Essay type:Â | Persuasive essays |
Categories:Â | Medicine Disorder Community health |
Pages: | 7 |
Wordcount: | 1711 words |
Each year, dengue fever infects millions of people worldwide. Dengue fever is a viral disease that is transmitted by infected female mosquitoes. Dengue disease is prevalent throughout the tropical and subtropical regions of the world. Dengue virus can affect anyone, but it is more common for people with a low immune system (Tantawichien, pg. 80). Even though an attack of dengue fever produces immunity for a lifetime, it is possible to get the illness several times because a serotype among its five causes dengue fever.
Dengue virus can cause mild or hemorrhagic dengue fever. Mild dengue fever results in illnesses like a rash, high temperature, and joint, and muscle pain, while dengue hemorrhagic fever causes a drop in blood pressure that may be severe due to severe bleeding and or death (Tantawichien, pg. 81). Although the disease has been rapidly increasing in us, Latin America and the Caribbean, the regions of western pacific islands and Asia, especially the areas in the South, register more cases than any other areas of the world. This assignment examines more about dengue fever and the dengue virus.
History and Significant Contributions of Dengue Fever
First reports of an illness that caused epidemics that was thought to be dengue fever possibly occurred in three continents, Africa Asia and North America, in the years 1779 and 1780 (Kadam, pg. 60). Other reports of an illness that was compatible with dengue fever occurred even earlier with the earliest record found in the from the Jin Dynasty Chinese encyclopedia. It contains the files of diseases, symptoms, and remedies between 265-420AD (Kadam, pg. 60). The outbreaks of illness in both the French West Indies in 1535 and Panama in 1699 were thought to be dengue. Therefore, a very similar illness or dengue fever had significant geographic distribution earlier than the 18th century. It is not clear whether the Batavia epidemics Cairo or Indonesia in 1779 was dengue fever. Still, it is most probable that the dengue virus was responsible for the 1780 Philadelphia epidemic (Kadam, pg. 60).
Dengue virus became endemic in many tropical urban centers from 1780 to 1940 because, during those periods, there were reports of a disease pattern associated with an illness like dengue fever (Kadam, pg. 61). An ideal condition for an increase in transmission of any mosquito-borne disease caused by ecological disruption during the Second World War, in pacific areas and Southeast Asia led to the first setting of a global pandemic of dengue fever. Benjamin rush was the first person to confirm a case reported in 1789, and he named the "disease break-bone fever" because of the symptoms of arthralgia and myalgia (Kadam, pg. 63).
Microorganisms Causing Dengue Fever
The dengue disease is caused by a pathogen called the dengue virus, which is in four serotypes named DEN-1, DEN-1, DEN-3, and DEN-4 (Tantawichien, pg. 82). The viruses belong to genus flavivirus and family flaviviridae. They are relatively small and spherical, and they are made of three structural proteins and seven nonstructural proteins. The major complexes within this family are Japanese encephalitis, tick-borne encephalitis, and dengue virus (Tantawichien, pg. 82).
The extensive cross-reaction in serologic tests is because of the epitopes of the flaviviruses. These epitomes make it difficult for unequivocal serologic diagnosis, which common among the four viruses. Although infection with one dengue serotype will provide lifetime immunity to the virus, there is still no cross-protective immunity to the other remaining serotypes; making it easy for people living in regions of endemic dengue to be infected with three of the four serotypes in their lifetimes (Tantawichien, pg. 82).
How Dengue Virus Causes Disease
Through exposure and continuous bite by an infected mosquito, the virus is injected into the body (Kadam, pg. 63). After infection, the virus will take three to fourteen days a day for the incubation period in the white blood cells with an average of four to seven days. After the incubation period, the virus continues to spread throughout the body. White blood cell responses in defense by producing several alarming proteins like interferon and cytokines, which are responsible for the common symptoms and a person. It may start to experience acute onset fever, which may be accompanied by a variety of both symptoms and nonspecific signs (Kadam, pg. 63).
In case of a severe infection, the production of the virus in the body significantly increases, and many other organs, such as liver and bone marrow, become affected (Kadam, pg. 63). The virus will cause capillary permeability in these organs, causing fluid from the bloodstream to leak into the body cavities through the walls of the small blood vessels (Kadam, pg. 63). The fluid leaks may result in less blood circulation in the blood vessels leading to low blood pressure inhibit sufficient supply of blood to vital organs. Besides, the dysfunction of bone marrow that was caused by the infection of the stromal cells results in a reduced number of platelets that are essential for blood clotting. Lack of platelets increases the risk of bleeding, which is a significant complication of dengue fever.
Host Defense to Dengue Fever
The human immune system is made up of two parts, innate and adaptive immune response (Tantawichien, pg. 83). The nonspecific natural immune response is capable of providing immediate protection against any pathogen invading the body. They are always the first in the defense line. They produce the type I interferon that encourages resistance of white blood cells to infected neighboring cells to limit the spread of the pathogen (Tantawichien, pg. 83). It also can create and activate natural killer cells during the stages of early infection.
