DENGUE VIRUS

DETAILED STUDY ABOUT DENGUE VIRUS

1. DENGUE VIRUS STUDENT OF RIPHAH INTERNATIONAL UNIVERSITY

2. CONTENTS What is dengue virus History of dengue virus Taxonomic classification Types of dengue virus Structure of dengue virus Modes of transmission Pathogenesis Epidemiology Clinical features Diagnosis Treatment and medicine Precautions Role of pharmacist References

3. WHAT IS DENGUE VIRUS Dengue virus  (DENV) is the cause of  dengue fever . In dengue fever platelet count is decreased It is a mosquito-borne, single positive-stranded RNA  virus  . Five serotypes of the  virus  have been found, all of which can cause the full spectrum of disease .

4. HISTORY OF DENGUE VIRUS Dengue viruses have been on the march for more than 100 years. Dengue originated in monkeys and spilled over into humans as long as 800 years ago. It was restricted to Africa and Southeast Asia until the mid-20th century. The dengue viruses spread throughout tropical Southeast Asia via maritime shipments. WEST INDIES Slaves in the West Indies who contracted dengue were said to have the posture and gait of a dandy, and the disease was known as "Dandy Fever". .

5. CONT… FIRST RECORD CASE The first record of a case of probable dengue fever is in a Chinese medical encyclopedia from the Jin Dynasty (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 1780s, shortly after the identification and naming of the disease in 1779. The first confirmed case report dates from 1789 and, by the term "break bone fever" because of the symptoms of myalgia and arthralgia A relatively large dengue outbreak occurred in September 2001 in Hawaii, where 1,644 persons had locally acquired dengue-like symptoms, of whom 122 were laboratory-confirmed. DENV-1 was isolated from 15 patients. The outbreak illustrates how the virus can be moved from a distant area of ongoing transmission to a new locality where mosquito vector populations are abundant enough to initiate an outbreak. A recent island wide epidemic occurred in 2007, with more than 10,000 cases

6. TAXONOMIC CLASSIFICATION HIRERCHEY DENGUE VIRUS GROUP GROUP 4 PHYLUM INCERTAE SEDIS ORDER UNASSIGNGNED FAMILY FLAVIVIRADEA GENUS FLAVIVIRUS SPECIE DENGUE VIRUS

7. TYPES OF DENGUE INFECTION There are two types of dengue infection Asymptomatic Symptomatic Dengue fever [with hemorrhage and without hemorrhage] DENV-1, DENV-2, DENV-3, and DENV-4 Dengue hemorrhagic fever [ no shock and dengue shock syndrome]

8. STRUCTURE OF DENGUE VIRUS DNA COMONENTS Internal structure [10 genes ] 3 structural 7 non structural MOLECULAR STRUCTURE External structure icosahedral DIAMETER 50nm in diamete r

9. MODE OF TRANSMISSION Dengue fever is transmitted to humans through the bites of infective female  Aedes  mosquitoes. When a patient suffering from dengue fever is bitten by a vector mosquito, the mosquito is infected and it may spread the disease by biting other people. The disease cannot be spread directly from human to human..

10. CONT… DENV can also be transmitted from an infected woman to her fetus in utero or infant during parturition. More research is needed to determine perinatal transmission rates and factors associated with perinatal transmission.   Sources of DENV are  Saliva of infected  Aedes spp.  mosquito Blood or organs from an acutely infected person   Modes of transmission also include   Mosquito bite Perinatal transmission Blood transfusion Organ transplantation Needle stick injury or laboratory accident INCUBATION PERIOD OF MOSQUITOE The incubation period ranges from 3 – 14 days, commonly 4 – 7 days.

11. PATHOGENESIS The manner of development of a disease is called pathogenesis PATHOGENESIS OF DENGUE FEVER It is strongly believed by many scientists studying  dengue pathogenesis  that a high  viral  load and activation of high numbers of nonprotective T cells result in a “storm” of inflammatory cytokines and other mediators, leading to the increased plasma leakage characteristic of DHF/DSS.

12. EIDEMIOLOGY Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in defined populations Dengue is widespread throughout the tropics, with risk factors influenced by local spatial variations of rainfall, temperature, relative humidity, degree of urbanization and quality of vector control services in urban areas. Before 1970, only nine countries had experienced severe dengue epidemics. Today, the disease is endemic in more than 100 countries .

13. CLINICAL FEATURES Dengue fever is clinically characterized by high fever, severe headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen lymph nodes and rash. The symptoms of first infection are usually mild. Once recovered, lifelong immunity to that serotype of dengue virus will develop Severe dengue include high fever, which lasts for  2 – 7 days and can be as high as 40 – 41°C, facial flush . Later, there may be severe abdominal pain, persistent vomiting, rapid breathing, fatigue, restlessness and manifestations of bleeding tendency such as skin bruises, nose or gum bleeding, and possibly internal bleeding. In severe cases, it may progress to circulatory failure, shock and death.

14. SYMPTOMS Dengue fever and dengue hemorrhagic fever has following phases FEBRILE Sudden onset of fever Headache Mouth and nose bleeding Muscle and joint pain Vomiting Rash diarrhea 2. CRITICAL Hypotension Pleural effusion Git bleeding 3 . RECOVERY Altered level of consciousness Seizures Itching Slow heart rate

15. DIAGNOSIS OF DENGUE FEVER ALSO KNOWN AS  Dengue Fever Antibodies, Dengue Fever Virus FORMAL NAME  Dengue Antibodies (IgG, IgM), Dengue Virus by PCR DIAGNOSIS TEST The diagnosis of dengue fever consist of the following tests CBC [Complete blood count] PCR test [Polymerase chain reaction] Antibody titer type for dengue virus LFT [ liver function test]

16. TREATMENT AND MEDICINE OF FEVER There is no specific medicine to treat dengue infection. If you think you may have dengue  fever , you should use pain relievers with  acetaminophen  and avoid medicines with  aspirin , which could worsen bleeding. You should also rest, drink plenty of fluids, and see your doctor   Patients with  dengue  hemorrhagic fever or  dengue  shock syndrome may require intravenous volume replacement.

17. Caripill [carica papaya leaf extract] is used as a treatment of dengue fever according to latest research.

18. PRECAUTIONS OF DENGUE FEVER You can protect yourself against dengue  fever  by taking the following precautions: Protect yourself against mosquito bites. Apply mosquito repellent, ideally one containing DEET. Protect yourself against mosquito bites Prevent mosquito breeding inside and outside your home Avoid visiting areas prone to mosquitoes Wear long sleeves and long pants to cover arms and sleeves. Use mosquito net while sleeping

19. ROLE OF PHARMACIST The role of pharmacist for the control of dengue fever is as follows The pharmacist must increase the awareness on dengue fever specially in rural areas. Evaluate the impact of awareness among people. Improve the patients compliance Drug selection Formulary management Medication management Drug dispensing Research and make new medicines relating to dengue

20. REFRENCES https://www.google.com/search?sxsrf=ALeKk01SdbQNln5xDIMJlMEaCV4lrpygtQ%3A1587050772715&ei=FHmYXtGsK4TBgQbAh6a https://www.slideshare.net/ZehraaCheaib/dengue-virus-42568757 https://www.google.com/search?q=structure+of+dengue+virus&sxsrf=ALeKk02iZWO9M2fd8rjfLSD5pt8JADWHLA:158705150 https://www.ghttps//www.google.com/search?q=structure+of+dengue+virus&sxsrf=A