Awareness Campaign on DENGUE DENGUE HEMORRHAGIC FEVER Presented

Awareness Campaign on DENGUE & DENGUE HEMORRHAGIC FEVER Presented By: Corporate HSE Team

Dengue Virus Dengue is a mosquito born infection which in recent year has become major international public health concern. Denguehemorrhagicfever(DHF), apotentiallylethal complication found first time in 1950’s in philipines and Thailand. The spread of Dengue is rapid in urban populations where household water storage is common and where solid waste disposal services are inadequate.

Transmission of Dengue Fever Dengue virus is transmitted to human through the bites of infective female Aedes mosquitoes. Mosquitoes generally acquire virus while feeding on the blood on an infected person. After virus incubation for 8 -10 days, an infected mosquito is capable , during probing and blood feeding, of transmitting the virus, to susceptible individuals for the rest of its life. • Dengue transmitted by infected female mosquito • Primarily a daytime feeder (appear during dawn & Desk) • Lives around human habitation • Lays eggs and produces larvae preferentially in artificial containers

Transmission Process

Life Cycle of a Mosquito

Symptoms of Dengue Fever • Fever • Headache • Muscle and joint pain • Nausea/vomiting • Rash • Hemorrhagic manifestations Patients may also report other symptoms, such as itching and aberrations in the sense of taste, particularly a metallic taste. In addition, there have been reports of severe mouth dryness after the acute phase of the illness.

1. The virus is inoculated into humans with the mosquito saliva. 2. The virus localizes and replicates in various target organs, for example, local lymph nodes and the liver. 3. The virus is then released from these tissues and spreads through the blood to infect white blood cells and other lymphatic tissues. 4. The virus is then released from these tissues and circulates in the blood.

5. The mosquito ingests blood containing the virus. 6. The virus replicates in the mosquito midgut, the ovaries, nerve tissue and fat body. It then escapes into the body cavity, and later infects the salivary glands. 7. The virus replicates in the salivary glands and when the mosquito bites another human, the cycle continues.

Transmission Illustration Diagram

Four Grades of DHF Grade 1 Fever and nonspecific constitutional symptoms Positive tourniquet test is only hemorrhagic manifestation Grade 2 Grade 1 manifestations + spontaneous bleeding Grade 3 Signs of circulatory failure (rapid/weak pulse, narrow pulse pressure, hypotension, cold/clammy skin) Grade 4 Profound shock (undetectable pulse and BP)

Preventions • Keep your homes and offices protected against mosquitoes. • Keep homes and offices airy, bright and safe from moisture. • Fix nets on doors and windows. • Wear full sleeves clothes. • Use mosquito nets while sleeping. • Don't leave the overhead tanks open & avoid using swimming pools. • Don't keep water in containers for more than a week. Instead, empty them every week, let them dry and then fill again. • Don't let the water falling from the overhead tanks to accumulate permanently. Instead dry it. • Don't let the water accumulate in any case both inside or outside the home. • Be mindful of your home's cleanliness. • Keep the fence and hedge boundaries duly cut both inside and outside the home, and spray over them with insecticides, particularly in the evening. • Don't let the water stay all the time in the flower pots, gamias of plants. Instead water them only in the morning every alternate day. • The best way to fight dengue is through sustained cleanliness and sanitation.

Programs to Minimize the Impact of Epidemics • Education of the medical community • Implementation of emergency contingency plan • Education of the general population

Facts about Dengue Fever in Pakistan - 2011 v. First outbreak in Pakistan was in 1994 probably came from Thailand Malaysia. v. Punjab is the most victimized province from Dengue fever. v. Approx. 900 cases are reported daily in Lahore. v. So far, over 9000 dengue cases have been reported in Lahore. v. Sindh & Islamabad are 2 nd and 3 rd largest victimized ares of Pakistan. v. In Karachi, total 1500+ cases has been reported. v. World Health Organisation in response to a request made by the director general health office had agreed to provide medicated bed nets shortly.

