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By Admin
#1908
Dengue Fever/Dengue Haemorrhagic Fever is an acute viral disease having the potential of causing, large scale outbreaks. The risk of dengue has shown an increase in recent years due to rapid, urbanization, life style changes and deficient water management including improper water storage practices in urban, peri-urban and rural areas, leading to proliferation of mosquito breeding sites. In India, the first evidence about the occurrence of dengue fever was reported during 1956 from Vellore district in Tamil Nadu. The first DHF outbreak occurred in Calcutta (Kolkata, West Bengal) in 1963 with 30% of cases showing haemorrhagic manifestations. In 1996, the country had experienced an outbreak recording a total number of 16517 cases (suspected) and 545 deaths. During 2003 as well, large number of cases and deaths had been reported (12754 and 215, respectively). In the year 2006, there was again upsurge in DF/DHF cases in the country, with a total 11638 cases and 174 deaths reported by 21 states of the country. All the four serotypes i.e. Dengue 1, 2, 3 and 4 have been isolated in India.

There is no specific treatment for dengue fever. Besides, the dengue vaccine has a long way to go. As any of the four dengue viruses can cause the disease, hence the vaccine must be tetravalent i.e., it needs to protect against all four viruses.

One of the primary problems in management of dengue is misinterpretation and resultant confusion because of the term ìhaemorrhagic feverî implying a significant haemorrhagic component to the patho-physiology and overshadowing the increased permeability, which causes depletion of the intravascular component. The doctor managing a dengue patient has to make evaluations of the haemodynamic state to assess for judicious fluid replacement at several points of time. A broad-angled evaluation involves integration of clinical and laboratory parameters, which are in turn summation of the disease process as well as the ongoing treatment. This understanding is crucial in guiding decisions about the volume, rate and type of fluid infusion. Most, if not all, deaths due to dengue are potentially avoidable. Thus, it was essential to frame the common guidelines on Clinical Management of Dengue for the physicians across the country.

These guidelines on clinical management of DF/DHF/DSS have been developed in consultation with the leading national and international experts in the field of clinical management of DHF. I am sure these will guide the clinicians for appropriate treatment of the patients with DF/DHF /DSS and would help in reducing the case fatality rate of DHF/ DSS.
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