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1、DenguefeverZhaozhixinThe3rdaffiliatedhospitalofSunYat-SenUniversityzxzhao@21cn.comWHATISDENGUEFEVER?Anacute,self-limited,febriledisease.DenguevirusaremaintainedinacyclethatinvolveshumansandAedesaegyptiprimarilyadiseaseofthetropicsOCCURSINtwoforms:Denguefever(DF)Dengueh
2、aemorrhagicfever(DHF)ClinicalmanifestationsDF:fever,headache,myalgias,bonepain.Lymphadenopathy,skinrash.LeukopeniaDHF:highfever,haemorrhage,hepatomegalyevidencesof“leakycapillaries”signsofcirculatoryfailure(dengueshocksyndrome,DSS.)Whyshouldwelearnit?2500millionatriskf
3、romdengueperyear.Epidemicinmorethan100countriesinAfrica,America,EasternMediterranean,South–eastAsiaandtheWesternpacific.TheglobalprevalenceofDHFgrowndramaticallyinrecentdecades:1970/1995:4foldincrease.Themostimportantmosquito-transmittedviraldiseaseintermofmortalityand
4、morbidity.EtiologyDenguevirus:envelopedRNAvirusClassified:familyofFlaviviridae.Serumtype:1-4causescloselyrelatedillness,severeandfataldiseasebutantigenicallydistincthomotypicimmunity:lifelongheterotypicimmunity:shortperiodbutcross-responsemayworsenthesecondinfectionbya
5、anotherserumtype.HowDFtransmitted?Sourcesofinfection:patientsandanyonewhowithCovertinfectionTransmittedvectors:AedesaegyptiisthemostcommonvectorsotherAedesmosquitosarelesseffiecitent:Ae.albopictus,Ae.polynesiesisPrimarilyadaytimefeederLivesaroundhumanhabitationThehost:
6、allsusceptibleifnevercameacrossdenguefever.Howdengueviruscausethedisease?(pathogenesisandclinicalpresentations)DenguevirusBloodstreamMononuclear-phagocytesystemsecondviremiaAntigenantibodycomplexescomplementsystemincubationLymphadenopathy,hepatomeglyBonemarrowdepressVa
7、scularpermeability↑Rash,haemarrhagicfeverBonepains,etcImfllamatorymaterialsriskfactorsforDHFImportantriskfactorsforDHFincludeVirusfactors:theserotype:2isthepredominatingthestrain:virulentstrainHostfactors:geneticpredispositiontheageChildren:experiencedapreciousdenguein
8、fectionInfantswithwaninglevelsofmaternaldengueantibody.immunestatus:ifthereareenhancingAb.EnchancingantibodyAmechanis
