The Impact of Dengue: What Nurses Must Know

The Impact of Dengue: What Nurses Must Know

As a nurse, here's what you should know about dengue fever: 

Dengue Overview

1. Dengue fever is a viral disease transmitted by Aedes mosquitoes.

2. Incubation period: 3-14 days.

3. Symptoms: Fever, headache, pain behind the eyes, joint pain, rash.

Types of Dengue

1. Dengue fever (DF)

2. Dengue hemorrhagic fever (DHF)

3. Dengue shock syndrome (DSS)

Assessment

1. Clinical presentation

2. Laboratory tests:

    - Complete Blood Count (CBC)

    - Platelet count

    - Liver function tests

    - NS1 antigen test

    - IgM/IgG antibody tests

These are Basic things a Nurses must know who is doing job as a Nurse

Dengue Fever Nursing Care

1. Monitor vital signs

2. Manage fever and pain

3. Prevent dehydration

4. Provide bed rest

5. Administer antipyretics and analgesics (as prescribed)

6. Monitor for signs of hemorrhage or shock

Dengue Complications

1. Hemorrhage

2. Shock

3. Organ impairment (liver, kidney)

4. Respiratory distress

5. Cardiac complications

Dengue Fever Prevention

1. Vector control: Eliminate breeding sites

2. Personal protection: Wear protective clothing, apply insect repellent

3. Vaccination (available in some countries)

Nursing Interventions for Dengue Fever

1. Educate patients and families on prevention and management

2. Administer fluids and electrolytes

3. Monitor platelet count and hemorrhage signs

4. Provide emotional support

5. Collaborate with healthcare team for early detection and management

Dengue Fever Emergency Management

1. Recognize signs of severe dengue (DHF/DSS)

2. Administer IV fluids and electrolytes

3. Monitor vital signs and laboratory results

4. Provide oxygen therapy (if necessary)

5. Refer to intensive care unit (ICU) if necessary

The Dengue Fever related questions also asked in many of the Nurses Recruitment Examinations

Global Health Considerations on Dengue Fever

1. Dengue is endemic in 128 countries

2. High-risk areas: Tropical and subtropical regions

3. Travelers to endemic areas should take precautions

In General about Dengue:

DENGUE DUO(NS1 ANTIGEN ,IGG & IGM ANTIBODY), RAPID-Dengue virus is transmitted by Aedes mosquitoes. It belongs to the genus Flavivirus and has four serotypes, DEN-1, DEN-2, DEN-3, and DEN-4. Infection with one dengue serotype provides lifelong immunity to that virus, but no cross protective immunity to the other serotypes. Human dengue infection causes a spectrum of illnesses ranging from inapparent or mild febrile illness to severe to fatal hemorrhagic disease. WHO classifies dengue infections as primary or secondary. It is believed that patients experiencing a secondary infection with heterologous serotypes have higher risk of complications, including Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). 

Dengue Test Utility: 

Dengue NS1 antigen can be detected in serum from day 1 after onset of clinical signs, up to day 9. Dengue specific IgM can be detected as early as 5 days after the onset of fever and generally persists for 30-90 days, although detectable levels may be present rarely upto 8 months post-infection. IgM antibody is also produced in secondary and tertiary dengue infections, although the response in some secondary and probably most tertiary infections is low level and transient. Dengue IgG levels usually start rising at the end of 1st week in primary infection and persists for months and sometimes for life. Patients with primary dengue infections usually are IgM positive & IgG negative with higher IgM concentrations, whereas patients with secondary infections are usually both IgG and IgM positive with higher IgG concentrations. 

Dengue Diagnosis:

Confirmed diagnosis of Dengue fever can be established in a suspected case with atleast one of the following tests: 1) Demonstration of NS1 antigen by ELISA 2) Demonstration of IgM antibody titre by ELISA in single serum sample, 3) IgG seroconversion in paired sera after 2 weeks with 4 fold rise in titre 4) Demonstration of viral nucleic acid by PCR 

Dengue Test Limitations: 

• A negative result may occur if the quantity of antigen/antibody present in the specimen is below the detection limit of the assay, or the antibodies are not present during the stage of disease when the specimen is collected. • Patients suffering from other flavivirus infections (Tick-borne encephalitis virus, Japanese encephalitis virus etc) may give a false positive dengue test due to presence of cross reactive epitopes. Hence all results should be interpreted in conjunction with clinical findings and patient history. • Due to sensitivity & specificity concerns, positive NS1 antigen/IgM results obtained with rapid dengue tests(RDT) are only provisional and point to “PROBABLE DENGUE” infection . For confirmatory dengue diagnosis, GOI notification 2016 mandates to test RDT positive specimens with ELISA