Dengue Patrol smkdmpr2 - A day with DR Tuan Jah and encik Zainudin at Pejabat Kesihatan Daerah Tanah Merah

A day  with DR Tuan Jah and

 Encik Zainudin at Pejabat Kesihatan Daerah Tanah Merah

We had one whole morning talk with assistant director of health department  and senior officer incharge - Tanah Merah Kelantan

Myths and facts about dengue
Muhaimin: Is it true that Dengue mosquitoes bite only during the day time?

Mr  Zainudin: Dengue is transmitted by the bite of the Aedes mosquito that typically attacks during day time.  Its favorite spots are below the elbow and below the knee.

Munir Mashadi :Is there a vaccine to prevent Dengue?
Dr Tuan Jah :No, till now there is no vaccine to protect against dengue. There has been recent progress in the field of vaccine development.  The candidate currently at the most advanced clinical development stage till now is live attenuated tetravalent vaccine.  

Muhaimin : Doctor, Is it true  that, drinking papaya leaves juice, goat's milk etc will help in gaining blood platelets?
Dr Tuan Jah :False, well,  it is a myth, till now it not proved scientifically.

Lydia : What is actually dengue fever? Is it totally new in our country?

Mr Zainudin. Let me answer that popular queation. Dengue fever is a disease carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called "break-bone" fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking. Health experts have known about dengue fever for more than 200 years.

Cikgu Maznah : What geographic areas are at high risk for contracting dengue fever?

Dr Tuan Jah : The situation in our country is reflected by the occurrence of major disease outbreaks in South East Asia over last few years. However, no reliable data are available to assess the exact magnitude of the disease in our country. In fact, many of the smaller outbreaks go unreported. However, the first major outbreak of dengue fevers happened  in the year 2015 was in Selangor  

Alia  :How is dengue fever contracted?

Mr Zainudin : That's a very good question. Dengue virus can be contracted from the bite of an infected Aedes mosquito. Mosquitoes become infected when they bite infected humans, and can later transmit the infection to other people.  Dengue cannot be transmitted from person to person without a mosquito as the intermediate vector.  

Dengue

Amirul : Sir, may I know what are dengue fever symptoms and signs?

Mr Zainudin : Dengue is usually accompanied with sign and symptoms of sudden high grade fever, accompanied by severe retro-orbital headache, body ache, sore throat and rashes. Other features like itching, nausea-vomiting suggestive of gall bladder inflammation or liver inflammation. Presence of restlessness (oxygen deficiency in the brain), abdominal pain and black stools (GI bleeding), minor bleeding from skin, nose, mouth etc signifies urgency.

Faiz : When should one get concerned?

Dr Tuan Jah :One should immediately go to the doctor if experiencing symptoms like recurrent vomiting, intolerable severe aches, headache/body ache, high grade fever, low BP, drowsiness, severe exertion, bleeding from any body part, rapid fall in platelets etc. The period of maximum risk is between the third and the seventh day of illness. But there is no need to panic and no platelet transfusion is required unless platelet count is less than 10,000 or there is a presence of spontaneous bleeding.  During epidemics, people of all ages are involved otherwise the disease is more common in children.

Listening to talk given by Encik Zainuddin 

 
Iffah : DR How is dengue fever diagnosed?
Dr Tuan Jah There are four main laboratory methods to diagnose dengue infection: NS1 Antigen, viral isolation in culture, detection of viral RNA by PCR technique, and specific IgM/IgG antibodies in paired sera. The gold standard is usually a combination of dengue NS1 and serology (Antibodies) methods. Dengue NS1 is positive in 80% cases in first day and in 2-3 days it is 60-80% positive. IgM test may take 5-7 days to become positive. Viral isolation is costly, the results are usually available after 6 to 10 days and it is only obtainable in laboratories with the appropriate infrastructure for cell culture or mosquito colonies.
The RT-PCR and other PCR-based techniques give results within 24 hours but they are also costly and they are not available for most clinicians.
On the contrary, there are commercially available immunochromatographic and ELISA tests for the detection of IgM/IgG antibodies which give results within minutes or few hours. However, the detection of antibodies in a dengue infected person is only possible after 4-5 days of disease onset. Moreover, a single positive IgM result suggests recent infection but paired sera samples (IgM or IgG) showing seroconversion or a fourfold titer increase are required to confirm diagnosis

Amirul :What is dengue hemorrhagic fever?

Mr Zainudin :Mostly dengue infections result in relatively mild illness, but a very small percentage of infections can develop into the far more serious dengue hemorrhagic fever (DHF). This disease is identified with low platelet count, leaking blood vessels causing bleeding from bodily orifices through nose, mouth and gums. Bruising can be another sign of bleeding inside the body. Unavailability of right treatment at right time can result in collapse of the blood vessels causing shock (Dengue shock syndrome) and very often death. Thus it is very necessary to seek for urgent medical help if patient starts bleeding from body orifices.  Dengue hemorrhagic fever is a serious condition responsible for 10% of total dengue related mortality.

Munir : Sir how can dengue fever be prevented?

Mr Zainudin : Here are some of the preventive tips for dengue:-Use a mosquito repellent spray or lotion on your body and stay in well-screened areas-Wear full sleeves clothes

-As dengue mosquito is a day biter so ensure while sleeping in afternoon area should have mosquito netting over the bed-Prevent dengue patients to go in crowded places, office or school-Avoid leaving any containers of standing water outside where mosquitoes can breed

-Put one tablespoon of petrol over standing water to deprive mosquito from oxygen which is required for breeding of mosquitoes.-Meet your doctor immediately if you have been in an area endemic to dengue fever and you have any illness with fever that lasts for more than two days

-Take lot of fluid to avoid dehydration in the form of coconut water, lemonade etc.

Nabila : What are the long term effects of Dengue fever?

Dr Tuan Jah :A dengue patient may have certain long term effects:-Immunological reaction in body developed following infection by one of the four dengue viruses appears to increase the risk of severe dengue when the same individual is infected with any of the remaining three virus.

-Vague muscle pain, joint pain and weakness which sustain for some weeks to several months.
-Patient becomes more vulnerable to several other diseases due to low body immunity.
-If dengue is accompanied by certain complications like encephalitis, seizures, depression, pneumonia, cardio myopathy, liver injury, orchitis, oophoritis etc then it may persist during post dengue period.

Muhaimin :What care should patients take after they come out of the illness?

Dr Tuan Jah :Due to dengue patients immunity power weakens. We advise patient to stay away from patient suffering from fever, cough, tuberculosis, infective diseases.  Follow healthy living and eating habits. Practice yoga and exercise daily. Include diet with high minerals, protein and vitamins and think positive.Venue : in front of  RISDA building - RISDA district office Tanah Merah

Date   : 24th August 2016

Community involved -  2 doctors

SMKDMPR2  DENGUE PATROL SQUAD – 31

Fotographer - 2

SMKDMPR2  DENGUE PATROL TEACHERS - 1