Tafakuri chokonozi: Ni dengu, dengi, au ni propaganda?!

[Kiranga]

Ni mara ya kwanza mafuriko kutukia Tanzania?

Nilichokuuliza ni uthibitisho, ambao hujautoa.

Mafuriko yanaweza kuwa si ya kwanza, lakini hilo halimaanishi kwamba threshold level au another triggering factor ishawahi kutokea.

Why did the one straw break the camels back? The million other straws below it.

By the way, hata kama huu ugonjwa ulikuwa upo, ni wajibu wa wanahabari kuhabarisha jamii. Watu wanakufa, ugonjwa hauna dawa, unataka mgonjwa kuwahishwa hospitali. Hata kama ulikuwepo tu na kinachotokea ni kuripotiwa zaidi, sioni kitu kibaya hapo.

In fact tunahitaji wanahabari waripoti zaidi, sio ku minimize magonjwa tanayoua watu kama."ya.kawaida tu". Ukiwa kitandani wewe unataka kufa ugonjwa huu huu utakuwa si.wa kawaida.

Pia, kwa nini watu wafanye self incriminating diversion?

Kwani wakitupa habari za dengue fever ndiyo hayo ya BOT hayawezi kuzungumzwa?

You can't chew gum and walk?

Again,

Toa uthibitisho kwamba hizi habari zinapandishwa makusudi kwa sababu za kisiasa.

Ama sivyo utakuwa umetupa sababu wengine kufikiri kwamba wewe ndiye unataka kutumia ugonjwa na vifo vya watu kisiasa kwa uchu kama mchawi anayekula nyama za watu bila kujali utu.

 

[Elungata]

Mod chomoa hii thread dengue ipo!

Tuliemishe umma wajikinge na ugonjwa! kila kitu siasa wazee

This is so sad

mkuu ulikutikana na masahibu gani mbona umekua mpole sana siku hizi?au we siyo The Rev i used to know?

 

[MUSSA ALLAN]

Mkuu Riwa comment yako hapo juu imejitosheleza sana. Nitaendelea kukuheshimu sana. Mungu atakulipa kwa kazi hii. Huyu Yericko Nyerere anadhani kuwa mfuasi wa Chadema ndio kupinga kila kitu na kufanyia siasa hata ugonjwa ambao unaweza kumpata hata yeye au ndugu zake wa karibu.

 

[juve2012]

Dengue ni sehemu ya matatizo ya watz,si tatizo pekee lakini media inataka tulizungumze kama tatizo pekee kwa kulifanya tatizo jipya.haya mengine yanayotaka mijadala SASA HIVI tumuachie nani?na hizi habari zikifika kwenye yale magazeti yetu pendwa ndio kabisaa,habari inakuwa ya mujini,ukizungumza katiba mpya unaonekana mwanasiasa kama vile katiba ni ya wanasiasa tu.Unajua Yeri ko mimi sikupendezwa hata namna media nyingi zilivyoripoti bunge la katiba.hili bunge limefanyiwa michezo michafu kama ule wa operesheni ya kuokoa tembo.lionekane halifai na huenda players walikuwa ndani ya bunge wakiact kama provocateurs.halafu limeahirishwa na kufanywa refu ukifika mwezi wa nane ule mzuka atakuwa kabaki nao Yericko na Lissu.lakini hii yote inafanikiwa kwa sababu wabongo priority zao ni michango ya harusi na "nashindwa kumwambia nampenda"!ndio maana watu wakiwa ngazi za chini wanakuwa malaika lakini wakipanda uongozi huko juu na kuzikuta fursa za kuwaibia watz waliolala,wanaingia kwenye majaribu kwa sababu inahitaji "utakatifu" wa hali ya juu kwa mtu kulinda maslahi yasiyomwajibisha.

 

[Mnyabwilo]

tuache siasa kwenye maisha ya binadamu

 

[juve2012]

Jambo baya ni pale Dengue kuwa jambo la kweli halafu litumike kuzima mijadala ya mambo mengine yenye umuhimu pia.na hizi coincidence hizi!anyway Yericko nimekuelewa.

 

[Riwa]

Unashindwa kumuelewa mtoa mada. Ugonjwa huo ulikuwepo,upo,na utaendelea kuwepo kama ilivyo malaria nk. Sasa kwa nini ghafla hivi umekuwa special? Kwa nini kuwaogopesha wananchi kuwa hatari imeingia nchini? Iko sababu itafute,na wengine wanaitafuta, halafu ukweli utajulikana.


Sent from my iPad using JamiiForums

Haina maana kuwa ugonjwa ukiwa na status ya 'mlipuko' basi haukuwahi kuwepo kabla...kuna magonjwa kama Ebola ambayo ni jamii hiyo hiyo ya Viral Haemorrhagic Fever, yapo na yataendelea kuwepo..lakini hayo ndio unakubali ni mlipuko! au? Hata Malaria imeshawahi kuwa 'mlipuko' (Malaria Outbreak) mara kadhaa katika mikoa ya kanda ya Ziwa (Kagera, Mara, Mwanza) na kukawa na national response kwa milipuko hiyo. Kuna vigezo ambavyo huzingatiwa mpaka serikali itangaze kuwa kuna 'mlipuko' wa ugonjwa Fulani ili kutrigger national response...miongozo (WHO or local) iliyoweka hivyo vigezo imeandikwa na wataalamu...sio mataahira wenye IQ anazodai Yericko.

 

[Tetty]

Inawezekana ugonjwa huu ulikuwepo siku nyingi,ila sababu ya usikivu wa serikali yetu umepanda ngazi kufika hapo ulipo.Na pia ni kosa la viongozi wetu na hasa madaktari kuufanyia uzembe ulipoanza tu.Sasa kama ulianza toka 2010 kwa nini haukufanyiwa fatiki ya nguvu leo usingekuwepo.Tunashughulikia majanga pale yanapotuzidi.

Na ndiyo maana watu watafikiri kuwa ni zoezi la kututoa maeneo

 

[wabara]

what the heck is this c.r.a.p?,if i may ask.

mijitu mingine bhana.ina-comment tu ili mradi ionekane ime-comment.
Yericko Nyerere asante kwa kuwatoa watu kama hawa ktk usingizi mzito.wapo wengi sana nchini hasa mikoa ya pwani.

