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What you should know about Dengue Fever

What you should know about Dengue Fever. Steve Drouin PUBH-6165 1/20/2013. Purpose . This presentation is generated to educate the frequent international traveler and anyone that wishes to know more about Dengue Fever.

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What you should know about Dengue Fever

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  1. What you should know about Dengue Fever Steve Drouin PUBH-6165 1/20/2013

  2. Purpose • This presentation is generated to educate the frequent international traveler and anyone that wishes to know more about Dengue Fever. • If used for educational purpose, the scholar is offered many different resources to aid in the direction to locate various information.

  3. Outline • Introduction • Disease • Causes for Reemergence of Infectious Disease • Research and Prevention • Public Health Policy

  4. Where is it at? • Statistics • Increases of Infectious Disease causing rapid emergence of epidemics • Vector borne disease infecting an estimated 100 million annually • DF is endemic in over 100 countries. • First reported as epidemic in 1950s in South Asia • Believed to originate in Africa and migrate during the slave trade http://www.who.int/denguecontrol/en/

  5. Transmission • Causes- • The primary culprit being the female Aedes aegypti (Ae aegypti) and infection can also be transmitted to a much lesser extent by the species Aedes albopictus aka the Tigris mosquito (NIAID, 2006). • Ae aegypti is well adapted to the environment it can breed in small amounts of water http://www3.niaid.nih.gov/topics/DengueFever/

  6. Aedesaegypti /albopictus

  7. Disease • Locations • Dengue Fever (DF) is found in areas of urban poverty and more commonly occurred during and shortly after the rainy seasons in tropical regions • Tropical Regions include Africa, Southeast Asia, The Caribbean, South/Central Americas, and the South/Central Pacific (NIAID, 2006). http://www3.niaid.nih.gov/topics/DengueFever/

  8. Symptoms • Other names: • O’nyong-nyong fever • Break-bone fever • Flu-like in nature • Sudden onset • Headaches • Severe joint and muscle pains* • Nausea/vomiting • Swollen glands • Fever up to 105°F • 2 separate appearing rashes** • Diagnosis with: CBC, serology studies, antibody titer

  9. Causes of Reimergence of Infectious Diseases • Behavior • Prevention • centered on education of travelers • use of Personal Protective Equipment (PPE) • Use of PPE • repellents for skin and clothing • avoiding of heavily polluted areas • staying in air conditioned/screened areas • use of bed/mosquito netting. • Education to local population for the recognition of potential breeding sites and regularly changing

  10. Causes of Reimergence of Infectious Diseases • Environment • Pesticides • increasing incidence of malaria and dengue fever found • Regions have not harbored either of the 2 viral illnesses • the disease vectors are still found indigenously in those regions (Reiter, 1998) (Patz, Daszak, Tabor, Aguirre, Pearl, Epstein & Bradley, 2004)

  11. Causes of Reimergence of Infectious Diseases • As global temperatures fluctuate, this can also cause frequent droughts and flooding. • Deforestation • leading cause of increases in many zoonotic diseases • Large emergence of epidemics is due to areas of disasters (Gubler, Reiter, Ebi, Yap, Nasci & Patz, 2001).

  12. Prevention • Repellent • DEET- • Gold standard, • Registered for use by public in 1957 • Can use over the age of 2 months. • No other compound available to public has the same effect/spectrum • Permethrin • Only recommended for use on clothing, equipment and netting. • Highly effective and can kill mosquitoes http://www.mosquito.org/repellents

  13. Prevention • Oil of citronella • Less effective of the repellents • Can only be used outdoors with no wind • Oil of lemon-eucalyptus • Not able to be used on children under the age of 3 yrs • Less irritant to the skin but higher concentrations needed to repel ticks • Newly registered available repellents • Metofluthrin (OFF Clip ON repellents) • Efficacy to the public limited, good signs in lab vs. vectors • Mosquito coils/Thermacell devices • Synthetic pyrethroid insecticides http://www.mosquito.org/repellents