Sri Lankan experts give serious advice on dengue The team comprises doctors, clinical experts, epidemiologist, physicians and communication specialists that is visiting Pakistan on the invitation of the Punjab government to make suggestions on treating and controlling the dengue fever as Sri Lanka has an excellent experience of defeating it. Ø Fumigation, being done officially or unofficially, can help overcome the spread of ailment by just 15 per cent while preventive measures taken by the community at homes can defeat it by 85 per cent. Ø The experts said Sri Lanka has successfully grappled with the disease over the past thirty years mainly by creating 100% public awareness. Ø They said that the panic created in Pakistan has led to most deaths because some affected who are already suffering from diabetes or heart problems can't physically and psychologically bear the pressure of the disease and collapse having cardiac arrest. Ø They said effect of dengue would ease by October and would end in December.

Efforts of Government Health Departments • Government of Punjab had developed Punjab Health Line Project for Dengue whose number is 0800 -99000. Any person can take information on by dengue by calling on it. • The government has raised awareness for spraying. Article 144 is implemented in Lahore for the prevention of dengue. • The Chief Minister of Punjab, Mr. Shahbaz Sharif, had called a meeting for this purpose. He had contacted with Dengue Special Mobile Team to immediate recovery of this epidemic. • Close liaison has been established with hospitals and National Institute of Health (NIH), Islamabad in order to work in coordination. A separate team comprising of a dispenser and a malaria worker has been deputed to create awareness amongst general public who are visiting the communities and advising them about the precautionary and preventive measures against the diseases, he added.

Voluntary Actions Khalid Book Depot-Lahore is voluntarily working free against the spread of this epidemic. If any one wants to spray in his community/home, please contact on this Number : 042 -37223881 Message by Health Division - Sindh Government ØDiv. Of Health –Sindh/District/Town Administration teams are spraying home to eradicate Dengue Fever. ØKindly Note: Only allow those teams who have gov. identification cards. ØTo get assisstance Please contact on the following Numbers: 0321 -2420780 0229240106 02199215970

Frequently Asked Questions: Q 1: How soon After Exposure do Symptoms appear: Ans: Normally 4 -6 days with a range of 3 -14 days. Q 2: How is Dengue Diagnosed? Ans: By blood test of followings ØPlatelets ØWhite Blood Cells (WBC) ØVirus Isolation Q 3: How is Dengue Treated? Ans: There is no specific treatment. Maintenance of the circulating fluid volume is the central feature of DHF case management. Use lot of fresh juices e. g. Apple juice, pomegranate juice, Papaya leaves syrup etc. are helpful in increasing platelets against fever. Panadol and use of paracetamol is the only drug of choice to bring down fever.

Q 4: Can I get Dengue from another person? Ans: It does not spread from person to person, but only spread by bites of infected mosquitoes. Q 5: Can fever become dangerous? Ans: Virus effects bone marrow, causes reduction of WBCs and platelets and also damage to blood vessels. Q 6: When should a patient suffering from Dengue go to the hospital or consult a doctor? Ans: Right from the day of fever. Generally progress towards dengue fever occur after 3 -5 days of fever. At this time, fever has often come down and we think it is recovering. Infact this is the most dangerous period that requires high vigilance from care-givers. Q 7: Is there a vaccine to prevent dengue fever? Ans: Yet, no vaccine available in the market, please avoid using any vaccine.

Q 8: Is dengue fever more serious in infants or pregnant women? Ans: Dengue fever in infants is less serious and has no effects in newborn. Pregnant mother can transfuse her blood for recovery of loss plateplets. “This is a challenge and can be overcome by a comprehensive public awareness campaign” For Urdu updates on Dengue Fever, Kindly check this website http: //www. columnpk. com/dengue-fever-in-urdu-symptoms-treatment-andprecautions/ For WHO guidelines, Kindly check this website http: //www. denguevirusnet. com/guidelines. html

Hope You have a Nice & Mosquito Bite Free Day