Dengue Guidelines for Diagnosis, Treatment, Prevention and by World Health Organization

By World Health Organization

This new version has been produced to make largely to be had to overall healthiness practitioners, laboratory body of workers, these concerned about vector keep an eye on and different public well-being officers, a concise resource of data of globally relevance on dengue. the tips supply up-to-date useful details at the medical administration and supply of scientific providers; vector administration and supply of vector keep an eye on companies; laboratory prognosis and diagnostic exams; and surveillance, emergency preparedness and reaction. taking a look forward, a few symptoms of latest and promising avenues of analysis also are defined. extra and extra exact particular counsel at the a number of professional parts relating to dengue can be found from different resources in WHO and in different places, a few of that are pointed out within the references.This e-book is meant to give a contribution to prevention and keep watch over of the morbidity and mortality linked to dengue and to function an authoritative reference resource for medical examiners and researchers. those directions are usually not meant to switch nationwide directions yet to aid within the improvement of nationwide or nearby guidance. they're anticipated to stay legitimate for 5 years (until 2014), even though advancements in learn may well swap their validity, given that many facets of the prevention and regulate of dengue are at present being investigated in numerous reports. the ideas include the main updated info on the time of writing. in spite of the fact that, the result of stories are being released on a regular basis and will be taken into consideration. to deal with this problem, the consultant can be on hand on the web and should be up-to-date usually through WHO.

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If possible, obtain haematocrit levels before and after fluid resuscitation. 35 Dengue: Guidelines for diagnosis, treatment, prevention and control There should be continued replacement of further plasma losses to maintain effective circulation for 24–48 hours. For overweight or obese patients, the ideal body weight should be used for calculating fluid infusion rates (textboxes J and K). A group and crossmatch should be done for all shock patients. Blood transfusion should be given only in cases with suspected/severe bleeding.

Shock occurs when a critical volume of plasma is lost through leakage. It is often preceded by warning signs. The body temperature may be subnormal when shock occurs. With prolonged shock, the consequent organ hypoperfusion results in progressive organ impairment, metabolic acidosis and disseminated intravascular coagulation. This in turn leads to severe haemorrhage causing the haematocrit to decrease in severe shock. Instead of the leukopenia usually seen during this phase of dengue, the total white cell count may increase in patients with severe bleeding.

If the vital signs are worsening and haematocrit is rising rapidly, increase the rate to 5–10 ml/kg/hour for 1–2 hours. Reassess the clinical status, repeat the haematocrit and review fluid infusion rates accordingly. 5 ml/kg/hr. Intravenous fluids are usually needed for only 24–48 hours. Reduce intravenous fluids gradually when the rate of plasma leakage decreases towards the end of the critical phase. This is indicated by urine output and/or oral fluid intake that is/are adequate, or haematocrit decreasing below the baseline value in a stable patient.

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