Dengue and dengue haemorrhagic fever world health organization. Dengue fever symptoms, diagnosis and treatment bmj best. Dengue is a mosquitoborne viral disease widely spread in tropical and subtropical regions. They are expected to remain valid for five years until 2014, although developments in research. Dengue is defined by fever as reported by the patient or healthcare provider and the presence of one or more of the following signs and symptoms. Endemic in more than 120 countries, particularly the southeast asian and western pacific regions, the caribbean, latin am. Information about dengue disease burden, its prevalence and incidence and geographic distribution is necessary to guide in planning appropriate control measures including the dengue vaccine that has recently been licensed in a few countries. The percentage of serologically confirmed cases at the. Guidelines on management of df dhf in adults epidemiology unit. Living or traveling to a region of the world where the infection is endemic is a risk factor for the disease. Comprehensive guideline for prevention and control of.
New dengue virus type 1 genotype in colombo, sri lanka. Shastri c,d, a associate professor, department of pediatrics, institute of child health, kolkata, west bengal, india b. Dengue fever df is caused by an arbovirus and spread by aedes mosquitoes. Dengue is a selflimited, systemic viral infection transmitted between humans by mosquitoes. In this report, the first in a series on dengue, we explore the estimations of disease and economic burdens of dengue. Dengue case classification should be harmonized as follows. See box 402 for information regarding the world health organization guidelines for classifying dengue. The incidence of dengue in thailand has been increased and reached the peak. Division of notifiable diseases and healthcare information proposed. Over the last 30 years, extensive dengue epidemics have occurred in brazil, characterized by emergences and reemergences of different serotypes, a change in the epidemiological profile and an increase in the number of severe and fatal cases. There has been considerable debate regarding the value of both the 1997 and 2009 world health organization who dengue case classification criteria for its diagnosis and management. A cross link of physical, genetic and socioeconomic factors come in to play to make an individual more susceptible to be affected by dengue. Dengue fever df accounts for almost 95% of all reported cases.
The number of travelassociated dengue cases peaked at approximately 900 in 2016 and could increase if large dengue epidemics occur in the region of the americas. Guidelines for plaque reduction neutralization testing of human antibodies to dengue viruses 2007 dengue. Dengue fever, dengue haemorrhagic fever, dengue shock syndrome, water sources, epidemic introduction dengue is a fast spreading arthropod borne viral disease. The series of national guidelines the guidelines have been developed by the communicable diseases. Sep 15, 2011 dengue has emerged as a major public health problem worldwide. A global strategy on dengue fever and dhf was developed in 1995 and its implementation was bolstered in 1999. In affected regions such as asia and latin america, severe dengue is a leading cause of hospitalization and mortality particularly in children.
Dengue with special focus on case management held at hotel lalit, new delhi in the. Dengue is an important health threat to a large proportion of the worldwide population, with an estimated 3. Comprehensive guideline for prevention and control of dengue. A 20gene set predictive of progression to severe dengue. Dengue fever is a mosquitoborne virus disease that has rapidly spread to several regions in recent times. The 1997 dengue case definition below is limited in terms of its complexity and applicability. Up to 50100 million infections are now estimated to occur annually in over 100 only 9 counties in 1955 endemic countries. Dengue revised 326 2011 dengue is a mosquitoborne infection which in recent years has become a major international public health concern. Pdf indian national guidelines for clinical management. Dengue remains a public health problem in the americas despite the efforts of the member states to stop and mitigate the impact of epidemics. Evaluation of the who classification of dengue disease severity.
Quantifying the burden of dengue is critical for policy makers to set. Dengue chapter 4 2020 yellow book travelers health cdc. The incubation period is 314 days average, 47 days. Symptoms include fever, headache, muscle and joint pains, and a. Between 100200 million m infections occur each year in more than 100 countries, resulting in about 20,000 deaths. Endemic in more than 120 countries, particularly the southeast asian and. Dengue viruses have spread rapidly within countries and across regions in the past few decades, resulting in an increased frequency of epidemics and severe dengue disease, hyperendemicity of multiple dengue virus serotypes in many tropical countries, and autochthonous transmission in europe and the usa. Indian national guidelines for clinical management of dengue fever. Countries or territories in which dengue or dengue haemorrhagic fever is known to occur, by who region, 19751996 pdf, 26kb annex 2. Searo technical publication series, new delhi, india 2011. The 1997 who criteria who, 1997 were used for dengue classi. Dengue viral infection the most rapidly spreading mosquitoborne viral disease in the world dengue virus. They were then rechristened the comprehensive guidelines for the prevention and control of dengue and dengue haemmorhagic fever. Review article diagnosis and management of dengue in children.
