Microbiology.docx

Name: Gutierrez, Holy Q. Course/Year: BSN-1 Block 4

Date:March

,2019

Causative Name: Dengue Disease: The universal name for the disease is Dengue Fever. Other names that are commonly associated with this disease include: Dengue Hemorrhagic Fever ((DHF) Disease caused by Dengue Fever), Breakbone Fever, Dandy Fever, O'nyong-nyong Fever, Dengue shock syndrome (DSS) and Dengue-like Disease. Other Name: Dengue Fever belongs to the family Flaviviridae and is caused by a singlestranded RNA Flavivirus and is compromised of four different types of etiological agents, which include: Dengue Virus 1 (DEN-1), Dengue Virus 2 (DEN-2), Dengue Virus 3 (DEN-3) and Dengue Virus 4 (DEN-4). Description: The first description of Dengue Fever was provided in 1780 by Benjamin Rush, signer of the Declaration of Independence, "This fever generally came on with rigor, but seldom with a regular chilly fit. The pains, which accompanied this fever, were exquisitely severe in the head, back, and limbs. The pains in the head were sometimes in the back parts of it and other times they occupied only the eyeballs. A few complained of their flesh being sore to the touch in every part of the body. Its general name among all classes of people was the Break-bone fever" . To this day, the origins of the word "dengue" are still debatable. Some believe that it is derived from the Swahili phrase "Ka-dinga pepo," meaning that the disease is caused by an evil spirit, which may have its origins in the Spanish word "dengue," meaning fastidious or careful. During the twenty century, Joseph Franklin Siler discovered the viral etiology and the transmission of the disease as the disease began to spread globally due to population movements. Mode of Transmission: The disease is transmitted through two in particular mosquito species, Aedes aegypti and Aedes albopictus. The mode of transmission is as follows: One of the mosquito species bites and individual who is infected with one of the four strains of the virus. The mosquito becomes infected with the dengue virus and bites a healthy person without the virus. One mosquito can inflict the virus and it cannot be spread directly from person to person. Portal of Entry: When a mosquito bites an infected person it becomes infected. When that same infected mosquito bites another person that person then becomes infected with the disease.

Pathogenesis: The pathogenesis of severe dengue is thought to be immune-mediated due to the timing of the clinical manifestations and higher incidence in secondary infections with a heterologous serotype. Recent evidence has provided further information of neutralizing versus enhancing monoclonal antibodies and their target epitopes on the dengue virion, which has major implications for vaccine design. The role of T-cell immunopathology has also been advanced with recent evidence of cross-reactive high pro-inflammatory cytokine producing T cells predominating in severe dengue. Recent large genome-wide association studies have identified specific susceptibility loci associated with severe disease. Epidemiological studies have served to define certain at-risk groups and specific viral virulence factors have recently been described. Signs/Symptoms: The disease ranges from mild to severe. Mild dengue fever causes chills, high fever (that lasts about five to seven days), rash, severe headache, pain behind the eyes and muscle and joint pain. The severe joint pain has given dengue the name "Breakbone Fever". The rash develops on the feet or legs about three to four days early during the disease with a second rash, measles-like in appearance occurring later in the disease. Generally, younger children have a milder illness (presence of no rash) than older children or adults which can lead to a misdiagnoses. Other symptoms such as nausea, vomiting, and abdominal pain may be present. More severe forms of the disease can progress into "Dengue Hemorrhagic Fever," where the blood vessels start to leak and cause bleeding from the nose, mouth and gums as well as internal bleeding. Bleeding with easy bruising, blood spots in the skin and blood in the stool may also appear .The blood vessels can collapse with a sudden drop in blood pressure causing "Dengue Shock Syndrome" Complications: If severe, dengue fever can damage the lungs, liver or heart. Blood pressure can drop to dangerous levels, causing shock and, in some cases, death. Control/Prevention: A strong emphasis of prevention has been placed on community efforts to increase awareness about the disease, how to recognize it and how to control the mosquito population that transmits it. Other important preventative measures include mosquito control by eliminating breeding sites and personal protection. Traveling during periods of minimal mosquito activity can also be helpful. When traveling to tropical areas it is important to remember to use mosquito repellants containing DEET or NNDB on skin and clothing. One should wear long-sleeved shirts and long pants tucked into socks when mosquitos are biting outdoors and avoid heavily populated residential areas. It is also recommended that one should stay in screened areas with air-condition and bed nets that readily available. Breeding sites can be eliminated by discarding items that collect rainwater and regularly changing outside animal containers. Public sprayings have also proved to be helpful in areas that are infected by the disease. Medical Intervention: No specific antiviral medication is currently available to treat dengue. The treatment of dengue fever is symptomatic and supportive in nature. Bed rest and mild

analgesic-antipyretic therapy are often helpful in relieving lethargy, malaise, and fever associated with the disease. Acetaminophen (paracetamol) is recommended for treatment of pain and fever. Aspirin, other salicylates, and nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided. Patients with dengue hemorrhagic fever or dengue shock syndrome may require intravenous volume replacement. Plasma volume expanders can be used in patients who do not respond to isotonic fluids Nursing Intervention: Nursing interventions for dengue fever include • Eradication of mosquitoes by eliminating breeding places • restore blood volume • Deficient fluid volume related to an elevated body temperature should be monitored • Deficient fluid volume r/t increased metabolic state should be monitored. At the end of the nursing care, the client will have restored normal fluid volume as evidenced by: • -Good skin turgor • -Moist mucous membranes • -Vital signs within normal limits • -Decreased perspiration • -Urine specific gravity within normal range