Kweli weye ni fidhuli uliye doda kama jina lako, hoyo bwanaako weye ni kumsifia tu hata kama anahara pahala...!?

Mtumwa mkubwa wa akili weye uso haya kama fisi.

Na ntarejea...

 

[Chakaza]

Haina maana kuwa ugonjwa ukiwa na status ya 'mlipuko' basi haukuwahi kuwepo kabla...kuna magonjwa kama Ebola ambayo ni jamii hiyo hiyo ya Viral Haemorrhagic Fever, yapo na yataendelea kuwepo..lakini hayo ndio unakubali ni mlipuko! au? Hata Malaria imeshawahi kuwa 'mlipuko' (Malaria Outbreak) mara kadhaa katika mikoa ya kanda ya Ziwa (Kagera, Mara, Mwanza) na kukawa na national response kwa milipuko hiyo. Kuna vigezo ambavyo huzingatiwa mpaka serikali itangaze kuwa kuna 'mlipuko' wa ugonjwa Fulani ili kutrigger national response...miongozo (WHO or local) iliyoweka hivyo vigezo imeandikwa na wataalamu...sio mataahira wenye IQ anazodai Yericko.

Sikatai. Inaweza kuwa lugha ya Yericko imesomeka tofauti kidogo. Ila hata mie nakubaliana naye kuwa something fishy katika matamko ya serikali juu ya ugonjwa huo. Hii nikutokana na madaktari wenyewe wanao dili na wagonjwa wao.
Anyway serikali hii imejaa vituko ila haiwezi kuvihifadhi sirini.


Sent from my iPad using JamiiForums

 

[MashaJF]

Nilipoona ile ripoti inayoonyesha Tanzania ni moja ya nchi kumi zenye IQ ndogo kabisa duniani, nilidhani ni hila tu za magharibi,

Lakini nilijifunza kuwa Kiongozi wa nchi ndiye hubeba taswira na aina ya watu wa taifa analoliongoza, Ikiwa taifa litampata kiongozi mpole basi nje ya taifa lake ataakisi upole wa watu wake,

Wakati ulaghai wa kikombe cha Ambilikile Mwaisapile kinaibuka, taifa lilikuwa kwenye mtafaruku wa kisiasa hasa madai ya katiba mpya na ufisadi mkubwa uliokuwa umeligubika genge la ccm na serikali yake, Kweli harambee ya serikali ilifanikiwa kuhamisha akili za Watz wote wakaelekea Loliondo isipokuwa mimi na wenzangu wachache tunaoona kwa jicho la tatu.

Leo ccm imebandwa na umma juu ya aina ya muungano wautakao, Umma unataka muungano wa serikali tatu, ccm na genge lake hawataki, wanataka taifa liendelee kutopea kwenye mauaji ya nashehe na mapadre pale Zanzibar, wanataka mfumo wa serikali mbili ulioshindwa kutatua matatizo ya muungano kwa miaka 50,

Na zaidi ccm na genge lake wameiba 200b katika akaubti maalumu ya Tanesco iliyopo BOT, hili ni tukio la wizi mkubwa zaidi kuliko ule wa EPA,

Lakini katika mkakati uleule wa kuzima kelele za umma, wameibuka na mzimu unaoitwa Dengue, unaotajwa kuwa ni ugongwa unaoambukizwa na mbu kwa lugha ya kikwetu ni 'suguni".

Haya ni maajabu ya tz, mbu huyu aibuke kuleta ugonjwa huo katika kipibdi hiki cha vuguvugu la ccm kukosa udhibiti wa nchi???

Mbu huyu mimi nimezaliwa kijijini kwetu namuoba, nimeishi nchi zenye baridi kali kama Urusi kwa miaka zaidi ya kumi nimemuona hasa kwenye mifugo aina ya kondoo wa sufi kule Kivey,

Nimeidmshi Uchina kwa miaka kadhaa mbu huyu yupo, na nimeng'atwa hasaa mitaa ya Suki, sijawahi kuona mtu kaugua na kuwa ni ni ugonjwa tishio kama propaganda ya ccm inavyotaka tuamini,

Nyumbani kwangu Mbutu Kiganboni hawa mbu ndio tunashinda nao na kulala nao kila kuchapo tangu na tangu,

Najiuliza hawa umbu wenye ugonjwa huo wametoka hapa wizara ya afya mtaa wa samora na shabani robert?

Inasemwa na inaaminika kuwa Watz ni wajinga na mazezeta kuliko nchi yoyote duniani, hili linajidhihirisha kuona tunatungiwa uongo eti kuna DENGUA, halafu 200b zinaibiwa, na kujaribu kuzima madai ya katiba ya umma inayotaka muungano wa Serikali tatu.

Dengue fever

Dengue fever - Wikipedia, the free encyclopedia accessed May 13, 2014

Dengue fever (UK /ˈdɛŋɡeɪ/ or US /ˈdɛŋɡiː/), also known as breakbone fever, is a mosquito-borne tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.
Dengue is transmitted by several species of mosquito within the genus Aedes, principally A. aegypti. The virus has five different types;[SUP][1][/SUP] infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications. As there is no commercially available vaccine, prevention is sought by reducing the habitat and the number of mosquitoes and limiting exposure to bites.
Treatment of acute dengue is supportive, using either oral or intravenous rehydration for mild or moderate disease, and intravenous fluids and blood transfusion for more severe cases. The number of cases of dengue fever has increased dramatically since the 1960s, with between 50 and 528 million people infected yearly.[SUP][2][/SUP][SUP][3][/SUP] Early descriptions of the condition date from 1779, and its viral cause and the transmission were figured out in the early 20th century. Dengue has become a global problem since the Second World War and is endemic in more than 110 countries. Apart from eliminating the mosquitoes, work is ongoing on a vaccine, as well as medication targeted directly at the virus.