Infected epithelial cells produce interferon, which is essential for the adaptive immune response activation. Even though the adaptive immune system might take long to respond, they provide long-term immunity against any invading pathogen (Kadam, pg. 63). The presence of humeral immune response and cell-mediated immune response in the adaptive immune response helps in clearing the infection, and it is responsible for providing immunity against pathogens that is lifelong.
As the virus enters the body, they start by infecting monocytes, macrophages, dendritic cells, and hepatocytes. Then the body triggers the innate immune response after realizing it has been infected with the dengue virus. An adaptive immune response is initiated when the triggered innate immune response is unable to curb the infection (Kadam, pg. 63). Then the antigens present on the virus activate B–cells once the adaptive immune response starts fighting. B-cells mature into plasma cells, which then produce antibodies that travel all over the bloodstream to bind with antigens making them noninfectious. The cytotoxic cells then recognize and kill any cell that is infected with a pathogen (Tantawichien, pg. 84)
Epidemiology
The dengue-like illness from 1780 to 1940 had a disease pattern that was characterized by lager epidemics that were always infrequent (Halstead, pg. 557). However, during this time, the dengue virus became endemic in many tropical urban centers due to a lack of apparent disease transmission, with individuals who have no immune contracting the dengue-like illness in few months of their exposure (Halstead, pg. 557). The number of dengue fever outbreak has increased in both tropical and subtropical regions, mainly in South America, Asia, and the Caribbean. Moreover, while patients recover from the disease, there is a small percentage in progress for dengue hemorrhagic fever (Halstead, pg. 557).
The epidemic has expanded in Asia, from Southeast Asian countries to east of chins, Sri Lanka, India, and Pakistan. In America, the epidemiologic changes have been full of drama (Halstead, pg. 558). In the 1950 and 1970s, there was rare epidemic dengue because the vector had been eradicated from most of South and Central America (Halstead, pg. 558). In 1970, there was no more eradication, and the virus started to reinvade from countries it was present. By the 1980s, most of the American region was experiencing significant dengue epidemics fever (Halstead, pg. 559).
Diagnosis, Symptoms, Treatment, and Prevention of Dengue Fever
Individuals with severe dengue fever can get treatment successful if the disease is diagnosed as early as possible. Dengue fever is diagnosed through serological and virological methods (Khetarpal et al., pg. 61). A virological way is the detection of the dengue virus, viral antigens, viral RNA, and antibodies that are present in the patient's tissues or blood against the virus. The virus can be detected in a patient's blood for only four to five days after the emergence of the symptoms. Another method of diagnosis is the detection of antibodies in an infected person's blood (Khetarpal et al., pg. 61).
The symptoms of dengue fever at the febrile phase maybe all or two the following; severe headache, swollen glands, rash, pain behind, the eyes, muscle, and joint pains, nausea, and vomiting (Khetarpal et al., pg. 62). Severe dengue symptoms are; fatigue, restlessness, blood in vomit, severe abdominal pain, persistent vomiting, rapid breathing, and bleeding gums (Khetarpal et al., pg. 62).
However, for now, there is no specific treatment for dengue fever, to control the symptoms of pains, muscle aches, fever, painkillers, and fever reducers can be taken (Khetarpal et al., pg. 63). For severe dengue fever, maintenance of a patient's body fluid volume is essential.
To prevent dengue is by avoiding further mosquito bites, mosquito breeding, personal protection from the bites of infected mosquitos, and reactive vector control, which includes spraying by health workers during outbreaks (Khetarpal et al., pg. 63).
The first vaccine by Sanofi Pasteur was in 2015, and it is used in more than 20 countries (Khetarpal et al., pg. 64). Reports showed that those who were subset with the vaccine had a higher risk of even more severe dengue than those who were not vaccinated (Khetarpal et al., pg. 64). Therefore, the use of the vaccine was shifted to those who live in endemic areas who had at least one previous report of dengue virus infection.
Work Cited
Halstead, Scott B. "Reappearance of chikungunya, formerly called dengue, in the Americas." Emerging infectious diseases 21.4 (2015): 557. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378492/
Kadam, D. B., Sonali Salvi, and Ajay Chandanwale. "Expanded dengue." J Assoc Physicians India 64.7 (2016): 59-63. https://pdfs.semanticscholar.org/89f6/67226edacd0f0fb218744530a29f75e6083f.pdf
Khetarpal, Niyati, and Ira Khanna. "Dengue fever: causes, complications, and vaccine strategies." Journal of immunology research 2016 (2016). https://www.hindawi.com/journals/jir/2016/6803098/
Tantawichien, Terapong. "Dengue fever and dengue hemorrhagic fever in adults." Southeast Asian J Trop Med Public Health 46.1 (2015): 79-98. https://www.asianpids.org/file/Adult%20Dengue.pdf#page=87
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