As the disease spreads to new geographical areas, the frequency of the outbreaks is increasing along with a changing disease epidemiology. Dengue shock syndrome dss has all of criteria for dhf plus circulatory failure as evidenced by. Penyakit dengue shock syndrom dss adalah penyakit dhf yang mengalami renjatan atau shock mansjoer, arief. Skin dendritic cell and t cell activation associated with. Department of health and human services centers for. To study the characteristics of dengue shock syndrome dss patients managed during rawalpindi dengue epidemic 2014. Rapid and weak pulse and narrow pulse pressure dss. Dengue fever is an acute, febrile, flu like illness caused by the dengue. Dengue fever is a disease caused by one of four related viruses transmitted to humans by the bite of an infected mosquito. Hepatic dysfunction in children with dengue shock syndrome. People with weakened immune systems as well as those with a second or subsequent dengue infection are believed to be at greater risk for developing. The dengue shock syndrome dss is characterized by bleeding that may appear as tiny spots of blood on the skin petechiae. Clinical and laboratory features, progress and outcome of these patients were analysed in order to identify risk factors associated with development of dengue haemorrhagic fever dhf and dengue shock syndrome dss.
Dengue is a febrile illness caused by infection with one of four dengue viruses denv transmitted by aedes aegypti or aedes albopictus mosquitoes during the taking of a blood meal. Lovera and others published clinical characteristics of dengue shock syndrome dss in children find, read and cite all the research you need on researchgate. Aggressive management of dengue shock syndrome may. Infection may be asymptomatic or present with a broad range of clinical manifestations including a mild febrile illness to a lifethreatening shock syndrome. Some patients, particularly children, experience a more severe and occasionally fatal form of the disease, called dengue haemorrhagic fever dhf, the most severe form of which is referred to as dengue shock syndrome dss. Uf cannot be diagnosed clinically and the diagnosis is based on serology or virology. The reasons why some patients progress to these potentially fatal forms are poorly under. All can cause syndromes that are selflimited or severe. Oct 23, 2016 dengue shock syndrome dss is the final stage of the more severe occurrence of dengue dengue haemorrhagic fever dhf, and is fatal without prompt treatment. The four dengue viruses are transmitted in tropical countries that circle the globe. Dengue shock syndrome dss is defined as any case that meets the four criteria for dhf and has evidence of circulatory failure manifested by.
As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of. The common severe syndromedengue haemorrhagic feverdengue shock syndrome dhf dss is characterised by sudden vascular permeability generated by cytokines released when t cells attack dengueinfected cells. Serotype infectivity and phylogenetic of dengue virus cause of dengue fever df, dengue hemorrhagic fever dhf, and engue shock syndrome dss in surabayaindonesia 1,5 infection with denv causes a spectrum of clinical disease ranging. Alternate hypothesis on the pathogenesis of dengue. Summary much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans.
Pdf serotype infectivity and phylogenetic of dengue virus. The term dengue shock syndrome dss is used when an infected person has gone into shock. Most primary infections cause a debilitating, but nonfatal, form of illness. Clinical and serologic study of cuban children with dengue hemorrhagic feverdengue shock syndrome dhf dss. The morbidity and mortality from dss can be decreased by early diagnosis of shock and adequate replacement of. Dengue shock syndrome ssd dengue syok sindrom dss adalah kasus deman berdarah dengue disertai dengan manifestasi kegagalan sirkulasi syok renjatan. Symptoms typically begin three to fourteen days after infection. Dengue shock syndrome dss is defined as dhf with signs of circulatory failure, including a narrow pulse pressure shock. Dengue is a leading cause of illness and death in tropical and subtropical areas.
Dengue hemorrhagic fever dhf and dengue shock syndrome dss occur as seasonal epidemics in the tropics and are important causes of death in asian children. Thrombocytopenia and platelet transfusions in dengue. Among these, there are 200,000 to 500,000 cases of potential lifethreatening dengue hemorrhagic fever dhfdengue shock syndrome dss, characterized by thrombocytopenia and increased vascular permeability. Repeat platelet count was 22,000mm 3 and the hematocrit 48%. Current and historical conditions indexed list of current and historical nationally notifiable conditions. Prior epidemic dengue out breaks in the united states 1922, south africa 1927, and greece 1928 afflicted adult patients who developed hemorrhagic manifestations and shock i. Severe dengue is a more serious form of disease that can result in. Patients can recover following appropriate medical treatment. Effectiveness of vitamin d in prevention of dengue. Dengue, dhfdengue hemorrhagic fever, dssdengue shock syndrome. Noting point is, in most people,dengue is less serious as. Dengue shock syndrome oxford medical case reports oxford.
