Dengue hemorrhagic fever

Through research, it was found that the development of dengue dengue (dengue) disease has a cycle. In Vietnam every 3-5 years, dengue is a major epidemic. The disease occurs all year round but concentrates from June to October.

Dengue dengue vectors in Vietnam are mainly Aedes Aegypti mosquitoes . (Photo: cober) Dengue dengue vectors in Vietnam are mainly Aedes Aegypti mosquitoes. This mosquito after drawing blood from an infected person will spread the disease to healthy people. It will be an infectious agent throughout its life cycle (about a month). Mosquitoes will grow well in hot climates and high temperatures.

Pathogenesis mechanism

In the world, many hypotheses explain the mechanism of dengue disease. Within the scope of this paper we only present Halstead's hypothesis, which is widely accepted. Dengue dengue usually occurs in people who have had Dengue antibodies before.

When the next invasive Dengue virus will combine with the previous antibody to form an antibody antigen complex, called an immune complex. This complex will activate the complement (one of the body's protective systems) resulting in increased vascular permeability, destruction of the hemostatic system (due to release of clotting factors) and reduction. Platelets cause hemorrhage (XH), bleeding and shock.

XH levels and symptoms

Dengue is usually divided into 4 degrees according to the degree of severe or mild disease.

Grade I: Fever, lymphadenopathy, aches, pulse, normal blood pressure (HA); positive signs of ligation. At this level it is difficult to distinguish from normal fever.

Degree II: Expression as degree I with mild XH.

Grade III: Pancreatic insufficiency (circulatory failure, fast, small vessels), low BP, moderate hemorrhage and shock money.

Grade IV: True shock, small vessels that are difficult to catch, even blood pressure cannot be measured. The incubation period is usually 5-7 days after which the following symptoms will appear:

Viral syndrome: High fever suddenly persists 39-40oC or fever into 2 phases, anorexia, nausea, abdominal pain, headache, muscle pain, peripheral lymphadenopathy, especially lymph nodes, elbow lymph nodes, even a big liver causes pain in the liver .

XH Syndrome: Including the following 3 regions. Bleeding under the skin. Examine the dots, the social groups may even have bruises. Mucosal XH: common symptoms of epistaxis, root bleeding. Internal XH: common manifestations of vomiting blood, go outside the black stool .

Shock syndrome: With symptoms such as drowsiness, struggle, cold limbs (especially right lower quadrant), vomiting much, less urination, decreased BP. This is a dangerous period that needs attention.

Shock syndrome: Fast pulse, small, weak, even unable to catch. HA plummeted; tired, cold skin, pale .

Subclinical signs (tests): Hematocrit increases, platelets decrease.

Treatment

Based on the social classification we have appropriate treatment.

With degrees I and II: Outpatient treatment should be avoided to avoid spreading to the community. Besides having to closely monitor, promptly detect shocking money signs. Need to use the following drug groups:

- Vitamin C strengthens the vessel wall.

- Use antipyretic drugs: Often used paracetamol (do not take aspirin because aspirin aggravates XH symptoms).

- Clearing the fluid: Drinking oresol solution or lemon juice, orange .

With degrees III and IV:

Immediately transfer electrolyte solutions and blood colloids. People often use the following infusion solutions: NaCl 0.9%; Glucose 5%, lactate Ringer solution, plasma or plasma substitutes (dextran gelatin .) during transmission should pay attention to the appropriate transmission speed and must be supervised by technical staff.

Use more cardiovascular drugs; oxygen, anti-social drugs. If the patient is more likely to have a blood transfusion, platelet block, plasma.

Prevention

In order to effectively prevent disease, we first need to promote propaganda so that people can take effective preventive measures. In unsanitary conditions, the weather is hot and rainy; crowded communities, economic and cultural exchanges . deepening between the areas of Aedes Aegypti mosquitoes growing and increasing, the incidence of diseases is increasing.

Effective preventive measures are to limit the development of mosquitoes by measures such as:

Mechanical measures: Use mosquito swatter, clean washers, water containers, environmental sanitation, water around the house, and screen.

Biological measures: Release fish to kill mosquito larvae.

Chemical measures: Spray mosquito repellent .

Besides, it is necessary to closely monitor cases of fever, isolation of dengue patients.

Currently the state has a policy to support in the prevention and treatment of dengue. It is therefore the responsibility of individuals and localities to promptly report cases of infection to related organizations to limit the spread of outbreaks on a large scale.