31401 - DENGUE: EPIDEMIOLOGY PART 1 SCOTT B HALSTEAD, MD...

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DENGUE: EPIDEMIOLOGY PART 1 SCOTT B HALSTEAD, MD Director, Research PEDIATRIC DENGUE VACCINE INITIATIVE
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TRANSMISSION Aedes aegypti breeds in clean water in and around houses. Daytime biting. Transmission from human to human requires the same female mosquito to bite a viremic human and then bite a susceptible human at an interval of around 10-12 days.
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FOUR VIRUSES Life time immunity follows infection to one type. Second, third and possibly four infections are possible. CHILDREN – first infections are mild, largely inapparent. ADULTS - first infections may produce DF, some viruses more overt than others.
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PRIMARY INFECTIONS Clinical Features ! In children – ! In adults DEN 1 & 3 – Disease/Infection ~1; g.i. hemorrhages may accompany peptic ulcer disease. DEN 2 & 4 - mild - moderate
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DENGUE FEVER Incubation period = 5 days Fever = 5 days Leukopenia Moderate thrombocytopenia Simmons et al Phil J Sci 44:1-252, 1931
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DENGUE 1 MACULO- PAPULAR RASH. Day 5 after onset of fever.
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DISEASE SPECTRUM MILD SEVERE DF DHF + Thrombocytopenia +++ Thrombocytopenia Hidden Vasc. Perm 1 ? Overt Vasc. Perm. 1. Wills BA et al J Infect Dis 190:810-818, 2004
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DENGUE HEMORRHAGIC FEVER/DENGUE SHOCK SYNDROME (DHF/DSS) Dengue vasculopathy
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DSS GRADE IV
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DSS GRADE III
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WHY IS DENGUE SUCH A BIG PROBLEM TODAY? Global population growth Rural to urban migration Growth of cities Deterioration of cities Jet travel Health services poorly organized/ underfunded Lack of vector control professionals
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Global Spread of Dengue Countries with active dengue + Aedes aegypti 50-100 million infections/year
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This note was uploaded on 02/22/2012 for the course HIST 312 taught by Professor Staff during the Fall '10 term at Rutgers.

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31401 - DENGUE: EPIDEMIOLOGY PART 1 SCOTT B HALSTEAD, MD...

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