadequate sanitation

4. Low vaccination coverage and

5. Large number of immigrants and refugees.

Cure and Management:

No specific cure available for dengue infection. Management of dengue fever includes

1. keeping the temperature of the body below 39 C

2. Give the patient paracetamol not more than 4 times in 24 hours (avoid Aspirin or mefenamic acid (Ponstan))

3. Large amount of the fluid is to drink

4. Patient should rest

5. Complete blood profile must be taken if fever persists for three days

6. Oral rehydration salt (ORS) must be given even if patient have no dehydration as sudden deterioration may occur if dehydration comes

7. Intravenous fluid can be started by primary care physician as it may help in patients life saving.

As the mosquito bites during the day time so full sleeve clothes and long dresses covering the limbs must be used along with repellents.

Reference and Further Reading:

Firdous Jahan, (2011). Dengue Fever (DF) in Pakistan. Asia Pacific Family Medicine, 10(1), 1.

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