Dengue(break bone fever), Dengue hemorrhagic fever(DHF) and Dengue shock syndrome(DSS) spread through Aedes aegyepti mosquitoes mainly in tropical & sub tropical countries the female Aedes aegyepti mosquitoes feeds on human blood mainly in the day time & has habitats men made uses water in container. Dengue virus is 1,2,3 & 4 types.
Incubation period: 3-7days
Onset Sudden attack. Temperature continue 7-8days 
Classic Dengue(break bone fever): 
-Malaise & chillness with rigor, coryza, headache, aching pain in eye balls,conjunctivitis, photo phobia, nausea, vomiting, anorexia, extreme backache, leg & joint pain, restless, insomnia, depression, abdominal discomfort
-Tongue furred, rapid pulse then slow & temperature falls to 100 degree F or low with sweats. -Patients feels better, but after 24-72hrs fever again reappears lasting 2-3days. typical saddle back fever – Morbilliform rash can appear in hands & feet. It can spreads to arms & thigh with itching. 
-Pain also returns, bradycardia, leucopenia during second time of fever & Sometime mild bleeding comes. 
Blood test- Isolate of virus, leucopenia & neutropenia sometime thrombocytopenia within first 5days of onset. Elisa test
Dengue hemorrhagic fever(DHF) and Dengue shock syndrome(DSS): All 4 dengue virus serotypes can cause DHF & DSS. 
-Temperature, excruciate pain in eye ball with headache, myopia, bodyache, anorexia, nausea, vomiting
-Epistaxis, gum bleeding, echymosis, haematemesis, melena,menorragia in female. -Due to plasma leakage low blood pressure, tachycardia, narrow pulse pressure
-Sometime pleural effusion, ascites & pericarditis
-Some patient may develop complication- Encephalitis, liver failure, myocarditis, disseminate intravascular coagulation.
-Patient develop cold, clammy skin, hypo-tension & shock, abdominal pain & trachycardia.
-Leucopenia, decreased Platelets Count, thrombocytopenia & raised liver enzymes.
-Chest xray for pleural effusion
-USG for ascites & gall bladder thicken
-During prolonged shock metabolic acidosis, hyponatraemia & blood urea increased. 
Prophylaxis & Preventive: 
-Drink sufficient water, daily about 3-4 litter 
-Use Mosquito net -Destroy Aedes aegyepti mosquitoes Adult & larvae
-In broad breeding places, sprays kerosene with DDT(Dicophane) powder & bleaching.
-Mosquito larvae clean from tracts & swamps.
-Alert to public & dwelling places for mosquito. 
-Cover all body with cloths. 
 Treatment: Homeopathy Treatment will be symptomatic. Eupatorium perfol, Arsenicum album, Gelsemium, Nux vomica, Merc. Cor. , Rhux Toxicodendron, Bryonia, Belladonna, Rhus Venenata etc are very useful Homeopathy medicine. Visit a doctor for proper treatment.
-Papaya, Papaya leafs & seeds  is good for Dengue treatment.
-Take sufficient water, if necessary saline & blood transfusion with nursing care. Regular blood platelet count should monitor if less platelet should be given. Oxygen should be given.



Written By: Dr. Biplab Kr. Ghosh Mondal                                                                                       Mob: 9830530696

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