Signs and symptoms

Schematic depiction of the symptoms of dengue fever​

Typically, people infected with dengue virus are asymptomatic (80%) or only have mild symptoms such as an uncomplicated fever.[SUP][2][/SUP][SUP][4][/SUP][SUP][5][/SUP] Others have more severe illness (5%), and in a small proportion it is life-threatening.[SUP][2][/SUP][SUP][5][/SUP] The incubation period (time between exposure and onset of symptoms) ranges from 3–14 days, but most often it is 4–7 days.[SUP][6][/SUP] Therefore, travelers returning from endemic areas are unlikely to have dengue if fever or other symptoms start more than 14 days after arriving home.[SUP][7][/SUP] Children often experience symptoms similar to those of the common cold and gastroenteritis(vomiting and diarrhea)[SUP][8][/SUP] and have a greater risk of severe complications,[SUP][7][/SUP][SUP][9][/SUP] though initial symptoms are generally mild but include high fever.[SUP][9][/SUP]
Clinical course

Clinical course of dengue fever[SUP][10][/SUP]​

The characteristic symptoms of dengue are sudden-onset fever, headache (typically located behind the eyes), muscle and joint pains, and a rash. The alternative name for dengue, "breakbone fever", comes from the associated muscle and joint pains.[SUP][2][/SUP][SUP][11][/SUP] The course of infection is divided into three phases: febrile, critical, and recovery.[SUP][10][/SUP]
The febrile phase involves high fever, potentially over 40 °C (104 °F), and is associated with generalized pain and a headache; this usually lasts two to seven days.[SUP][10][/SUP][SUP][11][/SUP] Nausea and vomiting may also occur.[SUP][9][/SUP] A rash occurs in 50–80% of those with symptoms[SUP][11][/SUP][SUP][12][/SUP] in the first or second day of symptoms as flushed skin, or later in the course of illness (days 4–7), as a measles-like rash.[SUP][12][/SUP][SUP][13][/SUP] A rash described as "islands of white in a sea of red" has also been described.[SUP][14][/SUP] Some petechiae (small red spots that do not disappear when the skin is pressed, which are caused by broken capillaries) can appear at this point,[SUP][10][/SUP] as may some mild bleeding from the mucous membranes of the mouth and nose.[SUP][7][/SUP][SUP][11][/SUP] The fever itself is classically biphasicor saddleback in nature, breaking and then returning for one or two days.[SUP][13][/SUP][SUP][14][/SUP]
In some people, the disease proceeds to a critical phase as fever resolves.[SUP][9][/SUP] During this period there is leakage of plasma from the blood vessels which typically lasts one to two days.[SUP][10][/SUP] This may result in fluid accumulation in the chest and abdominal cavity as well as depletion of fluid from the circulation and decreased blood supply to vital organs.[SUP][10][/SUP]There may also be organ dysfunction and severe bleeding, typically from the gastrointestinal tract.[SUP][7][/SUP][SUP][10][/SUP] Shock (dengue shock syndrome) and hemorrhage (dengue hemorrhagic fever) occur in less than 5% of all cases of dengue,[SUP][7][/SUP] however those who have previously been infected with other serotypes of dengue virus ("secondary infection") are at an increased risk.[SUP][7][/SUP][SUP][15][/SUP] This critical phase, while rare, occurs relatively more commonly in children and young adults.[SUP][9][/SUP]
The recovery phase occurs next, with resorption of the leaked fluid into the bloodstream.[SUP][10][/SUP] This usually lasts two to three days.[SUP][7][/SUP] The improvement is often striking, and can be accompanied with severeitching and a slow heart rate.[SUP][7][/SUP][SUP][10][/SUP] Another rash may occur with either a maculopapular or a vasculitic appearance, which is followed by peeling of the skin.[SUP][9][/SUP] During this stage, a fluid overload state may occur; if it affects the brain, it may cause a reduced level of consciousness or seizures.[SUP][7][/SUP] A feeling of fatigue may last for weeks in adults.[SUP][9][/SUP]
Associated problems

Dengue can occasionally affect several other body systems,[SUP][10][/SUP] either in isolation or along with the classic dengue symptoms.[SUP][8][/SUP] A decreased level of consciousness occurs in 0.5–6% of severe cases, which is attributable either to inflammation of the brain by the virus or indirectly as a result of impairment of vital organs, for example, the liver.[SUP][8][/SUP][SUP][14][/SUP]
Other neurological disorders have been reported in the context of dengue, such as transverse myelitis and Guillain-Barré syndrome.[SUP][8][/SUP] Infection of the heart and acute liver failure are among the rarer complications.[SUP][7][/SUP][SUP][10][/SUP]
Cause

Virology

Main article: Dengue virus

A TEM micrograph showing dengue virus virions (the cluster of dark dots near the center)​

Dengue fever virus (DENV) is an RNA virus of the family Flaviviridae; genus Flavivirus. Other members of the same genus include yellow fever virus, West Nile virus, St. Louis encephalitis virus, Japanese encephalitis virus, tick-borne encephalitis virus, Kyasanur forest disease virus, and Omsk hemorrhagic fever virus.[SUP][14][/SUP]Most are transmitted by arthropods (mosquitoes or ticks), and are therefore also referred to as arboviruses (arthropod-borne viruses).[SUP][14][/SUP]
The dengue virus genome (genetic material) contains about 11,000 nucleotide bases, which code for the three different types of protein molecules (C, prM and E) that form the virus particle and seven other types of protein molecules (NS1, NS2a, NS2b, NS3, NS4a, NS4b, NS5) that are only found in infected host cells and are required for replication of the virus.[SUP][15][/SUP][SUP][16][/SUP] There are five[SUP][1][/SUP] strains of the virus, called serotypes, of which the first four are referred to as DENV-1, DENV-2, DENV-3 and DENV-4.[SUP][4][/SUP] The distinctions between the serotypes is based on the their antigenicity.[SUP][17][/SUP]
Transmission

