Dengue also known as break bone fever is a mosquito to borne tropical disease caused by the dengue virus. It is an infectious disease caused viruses which are transmitted to humans by biting of a specific mosquito called Aedes Aegypti. Subsequent infection with a different type increases the risk of severe complications. As of now the Dengue does not have any vaccine but it can prevent by reducing the habitat and the number of mosquitoes and limiting exposure to bites. (Anonymous, n.d) The treatment of dengue to those affected patient is supported by the World Health Organization (WHO) and Department of Health (DOH). By these two organization the curing of dengue was been developed. (Anonymous, n.d) The Dengue fever can be risk and turn into dengue Hemorrhagic fever that consist of (3) three stages after it will turn into the last reaction of Dengue, the dengue shock Syndrome in this stage the disease cannot be cure. This disease can get anywhere and anytime if you do not have a right management. (Anonymous, n.d)
In the Philippine Setting, dengue is reported as a leading cause of childhood hospitalization. So that the importance of early vaccination for young children in endemic regions when a vaccination become available. Epidemics of dengue fever and dengue hemorrhagic fever occur every 3-4 years in the Philippines and together with other febrile illnesses in children they impose a considerable burden on the national health care system. (Capeding, 2012) The risk of dengue is not only in the Philippines it is also worldwide. In fact, the dengue was not stated in the Philippines it was reported in the French West Indies and panama. So that the prevention and management of this disease was not only in the Philippines it is worldwide. Background of the Study
Dengue The first recorded case of probable, dengue fever is in a Chinese Medical Encyclopedia from the Jin dynasty in the year of 265-420 AD which referred to a water poison associated with flying insects. The first recognized dengue epidemics occurred almost simultaneously in Asia, Africa and North America in the 1780’s, shortly after the identification and naming of the disease in 1779. The first confirmed case report dates from 1789 and is by Benjamin Rush, who gives the term break bone fever because of the symptoms of myalgia and arthralgia. (Dengue Virus Net., n.d) Dengue in the Philippines The involved large number of human volunteers recruited from U.S Army personnel performed their dengue studies in the Philippines. The first studies were made by Joseph Franklin Siler, Miltonweston Hall, and Arthur Parker Hitchens took place in 1924-1925, but the final study was conducted by James Stevens Simmons, Joseph Harold St. John, and Francois Hiie Kari Reynolds in 1923-1930. Both studies were originally published in the Philippine Journal Science and were reprinted with appendices by the Bureau of Printing, Manila. (Nishiura & Halstead, 2007)
Signs and Symptoms Dengue fever is an acute disease caused by a virus. The incubation period of an Aedes Aegypti is 3-15 days; symptoms may be seen between 7-10 days. It is found in the tropics and subtropics, is not an uncommon disease. These are the following symptoms: 1. Prodrome (stage before fever starts): malaise (not feeling well) and headache for (2) two days. 2. Acute onset: fever, back pain, joint pain, generalized body pains, pain on eye movement, nausea and vomiting. 3. Fever: Continuous high fever with break on fourth or fifth day usually lasts 7-8 days. 4. Rash: starts in 1-2 days on chest, hands, and legs. Before the rash appears, dengue is difficult to distinguish from malaria or influenza. The rash makes dengue certain. 5. Convalescence slow (Little, n.d)
Classification of dengue according to severity:
Grade 1: Fever with pain (in bones, body), nausea and headache. Grade 2: Grade 1 plus spontaneous bleeding of skin, gums and gastro- intestinal tract. Grade 3: Grade 2 plus circulatory failure.
Grade 4: Grade 3 plus shock with undetectable blood pressure and pulse. (Little, n.d)
Prevention and Management Since the dengue does not have any vaccine so the best way to prevent dengue is to prevent bites by mosquitoes but since preventing to those mosquitoes is hard there are many ways to secure people against mosquito. 1. Stay away from heavily populated residential areas, if possible. 2. Use mosquito repellents, even indoors.
3. When outdoors, wear long-sleeved shirts and long pants tucked into socks especially if you are going to a populated area. 4. Make sure windows and door screens are secure and free of holes. If sleeping areas are not screened or air conditioned, use mosquito nets. (Normandin,2012) If someone in the house gets dengue, be especially watchful about effort to protect the family members from mosquitoes because it could spread the infection. Already secured the family member but the community does not it have a great possibility that the other families have a risk in dengue.
