WHO Regional Office for the Western Pacific
Published: 1999
Total Pages: 134
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A comprehensive guide to the diagnosis, clinical management, epidemiological, surveillance, prevention and control of dengue and dengue haemorrhagic fever. Although guidelines and advice are universally relevant, the manual is specifically designed for use in South-East Asian countries, where dengue fever remains a major public health concern. Recommendations and advice respond to research demonstrating that different geographic areas show a variable response to infection, have different epidemiological patterns, and require different approaches to control. The book also responds to past failures to control dengue in these countries, citing almost exclusive concentration on space spraying of adult mosquitoes as one of the most important causes. With these problems in mind, the book places major emphasis on measures that can make communities responsible for vector control in the domestic environment as the best way to secure sustained improvements in prevention and control. The book has twelve chapters. The first summarizes what is known about the virus, vector, host, transmission cycle, and virus-host interactions. A brief overview of the global situation is followed by a detailed chronology of the resurgence of dengue in South-East Asia. Clinical manifestations and diagnosis are covered in chapter two, which includes precise criteria for reaching a diagnosis based on clinical manifestations and laboratory findings. Chapter three, on clinical management, gives particular attention to the management of dengue shock syndrome as a medical emergency. The important role of laboratory diagnosis is addressed in chapter four, which describes in detail the laboratory confirmatory tests that are essential for diagnosis. A chapter offering advice on the epidemiological surveillance of cases and vectors is followed by a brief description of vector distribution and bioecology. The second half of the book is devoted to strategies for prevention and control, emphasizing vector control measures that can be undertaken by communities as the best approach to successful and sustainable control. Detailed advice, supported by line drawings, checklists, and charts, is given for all appropriate environmental, biological, and chemical methods of vector control. The book also includes a chapter explaining how to develop an emergency plan for rapid response to epidemics. Further practical guidance is provided in a series of fifteen annexes, which include a model arbovirus laboratory request form, a guide to the relative sensitivity and interpretation of serological tests, and abundant advice on environmental and chemical methods of vector control specific to South-East Asia.