Epidemiological Analysis of Dengue

Dengue fever is a new disease and it has not been studied fully. Therefore, there exist only a few clinical trials and research studies dedicated to it. In few infection instances, dengue could be transmitted during organ transplant when the donors are infected. Usually, dengue has mild signs and effects, but it could progress to severe levels, which leads to adverse medical implications. Patients with advanced dengue fever manifest severe hemorrhagic signs such as bloody stool and melena. Therefore, paper will seek to comprehensive analysis the nature and epidemiological situation of dengue in society, especially in the tropic regions.

History of Dengue Fever

The origin of dengue fever is surrounded with mystery and lack of clear indication of the possible origin of the virus causing it. The first case of dengue fever was recorded in the Chinese medical records from late 265 AD in the Jin Dynasty. During the period, it was referred to as water poison related to insects. However, the large dengue epidemics occurred in the late 1980s, in Africa, Asia, and North America. After the recording of the numerous cases, the disease was identified and named in 1779. In 1789, the disease was referred to as breakbone fever. Following World War II, dengue fever was to spread globally to different areas of the world, including the Caribbean.

Since late 1955, the number of dengue fever infections has increased almost ten times. Some of the factors associated with the increased spread of dengue fever include the poor veterinary control, numerous international travels, overpopulation, and so on (Saqib, Rafique, Bashir, & Salam, 2014). Dengue fever is an emerging condition that is also thought to have originated from monkeys in Africa. However, the disruptions of the world during the Second World War lead to the spread of the disease to various parts of the world. 

Epidemiological Data

According to the U.S Centers for Disease Control and Protection (CDC) (2013), dengue fever occurs from the infections from four related viruses which ranges from dengue 1 to 4 (DENV 1, DENV 2, DENV 3 and DENV 4). Dengue is usually transmitted to humans by the mosquitos of Aedes eagypti and Aedes albopictus species. In some cases, dengue could be passed on via organ transplant from infected donors. Dengue is an endemic disease that mainly occurs in tropics regions and essentially leads to febrile conditions among travelers coming from Latin America, Asia, and the Caribbean. Based on the data and information from Chakravarti, Matlani, Kashyap, and Kumar (2012), one can say that over 100 nations experience dengue fever outbreaks. However, some of the local transmissions have been noted in certain areas, including Florida, Hawaii, and on the border of Texas and Mexico.

Even though the geographic distribution of dengue fever is similar to the distributions of malaria, the former has high risks of occurring in urban and residential regions. It is clear that the transmission of dengue fever has still been in the process in the different parts of the world. Based on clinical data, close to 75% of all dengue infections are asymptomatic (CDC, 2013). Dengue usually leads to mild to moderate and acute illness (Hsu et al., 2013). Approximately 5% of all dengue patients usually develop an adverse and severe condition, which can be life threatening (Hermann et al., 2015). Early medical results are nonspecific but they indicate that there is a high probability of dengue fever patients showing signs of shocks, which requires the development of an intensive supportive therapy to reduce the risk of death among patients with adverse dengue fever. 

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Usually, dengue fever starts after an incubation period of 3 to 10 days and then follows three stages. The steps include febrile, critical, and convalescent. The fever is expected to continue for 2-7 days. Other symptoms, which could be noted, include severe headaches, muscle and bone pain as well as muscle pains (Hsu et al., 2013). Key warning symptoms of the development of dengue to a more severe condition could be noted in the later stages of febrile phase, when certain signs such as persistent vomiting, shock, and difficulties in breathing are noted. The critical phase of dengue starts at defervescence and it could last for up to 2 days. 

Most patients’ medical condition will improve significantly in this stage, but some with significant plasma leakage would later develop severe dengue because of the increased vascular permeability. Patients could develop severe hemorrhagic signs such as bloody stool and melena among others. During pregnancy, data on dengue fever is restricted to health outcomes. Perinatal dengue fever transmission could occur, and maternal infection could increase the probability of symptomatic disease on the recently born babies. In almost 34% cases of perinatal transmission, instances led to thrombocytopenia, and in all cases, one newborn had dengue fever in the early two weeks after being born (Chakravarti et al., 2012). The placental transfer of maternal virus of dengue fever increases the risks of severe dengue infection significantly.

Application of the Levels of Prevention

Based on the National Institutes of Health (NIH) recommendations, the prevention levels of dengue fever will include various programs (Hermann et al., 2015). The department recommends that the way to prevent dengue infection would be to take prevention and precautionary measures to avoid mosquito bites. Despite the numerous clinical trials, there is still no vaccine for dengue. However, to protect oneself from being infected from mosquito bites, the use of mosquito repellent including picaridin and wearing protective clothing will be appropriate. The precautionary prevention measures are useful in reducing increased dengue virus infections. People traveling to dengue-endemic regions have higher risks of contracting dengue. Consequently, individuals traveling to the tropical regions are advised to avoid mosquito bites as possible through various prevention measures. 

The selection of accommodations should be appropriate to get rooms with well-screened doors and air condition. It is recommendable to carry insecticides to kill any mosquitoes if one encounters them. Long-term travelers should also avoid standing water as such areas assist in the breeding of mosquitoes within the local residences. Based on the healthy people 2020 goals, the prevention goals is aimed at preventing rather treating the condition as there are no particular antiviral agents to treat dengue (Hsu et al., 2013). Severe dengue patients require close and frequent observations in intensive care units to avoid any fatalities. The prevention efforts by the different health agencies and organizations understand that dengue is an emerging disease, and there is no cure available. As a result, the creation of awareness about the adverse implications of the illness is significant in different geographical regions.

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Conclusion

In summary, dengue is an emerging disease, which was first recorded in China in late 265 AD. However, many research studies suggest that dengue emerged from Africa and Asia with monkeys being the source of infection. Nevertheless, World War II led to the global dispersion of the disease. Four types of dengue viruses transmitted by mosquitoes include DENV 1, DENV 2, DENV 3, and DENV 4. If a person is infected by one of the viruses, he or she will be infected by dengue. Regarding prevention, the healthy people goals call for the creation of awareness to ensure the reduction of the number of infections because there is no treatment drug known for this dangerous dengue fever. For example, it is recommendable for long-term travelers to avoid standing water and being bitten by mosquitoes. Therefore, it is critical to prevent the rates of infection, especially in the tropics regions with the climate that allows the existence of a high number of mosquitoes.

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