Dengue Fever / Dengue Haemorrhagic Fever
This disease was first recorded in the year 1779-1780 is endemic in Asia, Africa and North America and occurs almost simultaneously with the level of morbidity and mortality are high. This illustrates that the spread of this disease is very extensive since more than 200 years ago and is a disease that is quite dangerous. When even this disease is still a serious problem in the health sector generally in tropical and subtropical areas with economic and health levels are low.
Dengue fever (DF) is a disease caused by the dengue virus, family Flaviviridae, the genus is a flavivirus. The disease is not transmitted directly from human to human, but through the intercession through mosquito bites. The species of mosquito that is the vector of the disease is the main intermediary Aedes aegypti and Aedes albopictus females.
DF is the mildest form of the following form is Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS).
Clinical manifestations of dengue virus infection in humans varies widely. Variations are so wide spectrum, ranging from asymptomatic, mild non-specific fever, Dengue Fever, Dengue Haemorrhagic Fever, to the most severe that dengue shock syndrome (DSS).
Dengue fever has signs and symptoms in the form of heat which lasts between 4-7 days after the bite of a mosquito carrying the virus is accompanied by the following symptoms which include:
- High heat up to more than 38 º C, which lasts up to 5-7 days.
- Headache and pain diretro-orbital (behind the eye).
- Pain in muscles and joints.
- Nausea and vomiting, no appetite.
- The presence of digestive disorders (constipation or diarrhea).
- Abdominal pain.
- The presence of rash (signs of redness) of the skin.
While Dengue Haemorrhagic Fever has the following signs and symptoms:
Symptoms of the above plus:
- The presence of spontaneous bleeding manifestations, such as red spots on the skin that do not disappear when pressed (especially in the area of ??the elbow, wrist and feet), positive tourniquet test, nosebleeds, bleeding gums, bleeding difficult to stop if it is injected or injured.
- Organ enlargement of the liver (liver) and spleen.
- The presence of thrombocytopenia, the platelet count is less than 100.000/mm ³ (normally 150-450 thousand / mm ³).
- Plasma leakage marked with hematocrit values (HCT) is increased or decreased by 20% or more of normal values, the presence of pleural effusion (fluid in the lungs) and ascites (accumulation of fluid in the abdominal cavity).
The most severe form of the viral infection is dengue shock syndrome (DSS) in which symptoms include:
Symptoms in DHF plus,
- An impairment of consciousness.
- Very low blood pressure.
- Rapid and weak pulse.
- Hands and feet pale and cold.
For ease in determining the diagnosis and prevent overdiagnosis, the WHO, divide into 4 degrees of clinical manifestations, namely:
- DHF Grade I: The signs of viral infection, the manifestation of bleeding that seemed only to test positive torniquet.
- DHF Grade II: Signs manifestations of viral infections with spontaneous bleeding (nosebleeds, red spots)
- DHF Grade III: Also called pre-shock phase, with signs of DHF grade II but the patient began to experience signs of shock; decreased consciousness, cold hands and feet, rapid and weak pulse palpable, pulse pressure was measured.
- DHF degree IV: Or the phase of shock (dengue shock syndrome also called / DSS), patients in shock with greatly decreased consciousness and coma, cold hands and feet and pale, the pulse is very weak to not palpable, pulse pressure can not be measured.
Nursing Management for Dengue Fever
In principle, because this is a disease due to a virus infection then there is no specific medicine to address them . Care provided only a symptomatic treatment is only a general state of repair of sufferers and to guard against dehydration ( lack of fluids ) . The treatment can be done at home if the patient is still able to eat and drink alone and no nausea or vomiting is severe ( DHF Grade I – II ) . Treatment can be done by providing a warm compress , heat the medicine go down , a pain reliever and Antiemetic if necessary .
If the condition of the patient does not improve or if there are signs of shock ( DHF Grade III – IV ) immediately brought to the nearest health facility .
DHF will generally experience healing after 7-8 days , if there is no secondary infection and the body’s basic defense is a good sufferer . Signs of healing among others, include fever down slowly , and drink appetite improved , fatigue is reduced and the body feels fresh again .