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DEAG advises doctors to follow WHO guidelines on dengue.

ISLAMABAD -- Dengue Expert Advisory Group (DEAG) has advised healthcare professionals to follow World Health Organization (WHO) guidelines to treat dengue patients.

According to Head of the Dengue Expert Advisory Group (DEAG) and Vice Chancellor of Shaheed Zulfikar Ali Bhutto Medical University Dr Javed Akram, national guidelines for clinical case management are on dengue fever (DF), dengue hemorrhagic fever (DHF) and dengue shock syndrome.

The guidelines stress that the critical phase for dengue patients start after the fever is over and the doctors should take care to avoid fluid overload in patients and look for plasma leakage.

Dengue infection is a dynamic disease and its clinical course changes as the disease progresses.

It is no wonder that a variety of diseases mimic dengue infection and should be considered in the differential while evaluating a patient with suspected dengue.

After the incubation period, the illness begins abruptly and will be followed by 3 phases: febrile, critical and recovery phase.

In 2011 WHO guidelines term expanded dengue syndrome has been used to include unusual manifestations of dengue infection which include neurological, hepatic, renal and other isolated organ involvement.

These could be explained as complications of severe profound shock or associated with underlying host conditions and diseases or co-infections.

According to WHO, the critical phase occurs towards the late febrile phase, often after 3rd day of fever or usually between 3rd to 5th day of illness but may go up to 7th day when a rapid drop in temperature may coincide with an increase in capillary permeability in some patients.

In other viral infections, the patient's condition improves as the temperature subsides, but the contrary happens in dengue hemorrhagic fever.

At this point the patient will either become better if no or minimal plasma leak occurs, or worse if a critical volume of plasma is lost.

The critical phase lasts for about 24-48 hours.

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Publication:The Frontier Star (Northwest Frontier Province, Pakistan)
Date:Feb 12, 2016
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