The mosquito Aedes aegyptifeeding on a human host​

Dengue virus is primarily transmitted by Aedes mosquitoes, particularly A. aegypti.[SUP][4][/SUP] These mosquitoes usually live between the latitudes of 35° North and 35° South below an elevation of 1,000 metres (3,300 ft).[SUP][4][/SUP] They typically bite during the day, particularly in the early morning and in the evening,[SUP][18][/SUP][SUP][19][/SUP] but they are able to bite and thus spread infection at any time of day all during the year.[SUP][20][/SUP] Other Aedes species that transmit the disease include A. albopictus, A. polynesiensis and A. scutellaris.[SUP][4][/SUP] Humans are the primary host of the virus,[SUP][4][/SUP][SUP][14][/SUP] but it also circulates in nonhumanprimates.[SUP][21][/SUP] An infection can be acquired via a single bite.[SUP][22][/SUP] A female mosquito that takes a blood meal from a person infected with dengue fever, during the initial 2–10 day febrile period, becomes itself infected with the virus in the cells lining its gut.[SUP][23][/SUP] About 8–10 days later, the virus spreads to other tissues including the mosquito's salivary glands and is subsequently released into its saliva. The virus seems to have no detrimental effect on the mosquito, which remains infected for life.[SUP][6][/SUP] Aedes aegypti prefers to lay its eggs in artificial water containers, to live in close proximity to humans, and to feed on people rather than other vertebrates.[SUP][6][/SUP]
Dengue can also be transmitted via infected blood products and through organ donation.[SUP][24][/SUP][SUP][25][/SUP] In countries such as Singapore, where dengue is endemic, the risk is estimated to be between 1.6 and 6 per 10,000 transfusions.[SUP][26][/SUP] Vertical transmission (from mother to child) during pregnancy or at birth has been reported.[SUP][27][/SUP]Other person-to-person modes of transmission have also been reported, but are very unusual.[SUP][11][/SUP] The genetic variation in dengue viruses is region specific, suggestive that establishment into new territories is relatively infrequent, despite dengue emerging in new regions in recent decades.[SUP][9][/SUP]
Predisposition

Severe disease is more common in babies and young children, and in contrast to many other infections it is more common in children that are relatively well nourished.[SUP][7][/SUP] Other risk factors for severe disease include female sex, high body mass index,[SUP][9][/SUP] and viral load.[SUP][28][/SUP] While each serotype can cause the full spectrum of disease,[SUP][15][/SUP] virus strain is a risk factor.[SUP][9][/SUP] Infection with one serotype is thought to produce lifelong immunity to that type, but only short term protection against the other three.[SUP][4][/SUP][SUP][11][/SUP] The risk of severe disease from secondary infection increases if someone previously exposed to serotype DENV-1 contracts serotype DENV-2 or DENV-3, or if someone previously exposed to DENV-3 acquires DENV-2.[SUP][16][/SUP] Dengue can be life-threatening in people with chronic diseases such as diabetes and asthma.[SUP][16][/SUP]
Polymorphisms (normal variations) in particular genes have been linked with an increased risk of severe dengue complications. Examples include the genes coding for the proteins known as TNFα, mannan-binding lectin,[SUP][2][/SUP] CTLA4, TGFβ,[SUP][15][/SUP] DC-SIGN, PLCE1, and particular forms of human leukocyte antigen from gene variations of HLA-B.[SUP][9][/SUP][SUP][16][/SUP] A common genetic abnormality in Africans, known as glucose-6-phosphate dehydrogenase deficiency, appears to increase the risk.[SUP][28][/SUP] Polymorphisms in the genes for the vitamin D receptor and FcγR seem to offer protection against severe disease in secondary dengue infection.[SUP][16][/SUP]
Mechanism

When a mosquito carrying dengue virus bites a person, the virus enters the skin together with the mosquito's saliva. It binds to and enters white blood cells, and reproduces inside the cells while they move throughout the body. The white blood cells respond by producing a number of signaling proteins, such as cytokines and interferons, which are responsible for many of the symptoms, such as the fever, the flu-like symptoms and the severe pains. In severe infection, the virus production inside the body is greatly increased, and many more organs (such as the liver and the bone marrow) can be affected. Fluid from the bloodstream leaks through the wall of small blood vessels into body cavities due to capillary permeability. As a result, less blood circulates in the blood vessels, and the blood pressure becomes so low that it cannot supply sufficient blood to vital organs. Furthermore, dysfunction of the bone marrow due to infection of the stromal cells leads to reduced numbers of platelets, which are necessary for effective blood clotting; this increases the risk of bleeding, the other major complication of dengue fever.[SUP][28][/SUP]
Viral replication

Once inside the skin, dengue virus binds to Langerhans cells (a population of dendritic cells in the skin that identifies pathogens).[SUP][28][/SUP] The virus enters the cells through binding between viral proteins andmembrane proteins on the Langerhans cell, specifically the C-type lectins called DC-SIGN, mannose receptor and CLEC5A.[SUP][15][/SUP] DC-SIGN, a non-specific receptor for foreign material on dendritic cells, seems to be the main point of entry.[SUP][16][/SUP] The dendritic cell moves to the nearest lymph node. Meanwhile, the virus genome is translated in membrane-bound vesicles on the cell's endoplasmic reticulum, where the cell's protein synthesis apparatus produces new viral proteins that replicate the viral RNA and begin to form viral particles. Immature virus particles are transported to the Golgi apparatus, the part of the cell where some of the proteins receive necessary sugar chains (glycoproteins). The now mature new viruses bud on the surface of the infected cell and are released by exocytosis. They are then able to enter other white blood cells, such as monocytes and macrophages.[SUP][15][/SUP]
The initial reaction of infected cells is to produce interferon, a cytokine that raises a number of defenses against viral infection through the innate immune system by augmenting the production of a large group of proteins mediated by the JAK-STAT pathway. Some serotypes of dengue virus appear to have mechanisms to slow down this process. Interferon also activates the adaptive immune system, which leads to the generation of antibodies against the virus as well as T cells that directly attack any cell infected with the virus.[SUP][15][/SUP] Various antibodies are generated; some bind closely to the viral proteins and target them for phagocytosis (ingestion by specialized cells and destruction), but some bind the virus less well and appear instead to deliver the virus into a part of the phagocytes where it is not destroyed but is able to replicate further.[SUP][15][/SUP]
Severe disease

