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GROUP I A PHARMACOTERAPHY IV

WHAT IS DENGUE FEVER?


Dengue Fever (DF)/Dengue Haemorrhagic Fever

(DHF) is an acute communicable disease caused by


Dengue virus is included in the group B Arthropod

Borne Virus (Arboviruses)

EPIDEMIOLOGY
About 50 million cases annually worldwide. DHF was first discovered in the Caribbean islands in 1963. Incidence of dengue fever highest in tropical and subtropical regions

Meanwhile in Sout East asia was first discovered in the Philippines and Thailand in 1950

THE SITUATION IN INDONESIA

Angka Insiden DBD per 100.000 Penduduk di Indonesia Tahun 1968 2009

POPULATION FACTORS AFFECT THE INCREASE AND DEPLOYMENT OF DHF CASES :


High population growth

Uncontrolled urbanization

Transportation improvements Ineffectiveness of effective mosquito vector control in endemic area.

ETIOLOGI

Virus dengue

TACSONOMY OF DENGUE VIRUS


Familia : Flaviviridae Genus : Flavivirus Spesies : Dengue virus

DENGUE VIRUS
1.

Causes dengue and dengue hemorrhagic fever

2.
3. 4. 5.

It is an arbovirus
Transmitted by mosquitoes

Composed of single-stranded RNA


Has 4 serotypes (DEN-1, 2, 3, 4)

DENGUE VIRUSES CHARACTERISTICS:


Genome consist of C gene (coding nucleocapsid sintese (Capsid)), M gene coding protein sintese, and E gene codingglycoprotein sintese for envelope.
stabil at ph 7-9 and at low temperature. Infectivity properties decrease at high temperature.

Sensitive to sodium deoxycholate, eter, kloroform and bile salt because the present of lipid envelope

Rod shape, sensitive to inactivation of Dietil eter and Na dioksikolat, stabil at 70oC

E proteine has three separated epitop : epitop A, B dan C.


Four serotype of dengue viruses (1 hingga 4) approximately a 60% - 74% is amino acid residue of E gene and be the distiction between the serotypes. It will trigger antibody reaction.

ECOLOGY:
Dengue Viruses stick to host with two ways : Binding to virus reseptor at cell surface Via anti dengue antibody that bind to cell
After the attachment, viruses enter cell via two ways : endositosis / pinositosis fusion between virus envelope with plasma membrane that followed by nucleocapsid extrication to sitoplasma

TRANSMISSION OF DENGUE VIRUS BY AEDES AEGYPTI


Mosquito feeds / acquires virus
Extrinsic incubation period Mosquito refeeds / transmits virus Intrinsic incubation period

Viremia
0 5 8 12 16 DAYS 20

Viremia
24 28

Illness Human #1

Illness

Human #2

VECTORS OF DENGUE FEVER

Aedes aegypti
Aedes aegypti is very common in Indonesia.

Aedes albopictus Aedes polynesiensis Aedes scutellaris complex

VECTORS OF DENGUE FEVER


Taksonomi Aedes aegypti
Filum
Kelas Ordo Familia Subfamilia

: Arthropoda
: Insecta : Diptera : Culicidae : Culicinae

Genus
Spesies

: Aedes
: Aedes aegypti

CHARACTERISTICS OF THE AEDES MOSQUITO


One

distinct

physical

feature black and white stripes on its body and legs.


Bites Lays

during the day. its eggs in clean,

stagnant water

Close-up of an Aedes mosquito

CONTINUE

Primarily, it is a daytime feeder Highly domesticated tropical mosquito, lives around human habitation

Lays eggs and produces larvae preferentially in

artificial water containers inside and around the


houses for example; plastic containers, flower vases, buckets, used automobile tires,..

DO YOU KNOW???

Only the female Aedes mosquito feeds on blood. This is because they need the protein found in blood to produce eggs. Male mosquitoes feed only on plant

nectar.

On average, a female Aedes mosquito can lay about 300 eggs during her life span of 14 to 21 days. Dengue mosquitos bite the early morning and the late afternoon.

Telur Aedes aegypti

Ae. aegypti sedang mengisap darah

Larva Aedes aegypti

LIFE CYCLE OF THE AEDES MOSQUITO

THANK YOU