Dengue shock syndrome dss is defined as dhf with signs of circulatory failure, including a narrow pulse pressure pdf on apr 1, 2014, d. Dengue hemorrhagic fever dhf is caused by the same viruses and is characterized by increased vascular permeability, hypovolaemia and abnormal blood clotting mechanisms. Guidelines for treatment of dengue feverdengue hemorrhagic fever in. Management of dengue haemorrhagic feverldengue shock. Dengue syok sindrom dss adalah kasus deman berdarah dengue disertai dengan manifestasi kegagalan sirkulasi syok renjatan. Despite the name, the critical feature that distinguishes dhf from dengue fever is not hemorrhaging, but rather plasma leakage resulting from increased vascular permeability.
Symptoms of dengue can become severe within a few hours. Chapter 2 clinical diagnosis dengue virus infections may be asymptomatic or may lead to undifferentiated fever, dengue fever df or dengue haemorrhagic fever dhf with plasma leakage that may lead to hypovolaemic shock dengue shock syndrome, dss figure 2. Dengue shock syndrome clinical sense medical joyworks. Dengue fever the clinical features of df frequently depend on the age of the patient. Dengue hemorrhagic feverdengue shock syndrome dhfdss is considered to be an antibodymediated viral disease, although this hypothesis remains. For example, two cases of dengue shock syndrome dss were recently described in swedish tourists returning from holiday in asia. Evidence of circulatory failure manifested indirectly by all of the following. There was a statistically significant difference in acidosis, ptt and hospital stay between the two groups. Dengue shock syndrome dss is defined as any case that meets the four criteria for dhf and has evidence of circulatory failure manifested by what to look for when you evaluate patients for dhf evaluate the patients heart rate, capillary refill, skin color and temperature. Older children and adults may have either a mild febrile syndrome or the classic incapacitating disease with high fever of abrupt onset. But since 1954, when dengue hem orrhagic fever dengue shock syndrome dhf dss was reported as a new phe nomenon in the philippines 2, it has. Acute pancreatitis with new onset diabetes in dengue shock syndrome dss is very rarely reported.
These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Infants and young children may have an undifferentiated febrile disease, often with a maculopapular rash. The disease can have severe manifestations, including dengue hemorrhagic fever dhf and dengue shock syndrome dss. The symptomatic cases are categorized as undifferentiated febrile illness uf, dengue fever df, dengue hemorrhagic fever dhf, dengue shock syndrome dss and unusual dengue ud or expanded dengue syndrome eds. Older children and adults may have either a mild febrile syndrome. There are four dengue virus denv types denv1, denv2, denv3, and denv4, all of which are capable of inducing severe disease dengue hemorrhagic fever dhfdengue shock syndrome dss. Dengue shok syndrome dss adalah sindroma syok yang terjadi pada penderita dengue hemorrhagic fever dhf atau demam berdarah dengue dbd. Dengue shock syndrome dss is a major public health problem with high morbidity and mortality, especially in a case of prolonged shock with subsequently massive bleeding. Fluids were given with caution, and fresh frozen plasma ffp and platelet transfusion was commenced. Virus dengue termasuk group b arthropod borne virus arbovirus dan sekarang dikenal sebagai genus flavivirusfamily flaviviridae yang mempunyai 4 jenis serotype yang diberi nama den1,den2,den3,dan den4. Dengue fever classical dengue fever or break bone fever is an acute febrile viral disease frequently presenting with headaches, bone or joint pain, muscular pains,rash,and leucopenia 7.
Dengue, dengue haemorrhagic fever and dengue shock. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Dengue shock syndrome dss is the final stage of the more severe occurrence of dengue dengue haemorrhagic fever dhf, and is fatal without prompt treatment. Dengue is a febrile illness caused by a flavivirus transmitted by aedes aegypti or aedes albopictus mosquitoes while taking a blood meal. The morbidity and mortality from dss can be decreased by early diagnosis of shock and adequate replacement of plasma loss. Dengue information disease surveillance epidemiology. Dec 22, 2011 the symptomatic cases are categorized as undifferentiated febrile illness uf, dengue fever df, dengue hemorrhagic fever dhf, dengue shock syndrome dss and unusual dengue ud or expanded dengue syndrome eds. Management of dengue haemorrhagic feverldengue shock syndrome. Jan 15, 2001 dengue hemorrhagic fever is an important cause of morbidity among asian children, and the more severe dengue shock syndrome dss causes a significant number of childhood deaths. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a.