It is not entirely clear why secondary infection with a different strain of dengue virus places people at risk of dengue hemorrhagic fever and dengue shock syndrome. The most widely accepted hypothesis is that of antibody-dependent enhancement (ADE). The exact mechanism behind ADE is unclear. It may be caused by poor binding of non-neutralizing antibodies and delivery into the wrong compartment of white blood cells that have ingested the virus for destruction.[SUP][15][/SUP][SUP][16][/SUP] There is a suspicion that ADE is not the only mechanism underlying severe dengue-related complications,[SUP][2][/SUP] and various lines of research have implied a role for T cells and soluble factors such as cytokines and the complement system.[SUP][28][/SUP]
Severe disease is marked by the problems of capillary permeability (an allowance of fluid and protein normally contained within blood to pass) and disordered blood clotting.[SUP][8][/SUP][SUP][9][/SUP] These changes appear associated with a disordered state of the endothelial glycocalyx, which acts as a molecular filter of blood components.[SUP][9][/SUP] Leaky capillaries (and the critical phase) are thought to be caused by an immune system response.[SUP][9][/SUP] Other processes of interest include infected cells that become necrotic—which affect both coagulation and fibrinolysis (the opposing systems of blood clotting and clot degradation)—and low platelets in the blood, also a factor in normal clotting.[SUP][28][/SUP]
Diagnosis

[TABLE="class: wikitable"]
[TR]
[TD="bgcolor: #B0CBE5, colspan: 5"]Warning signs[SUP][9][/SUP][SUP][29][/SUP][/TD]
[/TR]
[TR]
[TD]Worsening abdominal pain[/TD]
[/TR]
[TR]
[TD]Ongoing vomiting[/TD]
[/TR]
[TR]
[TD]Liver enlargement[/TD]
[/TR]
[TR]
[TD]Mucosal bleeding[/TD]
[/TR]
[TR]
[TD]High hematocrit with low platelets[/TD]
[/TR]
[TR]
[TD]Lethargy or restlessness[/TD]
[/TR]
[TR]
[TD]Serosal effusions[/TD]
[/TR]
[/TABLE]
The diagnosis of dengue is typically made clinically, on the basis of reported symptoms and physical examination; this applies especially in endemic areas.[SUP][2][/SUP] However, early disease can be difficult to differentiate from other viral infections.[SUP][7][/SUP] A probable diagnosis is based on the findings of fever plus two of the following: nausea and vomiting, rash, generalized pains, low white blood cell count, positive tourniquet test, or any warning sign (see table) in someone who lives in an endemic area.[SUP][29][/SUP]Warning signs typically occur before the onset of severe dengue.[SUP][10][/SUP] The tourniquet test, which is particularly useful in settings where no laboratory investigations are readily available, involves the application of a blood pressure cuff at between the diastolic and systolic pressure for five minutes, followed by the counting of any petechialhemorrhages; a higher number makes a diagnosis of dengue more likely with the cut off being more than 10 to 20 per 1 inch[SUP]2[/SUP] (6.25 cm[SUP]2[/SUP]).[SUP][10][/SUP][SUP][30][/SUP]
The diagnosis should be considered in anyone who develops a fever within two weeks of being in the tropics or subtropics.[SUP][9][/SUP] It can be difficult to distinguish dengue fever and chikungunya, a similar viral infection that shares many symptoms and occurs in similar parts of the world to dengue.[SUP][11][/SUP] Often, investigations are performed to exclude other conditions that cause similar symptoms, such as malaria, leptospirosis, viral hemorrhagic fever, typhoid fever, meningococcal disease, measles, andinfluenza.[SUP][7][/SUP][SUP][31][/SUP]
The earliest change detectable on laboratory investigations is a low white blood cell count, which may then be followed by low platelets and metabolic acidosis.[SUP][7][/SUP] A moderately elevated level of aminotransferase (AST and ALT) from the liver is commonly associated with low platelets and white blood cells.[SUP][9][/SUP] In severe disease, plasma leakage results inhemoconcentration (as indicated by a rising hematocrit) and hypoalbuminemia.[SUP][7][/SUP] Pleural effusions or ascites can be detected by physical examination when large,[SUP][7][/SUP] but the demonstration of fluid onultrasound may assist in the early identification of dengue shock syndrome.[SUP][2][/SUP][SUP][7][/SUP] The use of ultrasound is limited by lack of availability in many settings.[SUP][2][/SUP] Dengue shock syndrome is present if pulse pressuredrops to ≤ 20 mm Hg along with peripheral vascular collapse.[SUP][9][/SUP] Peripheral vascular collapse is determined in children via delayed capillary refill, rapid heart rate, or cold extremities.[SUP][10][/SUP]
Classification

The World Health Organization's 2009 classification divides dengue fever into two groups: uncomplicated and severe.[SUP][2][/SUP][SUP][29][/SUP] This replaces the 1997 WHO classification, which needed to be simplified as it had been found to be too restrictive, though the older classification is still widely used[SUP][29][/SUP] including by the World Health Organization's Regional Office for South-East Asia as of 2011.[SUP][32][/SUP] Severe dengue is defined as that associated with severe bleeding, severe organ dysfunction, or severe plasma leakage while all other cases are uncomplicated.[SUP][29][/SUP] The 1997 classification divided dengue into undifferentiated fever, dengue fever, and dengue hemorrhagic fever.[SUP][7][/SUP][SUP][33][/SUP] Dengue hemorrhagic fever was subdivided further into grades I–IV. Grade I is the presence only of easy bruising or a positive tourniquet test in someone with fever, grade II is the presence of spontaneous bleeding into the skin and elsewhere, grade III is the clinical evidence of shock, and grade IV is shock so severe that blood pressure and pulse cannot be detected.[SUP][33][/SUP] Grades III and IV are referred to as "dengue shock syndrome".[SUP][29][/SUP][SUP][33][/SUP]
Laboratory tests

When laboratory tests for dengue fever become positive where day zero is the start of symptoms, 1st refers to in those with a primary infection, and 2nd refers to in those with a secondary infection.[SUP][9][/SUP]​