World health organization regional office for southeast asia. Undifferentiated fever those who have been infected with dengue virus, especially for the first time i. These guidelines are not intended to replace national guidelines but to assist in the development of national or regional guidelines. Early diagnosis and prompt, effective treatment of malaria uncomplicated falciparum malaria can progress rapidly to severe forms of the disease, especially in people with no or low immunity, and severe falciparum. Diagnosis of dengue requires the presence of fever and at least 2 clinical findings or any warning signs. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Anyone who lives in or traveled to areas external icon where dengue virus is transmitted and has recently experienced signs and symptoms of dengue illness signs and symptoms of dengue may include fever, headache, rash, body aches, and bleeding manifestations. In 1999 the who regional office for southeast asia published the regional guidelines for the prevention and control of df dhf. The regional guidelines were extensively revised, updated and expanded with the focus on new and additional topics of current relevance to the populations of member states of the region.
Author summary dengue fever, an extensively spread mosquitoborne disease, is endemic in more than 100 countries. Dash regional adviser, vectorborne and neglected tropical diseases control ravbn, and editor, dengue bulletin world health organization regional office for southeast asia new delhi, india. Pcr as dengue confirmatory test available at the subnational and national reference laboratories. Economic and disease burden of dengue in southeast asia. Dengue surveillance is a critical public health task because of the presence of aedes aegypti in many jurisdictions and the risk for virus introduction. This led to a new who classification where dengue severity is divided into dengue without warning signs, dengue with warning signs, and severe dengue. The global distribution and burden of dengue nature. Here is the virus drawn as a 3dimensional model of the envelope protein. Epidemiology dengue is one of the most important arthropodborne viral diseases in terms of human morbidity and mortality. Dengue begins abruptly after an incubation period of 57 days range, 310 days, and the course follows 3 phases. Who dengue case definition 1997 compared with the new ppsdoh dengue case definition and classification who case definition of dengue and levels of severity 1997, 2011 new case classification and levels of severity doh 2011 case definition for dengue hemorrhagic fever dhf the following must all be present. Subsequently, the awareness of variable responses to the infection presenting. Dengue is a febrile illness caused by a flavivirus transmitted by aedes aegypti or aedes albopictus mosquitoes while taking a blood meal. The who regional office for southeast asia publish dengue.
There are four dengue virus denv types denv1, denv2, denv3, and denv4, all of which are capable of inducing severe disease dengue hemorrhagic fever dhf dengue shock syndrome dss. Evaluation of the who classification of dengue disease. Pdf on sep 1, 2011, muhammad zaman khan assir and others published guidelines for clinical case management of dengue fever. Sep 15, 2011 the exponential increase in published dengue research in recent years emphasizes the global importance of this infectious disease. Recommendations and iap id chapter plan of action jaydeep choudhury a,b, digant d. Department of health and human services centers for.
Suggested criteria for early notification of suspected cases are that the patient lives in or has travelled to a dengue endemic area, has fever for three days or more, has low or decreasing white cell counts, andor has thrombocytopaenia positive tourniquet test. The following core principles were used by the guidelines development group that drew up these guidelines. The burden of dengue in africa is not well understood. In 1999 the who regional office for southeast asia published the regional guidelines for the prevention and control of dfdhf. We estimated dengue mortality, incidence, and burden by age, sex, and country, as estimated for the global burden of disease study 20. Dengue is a flaviviridae virus, with five genetic types. To account for this difference in diagnosis, we reanalyzed the. A prospective study was conducted in abidjan, cote divoire from december 2011 to december 2012 to estimate the proportion of dengue and malaria cases among febrile patients during a period when dengue was not known to be circulating in the region, and to describe the clinical and virological characteristics of laboratorydiagnosed dengue. More than half of the global population lives in areas with risk of dengue transmission. Diagnosis and management of dengue in children iap.
