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Disease outbreaks: http://www.who.int/csr/don/en/
Overseas information: http://www.cdc.gov/Dengue/

DENGUE & DENGUE HAEMORRHAGIC FEVER

Dengue a mosquito borne viral disease has undergone a worldwide resurgence.
The "Dengue" mosquito ( Aedes aegpti ) prefers to feed on humans and has invaded urban tropical environment of many countries including Australia. Unlike the malarial mosquito which only feeds between dusk and dawn, the dengue mosquito is a daytime feeder. It is considered the most important mosquito spread viral disease in the world today. Severe headache, bone & muscle pain, high fever and rash usually occur 3-14 days after an infected bite. A Life threatening blood disorder can occur. There is no vaccination available so avoiding bites is essential.

Anyone suspected of being infected with Dengue, especially the haemorrhagic form (large bruises on skin, bleeding gums or blood from nose or bowel) should seek medical attention immediately. If untreated or incorrectly treated Dengue haemorrhagic fever can be fatal.
Also WHO. - www.who.int/csr/disease/dengue/en/index.html

Dengue Description
What is dengue ? Dengue is a viral infection which causes an influenza-like illness, with fever, malaise and body pains, followed by a measles-like rash. It lasts about 2 weeks, but may take several weeks for full recovery.
Dengue Haemorrhagic Fever (DHF) is a more severe form of dengue which occurs in people who have had previous exposure to dengue. It causes circulatory failure, respiratory distress and haemorrhage, and may be fatal.**
How is it transmitted ? The virus is transmitted through the bite of the Aedes mosquito, which occurs in both urban and rural settings, and is mainly day biting. The mosquito only travels short distances (<30 metres), so attention to reducing its breeding environment in proximity is important
The onset is from 3 -14 days.
There are 4 types of dengue virus, so that repeat infections can occur.
What is the risk of catching dengue? Dengue occurs mainly in SE Asia, Pacific Islands, India and Central America; but also can occur in East Africa, northern Australia and southern USA, and may occur in epidemics, especially during the rainy season. Risk is generally low, but greater during epidemics / rainy season.

Prevention of Dengue

Method Indications Side effects & contra-indications
Avoid mosquito bites Wear long sleeved dress and trousers, and use mosquito repellant during the day. Mosquito netting and repellant at night is also useful.
Vaccine No vaccine or prophylactic tablets are currently available, although experimental vaccines are being researched and trialed in hospitals.

Extract from NORTHERN SYDNEY AREA PUBLIC HEALTH UNIT included

** Dengue Haemorrhagic Fever (additional note)
The risk of DHF in travellers who have had dengue before and return to endemic dengue area is 0.5% to 1%. However the risk is higher if the traveller is infected by a different strain of dengue (1% to 13%). The risk is at the upper end of this range in children.

Information mostly taken from: "International Travel and Health" (WHO year book - internet only)
Australian Immunisation Handbook, 8th Edition - 9/2003 - Part1 - Part 2 & Part 3 (large pdf files)
Centre for Disease Control, USA -  www.cdc.gov/travel Travel Health Seminar Oct 96, June 97,Feb 98, March 99, May 2000, August 2002 & March 2005 - Victorian Medical Postgraduate Foundation.
Manual of Travel Medicine, Melbourne, Oct 2004. Updated 06/09/2006.  Additional references & disclaimer.

Last Page edit: 29 September, 2010

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North East Valley Division General Practice, Victoria, Australia, Disclaimer 
Level 1, Pathology Building, Repatriation Campus, A&RMC, Heidelberg West VIC 3081. .. map
Phone: 03 9496 4333, Fax: 03 9496 4349,  Email: nevdgp@nevdgp.org.au
 
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