(2) Signs and symptoms. The symptoms include nausea, vomiting,
headache, malaise, retro-orbital pain, fever, photophobia, and possibly bradycardia. If
the victim suffers the severe form of the disease, he experiences the above symptoms
but also extreme prostration, petechiae and mucosal hemorrhages, severe pains
throughout the body, jaundice, and oliguria. Some signs of this disease include
erythematous face, tachycardia, conjunctival redness during the congestive phase, and
on the third day, a period of calm. Just after the occurrence of the normal temperature,
there is a return of fever, bradycardia, hemorrhaging, hypotension, jaundice, and later
delirium.
(3) Treatment. The treatment consists of a liquid diet that limits food to high
carbohydrate, high protein liquids; if required, a saline and glucose IV should be
administered. Give sedatives and analgesics as necessary.
(4) Prevention. Mosquito control is the best preventive measure. Persons
traveling to or living in endemic areas should obtain the highly effective live virus
vaccine.
b. Dengue Fever (Dandy Fever, Breakbone Fever).
(1) General. This is a viral disease which is also caused by the Aedes
mosquitoes. Dengue fever occurs during warm weather (the active mosquito season).
One of several serotypes located between latitudes 25 degrees north and 25 degrees
south may be responsible for this fever.
(2) Signs and symptoms. The victim experiences a sudden onset of high
fever along with chills, and sore throat, depression, and prostration. There is also a
severe aching ("breakbone") of his extremities, back, and head. Bradycardia and
hypotension may also be present. For 3 or 4 days, there is the initial febrile phase, and
this is usually followed by remission lasting from a few hours to two days. In
approximately 80 percent of the cases, a skin eruption (maculopapular) appears during
the remission or the second febrile stage. The symptoms during this stage are milder
than those of the initial phase. In a high percentage of cases (mosquito-borne
hemorrhagic fever) in Southeast Asia, hemorrhages (gastrointestinal) and petechial
rashes occur. Until the skin eruption appears, it is difficult to distinguish dengue fever
from malaria, yellow fever, or influenza.
(3) Treatment. For shock, it is necessary to expand the circulating blood
volume. For discomfort, administer salicylates as necessary and allow a gradual
restoration of activity during the prolonged convalescence.
MD0589
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