National guidelines for clinical management of dengue fever. Diagnosis and management of dengue in children iap infectious diseases chapter 1. Dengue virus infection causes a wide range of clinical manifestations. We identified a new dengue virus 1 strain circulating in sri lanka that coincided with the 2009 dengue epidemic. Guidelines for diagnosis, treatment, prevention and control 2009 related who meeting reports. Den1, den2,den3, and den4 family flaviviridae genus flavivirus single stranded rna virus asian genotypes of den2 and den3. Dengue modeling 2011 cell mediated immunity in dengue vaccine development 2008. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever.
Dengue fever, also known as breakbone fever, is a mosquitoborne infectious tropical disease caused by the dengue virus. Dengue occurs in 100 countries worldwide maps 401 through 403, including puerto rico, the us virgin islands, and usaffiliated pacific islands. Disease surveillance and outbreak prevention and control pdf, 58kb chapter 7. There has been considerable debate regarding the value of both the 1997 and 2009 world health organization who dengue case classification criteria for its. The global burden of disease study 20 was an effort to comprehensively and systematically estimate death and disability from 306 causes, producing estimates by year, age, sex, and country for 199020. The disease is transmitted by aedes mosquitoes, which breed in the peridomestic environment. Dengue is common in more than 100 countries around the world.
The incidence of dengue has increased 30fold over the last 50 years. Dengue fever is common in tropical areas, so take extra precautions if you travel somewhere with this type of climate. Epidemiological or laboratory evidence is required to make the. Dengue is a self limiting acute mosquito transmitted disease characterized by fever, headache, muscle, joint pains, rash, nausea and vomiting. Cdph monthly update on number of laboratorypositive dengue cases in california pdf updated on the 1st friday of the month map and city list of aedes aegypti and aedes albopictus mosquitoes in ca, 2011 2020 pdf updated monthly on the 1st friday as new infestations are detected. Dengue is the most common and fastestspreading mosquitoborne virus in the world. Exclusion criteria were based on the definitive extents of. Aug 18, 2016 infection with any one of the four dengue virus serotypes can cause disease that ranges from a mild febrile illness through to haemorrhagic fever and shock.
Transmission from human to human is predominantly by the mosquito aedes aegypti, which bites in the daytime, is adapted to human habitats and has a preference for. Current and historical conditions indexed list of current and historical nationally notifiable conditions. Tropical medicine and international health volume 16 no 5 pp 598607 may 2011 s. Uncertainty in burden estimates, however, challenges policy makers ability to set priorities, allocate resources, and plan for interventions. It inflicts not only severe health concerns but also. Today, dengue is regarded as the most prevalent and rapidly spreading mosquitoborne viral. The presence of waterholding containers in and around the home needed for the mosquitos to complete their development sustains the reservoir for disease and is a risk factor. For greater clarity on these distinctions, a who committee developed case classification guidelines in 1974, based on studies of disease patterns in children in thailand in the 1960s, which were subsequently modified and published a number of times. In affected regions such as asia and latin america, severe dengue is a leading cause of hospitalization and. Interactive map of invasive aedes mosquito detections in california. Travelassociated and locally acquired dengue cases united. Dengue is found in tropical regions around the world, predominately in urban and periurban areas. Guidelines on management of dengue infection in adults. This work was funded in part by eu grant 2011261504 edenext and the paper is.
Infection may be asymptomatic or present with a broad range of clinical manifestations including a mild febrile illness to a lifethreatening shock syndrome. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever vii dengue fever is the fastest emerging arboviral infection spread by aedes mosquitoes with major public health consequences in over 100 tropical and subtropical countries in southeast asia, the western pacific and south and central america. It is the fastest spreading vectorborne viral disease and is now endemic in over 100 countries, resulting in 40% of the worlds population living in an area at risk for dengue. In fact, there has been a 30fold global increase in the incidence of dengue in the past 50 years, 6 with an estimated 50 million dengue infections now occurring each year. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden th. Denguehow best to classify it clinical infectious diseases.