  14. Good Practice • Wear long sleeves/pants during peak activity periods • Application of repellents sparingly to exposed skin. Apply to skin under clothes if clothes can be easily penetrated by mosquito • Avoid DEET concentrations greater than 50% to the skin, do not apply to children’s hands • Nursing women should minimize repellent use • Repellent saturation does not increase efficacy. 10% DEET approx 90 min coverage. 30% offers approx 5-6 hours protection http://www.mosquito.org/repellents

  15. Research • Presently no vaccinations • Less focus on the production of vaccines • the current research trends are directed toward the use of weakened or harmless viruses as potential candidates • Education • Government involvement to control breeding grounds

  16. Research • This method has been referred to as “sterile-insect technique” (WHO, 2009) • currently being used in the agriculture industry for a number of years to control the population of various species of fruit flies and parasitic screw worms • Successful countries include the United States, Mexico and throughout Central America. • Originally the technique began with the radiation of males, but this left the specimens in a weakened state and decreased the overall drive to reproduce. The newest approach is directed at the insertion of a single gene so that males produce non-viable offspring. http://www.who.int/bulletin/volumes/87/3/09-020309/en/

  17. Public Health Policy • Unhealthy Landscapes is a biennial meeting that was established in 2002 in Washington to discuss how the destruction of land affects the landscape and ultimately the ecology and Public Health. • The meeting advises on policies adaptation to evaluate the risk/benefits of landscape modification and the impact on Public Health and Safety. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1247383/

  18. Conclussion • Either traveling or learning, know what is endemic • One of many diseases transmitted by mosquitoes • Reemergence of many diseases can be linked to behaviors • Personal prevention and environmental changes • Learn the new

  19. Resources • American Mosquito Control Association (No date). Repellents. Retrieved from http://www.mosquito.org/repellents • National Institute for Allergy and Infectious Disease (2006). Dengue Fever. Retrieved from http://www3.niaid.nih.gov/topics/DengueFever/ • Phillips, Melissa Lee (2008). Dengue Reborn. Environmental Health Perspectives, 116; 382-88. Retrieved 04/04/2009 from EBSCO • World Health Organization (2009). Mosquito Wars. Bulletin of the World Health Organization, 87, 167-68. Retrieved from http://www.who.int/bulletin/volumes/87/3/09-020309/en/ • World Health Organization (2013). Dengue. Retrieved from http://www.who.int/denguecontrol/en/ • Khansnis, A &Nettleman, M (2005). Global Warming and Infectious Diseases. Archives of Medical • Research, 36(6), Nov-Dec, 689-696. Retrieved from http://linksource.ebsco.com.ezp.waldenulibrary.org/FullText.aspx?linkout=http%3a%2f%2fezp.waldenulibrary.org%2flogin%3furl%3dhttp%3a%2f%2fdx.doi.org%2f10.1016%2fj.arcmed.2005.03.041 • Reiter, P (1998). Global-Warming and vector-borne disease in temperate regions and high altitude. • The Lancet, 351 (9105), 839-840. Retrieved from • http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2978979-0/fulltext • Gubler,D., Reiter, P., Ebi, K., Yap, W., Nasci, R. & Patz, J. ( 2001). Climate Variability and Change in the • United States: Potential Impact on Vector-Borne and Rodent-Borne Diseases. EnvironmentalHealth Perspectives, 109(supplement 2): 223-233. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1240669/pdf/ehp109s-000223.pdf • Patz, J., Daszak, P., Tabor, G., Aguirre, A., Pearl, M., Epstein, J., & ... Bradley, D. (2004). Unhealthy landscapes: Policy recommendations on land use change and infectious disease emergence. Environmental Health Perspectives, 112(10), 1092-1098. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1247383/ • Ahern, M., Kovats, R., Wilkinson, P., Few, R. & Matthies, F. (2005). Global Health Impacts of Flood: Epidemiologic Evidence. Oxford Journals: Epidemiologic Reviews: vol. 27(1); pp. 36-46. doi: 10.1093/epirev/mxi004. Retrieved from http://epirev.oxfordjournals.org/content/27/1/36.full

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