Dengue haemorrhagic fever dhf and shock syndrome dss. Guidelines for diagnosis, treatment, prevention and control. In a small proportion of cases, the disease develops into severe dengue, also known as dengue. The capacity for oral infection and dissemination of two dengue type2 viruses, thnh793 and thnhpll93, isolated from patients exhibiting different disease severity, dengue shock syndrome dss. Dengue in the context of the imci i dengue, dengue haemorrhagic fever and dengue shock syndrome in the context of the integrated management of childhood illness department of child and adolescent health and development discussion papers on child health dengue in the context of the imci cah whofchcah05. Based on a clinical diagnosis of dengue shock syndrome dss plus myocarditis, dobutamine and noradrenaline infusions were started. Dengue and dengue hemorrhagic fever clinical microbiology. About 1 in 20 people who get sick with dengue will develop severe dengue.
Pdf characteristics of dengue shock syndrome dss patients. Dengue shock syndrome dss is one of the serious complications in cases of dengue haemorrhagic fever dhf. Although the mortality rate from all forms of treated dhf ranges from 1% to 26%, the mortality rate of severe dss may approach 47%, with one study reporting survival of only one of three children with dss and acute respiratory. Dengue shock syndrome an overview sciencedirect topics. The list of acronyms and abbreviations related to dss dengue shock syndrome. Severe dengue is a more serious form of disease that can result in shock, internal bleeding, and even death. Dengue shock syndrome dss must have 4 criteria for dhf and. Known also as dengue hemorrhagic fever dhf, it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat. Dengue fever,dengue shock syndrome linkedin slideshare. A syndrome due to the dengue virus that tends to affect children under 10, causing abdominal pain, hemorrhage bleeding and circulatory collapse shock. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever dhf, and eventually dengue shock syndrome dss.
Jul 15, 2009 based on a clinical diagnosis of dengue shock syndrome dss plus myocarditis, dobutamine and noradrenaline infusions were started. We describe a case of 30yearold man admitted in intensive care unit and was diagnosed with dss with rtpcr, ns1 antigen and dengue igm antibody being positive. Denv2 with 89 whole genomes were obtained from patients diagnosed with dengue fever df, n58, dengue hemorrhagic fever dhf, n 30 and dengue shock syndrome dss, n1 during july 2010 to january 20 in singapore. Abdominal ultrasound and computerized tomography confirmed acute pancreatitis. Dengue fever the clinical features of df frequently depend on the age of the. Hepatic dysfunction in children with dengue shock syndrome dengue bulletin. Dhf is a potentially deadly complication with symptoms similar to those of dengue fever, but. Jul, 2017 abdominal pain, muscle pain, haemorrhage and four more signs that indicate dengue has progressed to dengue shock syndrome. Dengue shock syndrome is a presentation of dengue syndromes when there are criteria of dhf plus signs of circulatory failure, manifested by.
The death rate associated with the more severe form dhf dss is approximately 5%, predominantly in children under the age of 15. Pdf serotype infectivity and phylogenetic of dengue. Known also as dengue hemorrhagic fever dhf, it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Risk factors associated with development of dengue. Dengue shock syndrome dss this is the most serious manifestation of dengue and results in untreated patients or vulnerable children. Dhf may progress to hypovolemic shock known as dss. It is important to increase awareness of dengue and dhf among physicians in temperate areas, however, because the disease can be lifethreatening. Abdominal pain, muscle pain, haemorrhage and four more signs that indicate dengue has progressed to dengue shock syndrome. The dengue shock syndrome dss is characterized by bleeding that may appear as tiny spots of blood on the skin petechiae and larger patches of blood under the skin ecchymoses. Dss is characterized by a massive increase in systemic capillary permeability with consequent hypovolemia. Management of cardiorespiratory collapse in dengue shock syndrome references 12 dengue. Dengue fever treatment as with most viruses, treatment options for dengue will only manage its symptoms. Summary dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity the cocirculation of multiple serotypes, and the emergence of dengue hemorrhagic fever in new geographic regions.291 4 1426 1240 664 636 678 1006 1389 172 1224 889 419 756 870 1159 1009 829 493 486 886 1502 528 1116 60 718 833 1036 1449 1293 1400 1196 870 1243 1388 1225 1248 1079 620 992 203 1419 442 608 519 191