The diagnosis of dengue fever may be confirmed by microbiological laboratory testing.[SUP][29][/SUP][SUP][34][/SUP] This can be done by virus isolation in cell cultures, nucleic acid detection by PCR, viral antigen detection (such as for NS1) or specific antibodies (serology).[SUP][16][/SUP][SUP][31][/SUP] Virus isolation and nucleic acid detection are more accurate than antigen detection, but these tests are not widely available due to their greater cost.[SUP][31][/SUP] Detection of NS1 during the febrile phase of a primary infection may be greater than 90% however is only 60–80% in subsequent infections.[SUP][9][/SUP] All tests may be negative in the early stages of the disease.[SUP][7][/SUP][SUP][16][/SUP] PCR and viral antigen detection are more accurate in the first seven days.[SUP][9][/SUP] In 2012 a PCR test was introduced that can run on equipment used to diagnose influenza; this is likely to improve access to PCR-based diagnosis.[SUP][35][/SUP]
These laboratory tests are only of diagnostic value during the acute phase of the illness with the exception of serology. Tests for dengue virus-specific antibodies, types IgG and IgM, can be useful in confirming a diagnosis in the later stages of the infection. Both IgG and IgM are produced after 5–7 days. The highest levels (titres) of IgM are detected following a primary infection, but IgM is also produced in reinfection. IgM becomes undetectable 30–90 days after a primary infection, but earlier following re-infections. IgG, by contrast, remains detectable for over 60 years and, in the absence of symptoms, is a useful indicator of past infection. After a primary infection IgG reaches peak levels in the blood after 14–21 days. In subsequent re-infections, levels peak earlier and the titres are usually higher. Both IgG and IgM provide protective immunity to the infecting serotype of the virus.[SUP][6][/SUP][SUP][11][/SUP][SUP][16][/SUP] The laboratory test for IgG and IgM antibodies can cross-react with other flaviviruses and may result in a false positive after recent infections or vaccinations with yellow fever virus or Japanese encephalitis.[SUP][9][/SUP] The detection of IgG alone is not considered diagnostic unless blood samples are collected 14 days apart and a greater than fourfold increase in levels of specific IgG is detected. In a person with symptoms, the detection of IgM is considered diagnostic.[SUP][6][/SUP]
Prevention

A 1920s photograph of efforts to disperse standing water and thus decrease mosquito populations​

There are no approved vaccines for the dengue virus.[SUP][2][/SUP] Prevention thus depends on control of and protection from the bites of the mosquito that transmits it.[SUP][18][/SUP][SUP][36][/SUP]The World Health Organization recommends an Integrated Vector Control program consisting of five elements:[SUP][18][/SUP]

1. Advocacy, social mobilization and legislation to ensure that public health bodies and communities are strengthened;
2. Collaboration between the health and other sectors (public and private);
3. An integrated approach to disease control to maximize use of resources;
4. Evidence-based decision making to ensure any interventions are targeted appropriately; and
5. Capacity-building to ensure an adequate response to the local situation.

The primary method of controlling A. aegypti is by eliminating its habitats.[SUP][18][/SUP] This is done by getting rid of open sources of water, or if this is not possible, by addinginsecticides or biological control agents to these areas.[SUP][18][/SUP] Generalized spraying with organophosphate or pyrethroid insecticides, while sometimes done, is not thought to be effective.[SUP][5][/SUP] Reducing open collections of water through environmental modification is the preferred method of control, given the concerns of negative health effects from insecticides and greater logistical difficulties with control agents.[SUP][18][/SUP] People can prevent mosquito bites by wearing clothing that fully covers the skin, using mosquito netting while resting, and/or the application of insect repellent (DEET being the most effective).[SUP][22][/SUP] However, these methods appear not to be sufficiently effective, as the frequency of outbreaks appears to be increasing in some areas, probably due to urbanization increasing the habitat of A. aegypti. The range of the disease appears to be expanding possibly due to climate change.[SUP][1][/SUP]
Management

There are no specific antiviral drugs for dengue, however maintaining proper fluid balance is important.[SUP][9][/SUP] Treatment depends on the symptoms.[SUP][37][/SUP] Those who are able to drink, are passing urine, have no "warning signs" and are otherwise healthy can be managed at home with daily follow up and oral rehydration therapy.[SUP][37][/SUP] Those who have other health problems, have "warning signs" or who cannot manage regular follow up should be cared for in hospital.[SUP][7][/SUP][SUP][37][/SUP] In those with severe dengue care should be provided in an area where there is access to an intensive care unit.[SUP][37][/SUP]
Intravenous hydration, if required, is typically only needed for one or two days.[SUP][37][/SUP] The rate of fluid administration is titrated to a urinary output of 0.5–1 mL/kg/h, stable vital signs and normalization of hematocrit.[SUP][7][/SUP] The smallest amount of fluid required to achieve this is recommended.[SUP][37][/SUP] Invasive medical procedures such as nasogastric intubation, intramuscular injections and arterial punctures are avoided, in view of the bleeding risk.[SUP][7][/SUP] Paracetamol (acetaminophen) is used for fever and discomfort while NSAIDs such as ibuprofen and aspirin are avoided as they might aggravate the risk of bleeding.[SUP][37][/SUP]Blood transfusion is initiated early in people presenting with unstable vital signs in the face of a decreasing hematocrit, rather than waiting for the hemoglobin concentration to decrease to some predetermined "transfusion trigger" level.[SUP][38][/SUP] Packed red blood cells or whole blood are recommended, while platelets and fresh frozen plasma are usually not.[SUP][38][/SUP] Corticosteroids do not appear to affect outcomes and may cause harm, thus are not recommended.[SUP][39][/SUP]
During the recovery phase intravenous fluids are discontinued to prevent a state of fluid overload.[SUP][7][/SUP] If fluid overload occurs and vital signs are stable, stopping further fluid may be all that is needed.[SUP][38][/SUP] If a person is outside of the critical phase, a loop diuretic such as furosemide may be used to eliminate excess fluid from the circulation.[SUP][38][/SUP]
Epidemiology

