Title: A study on the epidemiological, clinical and laboratory profile of patients admitted with Dengue fever at a tertiary medical centre in South Kerala
Authors: Padma Kumar Balasundaram, Sudharmma Rama Krishnan, Baraneedaran S
DOI: https://dx.doi.org/10.18535/jmscr/v7i10.90
Abstract
Background of the Study
Globally 50 million dengue infections are reported annually[1]. In recent years Dengue has become one of the most important mosquito borne viral disease around the world. Female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Aedes Albopictus transmits Dengue. Chikungunya, yellow fever and Zika infection are also transmitted by this mosquito. Due to local variations in risk influenced by rainfall, temperature and unplanned rapid urbanization dengue is widespread throughout the tropics[1].
Dengue haemorrhagic fever was first recognized in the Philippines and Thailand in the 1950s during dengue epidemics. Today, severe dengue affects most Asian and Latin American countries and has become a leading cause of hospitalization and death[2]. The annual incidence is estimated to be 7.5 to 32.5 million in India[3]. Dengue viruses (DV) belong to the family Flaviviridae. There are four serotypes of the virus DV-1, DV-2, DV-3, and DV-4[2]. It is a positive-stranded encapsulated RNA virus. DV is composed of three structural protein genes. These structural protein genes encode the nucleocapsid or core(C) protein, a membrane-associated (M) protein, an enveloped (E) glycoprotein, and seven non-structural (NS) proteins. Infection with one dengue serotype provides lifelong homotypic immunity to that serotype. It also confers a very brief period of partial heterotypic immunity to other serotypes. But a person can eventually be infected by all 4 serotypes[4].
The disease spectrum may vary with asymptomatic illness to life threatening diseases like dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS).
The diagnosis can be made by IgM ELISA during recovery or by antigen-detection ELISA or RT-PCR during the acute phase[14]. There are no specific management of dengue, other than supportive care.
Indian Scenario
Dengue fever (DF) probably was reported in India from Calcutta (now Kolkata), West Bengal in 1872. An epidemic of dengue hemorrhagic fever (DHF) was reported in Kolkata in July 1963. Around 0.1 million people were affected, mostly children with 40% case fatality rate in hospital admitted DHF cases. The first dengue haemorrhagic fever occurred in Calcutta during that epidemic. Since then several outbreaks have been reported in various states in India both the urban and rural areas.