Transcript dengue fever in malaysia

DENGUE FEVER IN MALAYSIA
Prepared by :
Fadhila Binti Mohd Hanapiah
Nadiah Binti Suffian
INTRODUCTION
 Dengue is a viral infection transmitted by mosquitoes, mainly
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the Aedes aegypti species.
The virus is contracted from the bite of a striped Aedes
aegypti mosquito that has previously bitten an infected
person. One mosquito bite can inflict the disease.
There are four strains or serotypes of dengue virus namely
DEN-1, DEN-2, DEN-3 and DEN-4.
The mosquito flourishes during rainy seasons but can breed in
water-filled containers, year-round.
The virus is not contagious and cannot be spread directly
from person to person. There must be a person-to-mosquitoto-another-person pathway.
Dengue haemorrhagic fever  severe form of dengue. A
second attack by dengue virus of a different serotype from
the first infection.
Approximately 1% of patients with dengue infection progress
to dengue haemorrhagic fever.
WORLD-WIDE DENGUE
DISTRIBUTION
EPIDEMIOLOGY
 1902 - The earliest recorded case of dengue fever
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in Malaysia  Penang
1962 – The first major dengue outbreak in
Malaysia  Penang
1973 – A nationwide outbreak  Kuala Lumpur
Since then dengue has become a major public
health problem in the country.
Dengue cases/deaths mounts parallel
with the rapid development,
expansion of urban areas &
population density
(as of Sept 2008 =
27,730,000 inhabitants).
INCIDENCE OF DENGUE CASES
IN MALAYSIA FROM 1998-2008
Year
Case
Death
1998
27381
82
1999
10146
37
2000
7103
45
2001
16386
50
2002
15493
54
2003
31545
72
2004
33895
102
2005
39654
107
2006
34386
70
2007
48846
98
2008
49355
112
P/S : 28.12.2008 –
03.01.2009, 1157 cases
were reported with 4
deaths so far…
Reported Dengue Cases in Malaysia
50000
45000
40000
35000
30000
25000
20000
15000
10000
5000
0
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Reported Dengue Deaths in Malaysia
120
102
100
80
112
107
98
82
72
60
40
37
45
50
70
54
20
0
1998
1999
2000
2001
2002
2003
Year
2004
2005
2006
2007
2008
DIAGNOSIS
 Classic symptoms : high fever, a petechial rash with
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thrombocytopenia & relative leukopenia (decrease in
the number of circulating WBC in the blood).
WHO definition of DHF :
Fever
Haemorrhagic tendency [positive tourniquet test (>
than 20 petechiae per square inch), spontaneous
bruising, bleeding from mucosa, gingiva, injection
sites, vomiting blood or bloody diarrhea].
Thrombocytopaenia [<100,000 platelets per mm³].
Evidence of plasma leakage [rise in hematocrit level >
than 20%].
Serology (identification of antibodies in the blood
serum) & polymerase chain reaction (PCR)  to
confirm the diagnosis of dengue if clinically indicated.
SYMPTOMS
 Sudden high fever (39-41.5°C)
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for 2 to 7 days
Headache
Pain behind the eyes
Muscle pain, joint pain, bone pain
(break-bone fever)
After 1 to 2 days of fever, the
patient develops initial rash with
discoloured spots, often described
as “Isles of white in a sea of red”
Second rash may develop to palms
and soles, and skin may peel off
(desquamate) & body
temperature drops
TREATMENTS
 No specific antiviral treatment, only supportive
treatment is given to such patients.
 If the patient is dehydrating, adequate fluids are
to be taken.
 Intravenous fluid is administered if the patient is
unable to maintain oral intake.
 For severe body ache, painkillers may be needed.
 For severe headache and for joint and muscle
pain, acetaminophen/paracetamol and codeine
may be given.
 If there is significant bleeding, blood or platelet
transfusion will be carried out.
Note : Aspirin should be avoided as this drug
may worsen the bleeding tendency (because
of its anticoagulant effects & the increased
risk of developing Reye syndrome).
PREVENTIONS
There is currently no vaccine available for the dengue fever.
STRATEGIES
 Individual roles. People are urged to empty
stagnant water from old tires, trash cans &
flower pots.
 Mosquito control. Place larvicide e.g.
Abate® or any other suitable insecticides
into any exposed water container. Use
mosquito repellant sprays that contain
NNDB or DEET.
 Enforcement. Local authorities from
Ministry of Health conduct on-site check &
destroy larvae at residential premises &
construction sites. Fines may be imposed on
the owner of properties.
PREVENTIONS
 Fogging with insecticide. Fogging would
be carried out by local authorities in
housing area where 2 or more cases of
dengue fever are reported within one
week.
 Information. In Nov 2007, the Ministry
of Health carried out a major campaign
against Aedes. During the campaign
free packages of Abate® were
distributed. Leaflets & brochures to
inform the public on ways to prevent &
curb Aedes breeding are distributed.
 Awareness campaign. Schools & local
communities are encouraged to carry
out communal cleaning activities. Public
awareness campaigns through
strategically placed posters & television
advertisements are also done.
REFERENCES
 http://ms.wikipedia.org/wiki/Demam_Denggi
 http://en.wikipedia.org/wiki/Dengue_fever
 http://www.gov.my/MyGov/BI/Directory/Citizen/CitizenH
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ealth/HealthPersonal/CommonDiseases
http://library.thinkquest.org/07aug/01614/denguemalaysia.html
http://www.dph.gov.my/vektor/eng/kes_dd_tahunan.htm
http://www.infosihat.gov.my/isusemasa.php?id=17
http://www.myhealth.gov.my/myhealth/bm/template.jsp
?showMe=28&storyid=1231474221719
http://wonder.cdc.gov/wonder/prevguid/p0000373/p000
0373.asp
http://www.who.int/csr/disease/dengue/en/index.html