See also: Dengue fever outbreaks

Dengue distribution in 2006

---

Epidemic dengue and A. aegypti
A. aegypti, without epidemic dengue
​

Most people with dengue recover without any ongoing problems.[SUP][29][/SUP] The mortality is 1–5% without treatment,[SUP][7][/SUP] and less than 1% with adequate treatment;[SUP][29][/SUP]however severe disease carries a mortality of 26%.[SUP][7][/SUP] Dengue is endemic in more than 110 countries.[SUP][7][/SUP] It infects 50 to 528 million people worldwide a year, leading to half a million hospitalizations,[SUP][2][/SUP][SUP][3][/SUP] and approximately 25,000 deaths.[SUP][8][/SUP] For the decade of the 2000s, 12 countries in Southeast Asia were estimated to have about 3 million infections and 6,000 deaths annually.[SUP][40][/SUP] It is reported in at least 22 countries in Africa; but is likely present in all of them with 20% of the population at risk.[SUP][41][/SUP]
Infections are most commonly acquired in the urban environment.[SUP][6][/SUP] In recent decades, the expansion of villages, towns and cities in endemic areas, and the increased mobility of people has increased the number of epidemics and circulating viruses. Dengue fever, which was once confined to Southeast Asia, has now spread to Southern China, countries in the Pacific Ocean and America,[SUP][6][/SUP] and might pose a threat to Europe.[SUP][5][/SUP]
Rates of dengue increased 30 fold between 1960 and 2010.[SUP][42][/SUP] This increase is believed to be due to a combination of urbanization, population growth, increased international travel, and global warming.[SUP][2][/SUP] The geographical distribution is around the equator with 70% of the total 2.5 billion people living in endemic areas from Asia and the Pacific.[SUP][42][/SUP] An infection with dengue is second only to malaria as a diagnosed cause of fever among returning travelers.[SUP][11][/SUP] It is the most common viral disease transmitted by arthropods,[SUP][15][/SUP] and has a disease burden estimated at 1,600 disability-adjusted life years per million population.[SUP][16][/SUP] The World Health Organization counts dengue as one of seventeenneglected tropical diseases.[SUP][43][/SUP]
Like most arboviruses, dengue virus is maintained in nature in cycles that involve preferred blood-sucking vectors and vertebrate hosts.[SUP][6][/SUP] The viruses are maintained in the forests of Southeast Asia and Africa by transmission from female Aedes mosquitoes—of species other than A. aegypti—to her offspring and to lower primates.[SUP][6][/SUP] In towns and cities, the virus is primarily transmitted by the highly domesticated A. aegypti. In rural settings the virus is transmitted to humans by A. aegypti and other species of Aedes such as A. albopictus.[SUP][6][/SUP] Both these species have had expanding ranges in the second half of the 20th century.[SUP][9][/SUP] In all settings the infected lower primates or humans greatly increase the number of circulating dengue viruses, in a process called amplification.[SUP][6][/SUP]
History

The first record of a case of probable dengue fever is in a Chinese medical encyclopedia from the Jin Dynasty (265–420 AD) which referred to a "water poison" associated with flying insects.[SUP][44][/SUP][SUP][45][/SUP] The primary vector, A. aegypti, spread out of Africa in the 15th to 19th centuries due in part to increased globalization secondary to the slave trade.[SUP][9][/SUP] There have been descriptions of epidemics in the 17th century, but the most plausible early reports of dengue epidemics are from 1779 and 1780, when an epidemic swept across Asia, Africa and North America.[SUP][45][/SUP] From that time until 1940, epidemics were infrequent.[SUP][45][/SUP]
In 1906, transmission by the Aedes mosquitoes was confirmed, and in 1907 dengue was the second disease (after yellow fever) that was shown to be caused by a virus.[SUP][46][/SUP] Further investigations by John Burton Cleland and Joseph Franklin Siler completed the basic understanding of dengue transmission.[SUP][46][/SUP]
The marked spread of dengue during and after the Second World War has been attributed to ecologic disruption. The same trends also led to the spread of different serotypes of the disease to new areas, and to the emergence of dengue hemorrhagic fever. This severe form of the disease was first reported in the Philippines in 1953; by the 1970s, it had become a major cause of child mortality and had emerged in the Pacific and the Americas.[SUP][45][/SUP] Dengue hemorrhagic fever and dengue shock syndrome were first noted in Central and South America in 1981, as DENV-2 was contracted by people who had previously been infected with DENV-1 several years earlier.[SUP][14][/SUP]
Etymology

The origins of the Spanish word dengue are not certain, but it is possibly derived from dinga in the Swahili phrase Ka-dinga pepo, which describes the disease as being caused by an evil spirit.[SUP][44][/SUP] Slaves in the West Indies having contracted dengue were said to have the posture and gait of a dandy, and the disease was known as "dandy fever".[SUP][47][/SUP][SUP][48][/SUP]
The term "breakbone fever" was applied by physician and United States Founding Father Benjamin Rush, in a 1789 report of the 1780 epidemic in Philadelphia. In the report title he uses the more formal term "bilious remitting fever".[SUP][49][/SUP] The term dengue fever came into general use only after 1828.[SUP][48][/SUP] Other historical terms include "breakheart fever" and "la dengue".[SUP][48][/SUP] Terms for severe disease include "infectious thrombocytopenic purpura" and "Philippine", "Thai", or "Singapore hemorrhagic fever".[SUP][48][/SUP]
Research

Public health officers releasingP. reticulata fry into an artificial lakein the Lago Norte district of Brasília, Brazil, as part of a vector control effort​