These are the some ways to reduce the breeding habitat to lower mosquito populations. 1. Items that collect rainwater or to store water (plastic containers, drums, buckets, pails, tires) should be covered or properly discarded. 2. Pet and animal watering containers and flower vases should be emptied and cleaned at least once a week. 3. Keep the gutters clean of leaves and debris that might hinder water flow. (Hicks,2014) Treatment There is no exact medicine to eliminate the dengue infection. But if you feel the mild symptoms of dengue. There are the 3 ways or the first aid to reduce the infection: 1. Use pain relievers with acetaminophen
2. Avoid medicines with aspirin or ibuprofen
3. Drink plenty of water (Hicks, 2014)
After the first 24 hours after the fever goes down, get to a hospital immediately to be checked for complications. Some cases of this turn into dengue hemorrhagic fever (DHF), the treatment of DHF is made in hospital. These are the emergency treatment method:
1. Hydration with intravenous (IV) fluid
2. Over-the-counter r prescription drugs to manage pain.
3. Electrolyte therapy
4. Blood transfusions
5. Careful monitoring of blood pressure
6. Oxygen therapy
7. Skilled nursing observations
All these methods are aimed at controlling and alleviating the symptoms while helping your body heat naturally. Doctors will continue to monitor your body’s response. (Stoltzfuz & Yu, 2012)
Statement of the Problem
In stating the problem, it will help on solving the specific topic to be discussed. Those problems will go to be answer by this study. In solving to all of these problems makes it clarified to everyone. 1. What is the main cause of dengue?
2. What are the prevention and management that the government will do to prevent dengue? 3. How many years that the epidemics of dengue occur in the Philippines? 4. What are the Connection of Dengue fever, Dengue Hemorrhagic fever and dengue shock syndrome? 5. What will be the first aid that can do before going in the hospital?
Significance of the Study
The importance of this study of our course is, it will give us advance knowledge about this disease because it can help us to be more skillfully competent to care all our patients that have the same disease. The studying of disease could help to all people because all of us could be have this disease and I hope it will not.
The result of this study would be beneficial to our:
1. Nursing Student. It will serve as their reference to their studying about any kind of disease and because of this, they can give an appreciate care for this their soon to be patients. 2. Community. They will be more knowledgeable to the disease when it comes to their signs and symptoms and because of it less will be suffer in dying. It will not only beneficial to all medical practitioner that promoting the health and prevention of illness and disease but also to all people around the society because it will make them more responsible and knowledge. Scope and Limitation
The general purpose of the study is to give information to all people about the dengue cases that happening worldwide.
Our subject matter and topic studied and discussed will be the following:
2. Dengue in the Philippines
3. Signs and symptoms
4. Treatment, prevention and management
The Location of study will be focused in the Philippines.
Definition of Terms
This part of this study will help to improve the vocabulary and also to be more familiarize in the words. Those words always use by the medical practitioner such as Nurses, Doctors and other. 1. Acetaminophen – an analgesic drug used to treat headaches, arthritis, etc., and also to reduce fever, often as an alternative aspirin but known as paracetamol. 2. Aedes Aegypti – kinds of mosquito that transmit dengue virus that causes dengue fever. 3. Arthralgia – pain in a joint
4. Aspirin – a synthetic compound used medicinally to relieve mild or chronic pain to reduce fever and inflammation. 5. Break bone Fever – the terms used by Benjamin Rush in Dengue. 6. Dengue – a disease of the tropics transmitted by mosquitoes, and causing sudden fever and acute pains in the joints. 7. Dengue Hemorrhagic Fever – a severe, potentially deadly infection spread by mosquitoes. 8. Dengue Shock Syndrome – a syndrome due to dengue virus. 9. Department of Health (DOH) – is the principal health agency in the Philippines. It is responsible for ensuring access to basic public health services to all Filipinos through the provision of quality health care and regulation of providers of health goods and services. 10. Electrolyte Therapy – administered electrolyte to supports the basic function of the body 11. Ibuprofen – a synthetic compound used wisely as an analgesic and anti- inflammatory drug. 12. Intravenous – existing or taking place within or administered into, a vein or veins. 13. Myalgia – pain in a muscle or group of muscles.
14. Oxygen Therapy – is the administration of oxygen as a medical intervention. 15. Water Poison – associated with flying insects.
16. World Health Organization (WHO) – is a specialized agency of the United Nation (UN) that is concerned with international public health.
Anonymous (n.d). Dengue Fever. Retrieved from http://en.m.wikipedia.org/wiki/Dengue_fever Capeding, Maria Rosario (2012). Dengue in the Philippines. Retrieved from http://www.denguematters.info/content/issue-7-dengue-philippines. Dengue Virus Net (n.d). History of Dengue. Retrieved from http://www.denguevirusnet.com/history-of-dengue.htm Nishiura, Hiroshi & Halstead, Scott B. (2007). Natural History of Dengue Virus (DENV)-1 and (DENV)-4 Infections: Reanalysis of Classic Studies. Retrieved from http://m.jid.oxfordjournals.org/content/195/7/1007.full Little, David (n.d). Dengue-Homeopathic Treatment. Retrieved from http://www.prisma.net.bd/dengue.htm Hicks, Rob (2004). Dengue. Retrieved from http://www.m.webmd.boots.com/a-to-z-guides/dengue?page=4 Normandin, Bree (2012). Dengue Fever. Retrieved from http://www.healthline.com/health/dengue-fever#Prevention6 Stoltzfus, Seth & Yu, Winnie (2012). Dengue Hemorrhagic Fever Retrieved from http://www.healthline.com/health/dengue-hemorrhagic-fever#Treatmemt6