Clinical practice guidelines of denguedengue hemorrhagic. Differentiation between classic dengue fever df and dengue haemorrhagic fever dhf or severe dengue is a key aspect of dengue case classification. Acutephase and convalescentphase serum samples should be sent to the state health department or to the centers for disease control and prevention cdc for testing. Dengue fever is a virus transmitted to humans through bites from the aedes mosquito, a daybiting mosquito. Incorporating the revised dengue guidelines in general. While most of the clinical cases present a febrile illness, severe forms including hemorrhagic fevers and shock with fatalities are reported. In dengue endemic regions, suspected, probable, and confirmed cases of dengue infection should be reported to the relevant authorities as soon as possible. Dengue guidelines for diagnosis, treatment, prevention and control dengue guidelines for diagnosis, treatment, prevention and control new edition neglected tropical diseases ntd tdr world health organization hivaids, tuberculosis and malaria htm 20, avenue appia world health organization 1211 geneva 27. Endemic in more than 120 countries, particularly the southeast asian and western pacific regions, the caribbe. Dengue ns1 rdt as forefont diagnosis at the h ealth center rhu level. Some infections result in dengue haemorrhagic fever dhf and in its severe form dengue shock.
Dengue is a febrile illness caused by infection with one of four dengue viruses denv transmitted by aedes aegypti or aedes albopictus mosquitoes during the taking of a blood meal. Forty percent of the worlds population, about 3 billion people, live in areas with a risk of dengue. Nationally notifiable diseases and other conditions of public health importance. Patients with dengue will have a history of living in, or recent travel to, a region where the disease is endemic. The pdf version will be available on the who searo website. Epidemiologic update on the dengue situation in the western pacific region, 2011 regional analysis yuzo arima, a zoe rebecca edelstein, a hwi kwang han, a and tamano matsui a a emerging disease surveillance and response, division of health security and emergencies, world health organization regional office for the western pacific, manila, philippines. Dengue viruses are spread to people through the bite of an infected aedes species ae. Dengue cdna national guidelines for public health units. Dengue clinical management guidelines training for hospitals. Dengue is classified as dengue with or without warning signs and severe dengue. Office of surveillance, epidemiology and laboratory services. These original guidelines had been updated in 1986, 1997 and 2011 who searo.
As the death toll is rising day by day yet, the city corporation is taking not enough precautions lately. Dengue is in the same family as other well known viruses carried by mosquitoes that cause tropical diseases, such as yellow fever, west nile, and zika virus. The number of cases and severity of disease associated with dengue infection in sri lanka has been increasing since 1989, when the first epidemic of dengue hemorrhagic fever was recorded. Dengue is a mosquitoborne flavivirus found in tropical and subtropical regions of the world, mostly in urban and semiurban settings. Author summary dengue fever, or break bone fever, is the most common infectious disease transmitted by a mosquito, and is a major economic and disease burden in endemic countries. The number of reported dengue cases in malaysia shows an increasing trend. Since the 1970s, clinical dengue has been classified according to the world health organization guideline as dengue fever and dengue hemorrhagic fever. A more lethal complication, dengue hemorrhagic fever dhf, was first recognized during. Dengue is endemic throughout the tropics and subtropics and is a leading cause of febrile illness among travelers returning from latin america, the caribbean, and southeast asia. Acutephase samples for virus diagnosis may be stored on dry ice 70c or, if delivery can be. Dengue guidelines who 2011 free download as pdf file.
Epidemiologic update on the dengue situation in the western. Dengue chapter 4 2020 yellow book travelers health. Download dengue guideline 2018 for sigh symptoms, investigations and treatment of dengue. Suggested criteria for early notification of suspected cases are that the patient lives in or has travelled to a dengueendemic area, has fever for three days or more, has low or decreasing white cell counts, andor has thrombocytopaenia positive tourniquet test. Dengue classification according to the world health organization guidelines issued in 2009.
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