Research efforts to prevent and treat dengue include various means of vector control,[SUP][50][/SUP] vaccine development, and antiviral drugs.[SUP][36][/SUP]
With regards to vector control, a number of novel methods have been used to reduce mosquito numbers with some success including the placement of the guppy (Poecilia reticulata) or copepods in standing water to eat the mosquito larvae.[SUP][50][/SUP] Attempts are ongoing to infect the mosquito population with bacteria of theWolbachia genus, which makes the mosquitoes partially resistant to dengue virus.[SUP][9][/SUP][SUP][51][/SUP] There are also trials with genetically modified male A. aegypti that after release into the wild mate with females, and their offspring unable to fly.[SUP][52][/SUP]
There are ongoing programs working on a dengue vaccine to cover all four serotypes.[SUP][36][/SUP] Now that there is a fifth serotype this will need to be factored in.[SUP][1][/SUP] One of the concerns is that a vaccine could increase the risk of severe disease through antibody-dependent enhancement (ADE).[SUP][53][/SUP] The ideal vaccine is safe, effective after one or two injections, covers all serotypes, does not contribute to ADE, is easily transported and stored, and is both affordable and cost-effective.[SUP][53][/SUP] As of 2012, a number of vaccines were undergoing testing.[SUP][19][/SUP][SUP][53][/SUP] The most developed is based on a weakened combination of the yellow fever virus and each of the four dengue serotypes.[SUP][19][/SUP][SUP][54][/SUP] It is hoped that the first products will be commercially available by 2015.[SUP][36][/SUP]
Apart from attempts to control the spread of the Aedes mosquito and work to develop a vaccine against dengue, there are ongoing efforts to develop antiviral drugsthat would be used to treat attacks of dengue fever and prevent severe complications.[SUP][55][/SUP][SUP][56][/SUP] Discovery of the structure of the viral proteins may aid the development of effective drugs.[SUP][56][/SUP] There are several plausible targets. The first approach is inhibition of the viral RNA-dependent RNA polymerase (coded by NS5), which copies the viral genetic material, with nucleoside analogs. Secondly, it may be possible to develop specific inhibitors of the viral protease (coded by NS3), which splices viral proteins.[SUP][57][/SUP] Finally, it may be possible to develop entry inhibitors, which stop the virus entering cells, or inhibitors of the 5′ capping process, which is required for viral replication.[SUP][55][/SUP]
Notes

 

[Kukamido]

mkuu nimekuelewa japo sijapenda ulivyotumia haka badala ya huu ugonjwa.

 

[Maboso]

Wewe Mohamedi Mtoi unaumwa. Yawezekana Dengue (breakbone fever) imekupanda hadi kichwani na umeanza kuchanganyikiwa. Hebu wahi mapema hospitali.

 

[mrangi]

Watu wanakufa wewe unaleta siasa. Inamaana wanaokufa wanaigiza. Subiri yakukute ndo utajua.

si unajua hao wana siasa wanataka muda wote tupigixane makelele tu serikali tano sijui mara wizi wa bilion 600 mwisho wa siku hazitusaidi kitu..

 

[PUNKY]

Aisee kani ukweli huu ni usalit katika kiwango cha juu kabisa, wanachofanya viongozi wetu

 

[Yericko Nyerere]

Unaleta siasa kwenye maisha ya watu-shenzi kabisa

Siasa ni ipi kati ya mimi ninaewazindua muache kuwa makondoo wa shughuli au hao wanaowafanya nyie makondoo??

 

[IKWETE]

Dengue ni ACT. Vyote vimekuja kwa nyakati sawa sawa na madhara yake yanafanana. Dengue=ACT

 

[Safari_ni_Safari]

hakuna cha maana ktk hii hekaya. kwa sasa tutoe elimu tuliyonayo kuwatahadharisha wananchi juu ya gonjwa hilo

Tamko rasmi la serikali liko wapi juu ya huu ugonjwa?

 

[Nyamgluu]

kwa hiyo hawa wanaokufa ni matapeli au?

Hahahahahaha! Umenchekesha sana ndugu! embu nitafuta laptop nikugongee like!

Dah! Sisi waAfrika iko kitu tulimkosea Mungu au Miungu! Siasa mpaka huku!
Hahaha! Dah!

 

[Nyamgluu]

Yericko Nyerere ... Mara zote nimekuheshimu kwa makala zako zenye mashiko na hasa za mrengo kama wangu na pia mpenzi kwa chama changu. Lakini hapa kwa hili Dengue Fever umeingia 'choo cha kike'! Kuumwa na mbu Aedes Aegypti haina maana ndio umeambukizwa Dengue, inabidi mbu huyo abebe virusi vya Dengue ndio aweze kukuambukiza, si kila mbu wa Aedes amebeba virusi. Dar es salaam imekumbwa na mvua kubwa hivi karibuni, na kutokana na miundombinu dhahifu hasa maeneo ya makazi, maji yametuama na kufanya mazalia makubwa ya mbu, si Aedes tu...hata Anopheles...hivyo milipuko ya magonjwa kama Dengue Fever na Malaria ni vitu vya kutaraji. Kuna watu wanalala nje mpaka sasa wakiwa hawana hata misaada ya vyandarua, haya unayoongea kuwa 'wana IQ ndogo' kupigwa changa la macho na CCM wakati wanaumwa au wako kwenye hatari kuumwa ni matusi makubwa kwao. Serikali kupitia Wizara ya Afya imeshatoa tamko kuhusiana na mlipuko huu..ina maana wataalamu wote wa team ya EPR (ikishirikisha wadau mbali mbali, mimi nikiwemo) na juhudi zetu za kucontrol huu mlipuko..sie wote ni matahaira, na Yericko yeye ndio veeery smart kisa tu ni Chadema! Bullshit! Watu wenye Bongo mgando kama wewe ndio mnakitia doa chama chetu na vikauli vyenu vyenye conspiracy za kipuuzi kabisa sometimes. Acha wataalamu wadeal na hili...wewe hata kama huwezi tu kuhamasisha watu kuepuka tabia hatarishi...basi kapige tu politiki kijiweni huko! So disappointed...

So refreshing! Asante mkuu Riwa. Hili ndilo tatizo la kutukuza siasa nchini kwetu mpaka inaonekana siasa ndio majibu ya KILA KITU! What Yericko wrote is beyond comprehension kwangu aisee.
Yani sina hata pakuanzia kuongea. Huyo ndio kati ya watu wanaopigania kuongoza hii nchi aisee!
I'm really touched and hurt for the sake of our people! So sad!
Yericko, sio kila jambo ni siasa. Tafadhali kuwa na tabia ya kuuliza na kuchunguza kabla ya kupayuka uharo kama huu siku ingine.
But anyways, kupayuka ujinga ni hallmark ya viongozi wetu, so I believe you not only qualify but on the road to being a master!