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There were merely 41 instances in 1963 and the following onslaught of dandy fever merely occurred in 1973 which is 1487 and it increase to 2200 in 1974. From 1975 until 1981, the instances of dandy fever febrility are below 1000 per twelvemonth but in 1982, the instances dramatically increase to 3052. After the undermentioned twelvemonth, there was significance addition in 1987 with 2025 instances, 1991 with 6628 instances and 1998 with 27381 instances which was the highest instances of dandy fever febrility in 90 ‘s. In 1999, the instances decrease but from 2000 to 2004, the instances keep increasing every twelvemonth. Finally in 2005, the DF instances lessening all of a sudden and dramatically. The tabular array 1.1 is non demoing a definite form of rhythm in ‘rise and autumn ‘ of DF in Malaysia.

On Saturday 18 December 2010, Bernama, the intelligence bureau reported from Papar, Sabah that this twelvemonth at December 17 the figure of dengue instances increased from 39,597 in 2009 to 45,037. In add-on the deceases besides increase from 84 deceases in 2009 to 133 deceases. The metropolis that record the highest figure of dengue instances in Malaysia is Selangor which is 15,964 instances and 44 deceases. Second is Johor with 4,299 instances and 12 deceases, and Sarawak with 4,174 instances and 14 deceases. Sabah is at moderate degree where the dandy fever instances is 2,063 instances and three deceases this twelvemonth said the Health Deputy Minister Datuk Rosnah Abdul Rashid Shirlin today when establishing the Karnival Mesra organised by the Papar District Hospital. However, she stressed that “ But it does n’t intend we should be less concerned about guaranting its bar ” . There are still topographic points in Sabah where dandy fever instances are active such as Kg Pasir Putih and Kg Jawa in Tawau have two instances in each topographic point. Taman Wira Jaya and Kg Limbungan in Tuaran besides have two instances. Last, Kg Lipong in Beluran besides active with dengue instances. ( MySinchew, 2010 )

How dengue febrility transmitted?

Primary reservoir for dandy fever is human but there are nonhuman Primatess in Africa and Asia that act as host besides. The difference between human and nonhuman host is the nonhuman host will non develop DHF but human host will develop DHF. When a mosquito provender bearer of the virus, the mosquito will get the virus. Therefore, if the mosquito bites another host instantly, it can convey dandy fever. Other than that, there is another manner where viral replicate in the salivary secretory organs of the mosquito for 8 to 12 yearss. 15- to 65-day of the mosquito lifetime, the mosquito will be staying infected by the virus ( Suzanne Moore Shepherd, 2009 ) . Harmonizing to Chye JK, Lim CT & A ; Ng KB et al. , dengue virus can convey by perpendicular transmittal besides. ( As cited Suzanne Moore Shepherd, 2009 )

The dandy fever fever transmitted to human from an septic mosquito bite of the female striped Aedes mosquito largely during examining and blood eating. However, the marks and symptoms of dandy fever febrility will non look instantly. It will be in an incubation period where the dandy fever viruses multiply for 3 to 15 yearss before the marks and symptoms can look. ( Expatriate Malaysia, 2010 )

There are many types of dandy fever viruses that can do dandy fever febrility. Therefore, it is possible to acquire infected by dandy fever fever more than one clip but it will be harsher such as dandy fever hemorrhagic febrility. However, this instances rarely happen because there will be antibodies from the primary exposure to contend the viruses during 2nd exposure. ( Mike paddock, 2010 )

Dengue viruses

Flavivirus is the genus that causes dandy fever febrility which is with single-stranded RNA virus. There are four types of viral serotypes which are dengue virus 1 ( DENV-1 ) , dengue virus 2 ( DENV-2 ) , dengue virus 3 ( DENV-3 ) , and dandy fever virus 4 ( DENV-4 ) . All these are related but antigenically different and have different genotypes.

DENV is a 50-nm virus enveloped with a lipid membrane ( figure1 )

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Figure 1. Dengue virus atom and microscopic image of dandy fever viruses

The surface of the viral membrane consists of 180 indistinguishable transcripts of the envelope ( E ) protein which is attached by short transmembrane section. There are several structural and non-structural mature peptides joined together to organize a individual big polyprotein which have about 11000 bases. The structural divided into 3 structural proteins which are mirid bug ( C ) protein, the envelope ( E ) glycoprotein and the membrane precursor ( prM ) protein. Besides, the nonstructural proteins divided into seven which are NS1, NS2a, NS2b, NS3, NS4a, NS4b and NS5. On both the 5 ‘ and 3 ‘ terminals, there are short non-coding parts ( Figure 2 ) . ( Dengue virus cyberspace, 2011 )

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Figure 2. Dengue virus genome construction with the structural and nonstructural cistrons

The maps of the envelope proteins are transport viral genome into the host cell, haemagglutination of red blood cells, initiation of neutralizing antibodies, and protective immune responses. When the sum of viral addition, the degree of secreted NS1 ( sNS1 ) in plasma will besides increase. This NS1 involve in viral RNA reproduction. Therefore, during secondary dandy fever, the degree of NS1 will be in high degree which is of import in the formation of go arounding immune composites that cause terrible dandy fever ( Padmalal Gurugama, Pankaj Garg, Jennifer Perera, Ananda Wijewickrama, Suranjith L Seneviratne, 2010 ) . NS3 act as a peptidase and a helicase, NS5 is the RNA polymerase which in charge of viral RNA reproduction. ( Dengue virus Internet, 2011 )

A patient can acquire womb-to-tomb homotypic unsusceptibility and partial herotypic unsusceptibility when one dandy fever serotype infects the patient. However each people can be infected by all 4 serotypes. These dengue viruses can be transmitted through the bite of septic Aedes mosquito. The most common is Aedes aegypti which can be the extremely efficient mosquito vector but other Aedes species such as Aedes albopictus besides can go the vector. ( Suzanne Moore Shepherd, 2009 )

Symptoms of Acute Dengue febrility

High febrility ( Health Grades Inc, 2010 )

High febrility may make 105 Fahrenheit during dengue infection. Fever occurs when any pyrogens enter the human organic structure and trigger immune system. Pyrogen is a substance that can bring forth fever such as virus, Fungis, bacteriums, drugs and toxins. The chief map of hypothalamus is to maintain temperature of the organic structure to the normal degree through warming mechanism, metamorphosis and besides chilling mechanism. Therefore, temperature of the organic structure increases when pyrogens affect hypothalamus. ( WebMD, Inc, 2010 )

During high febrility, a patient will undergo desiccation which will do the feeling of ‘burning eyes ‘ . Normally, a patient will experience better for a full twenty-four hours after high febrility for two to four yearss but the febrility will return for several more yearss. ( Steve kander, 2010 )

Headache ( Expatriate Malaysia, 2010 )

Headache is a hurting environing encephalon such as caput and cervix where the nervousnesss and musculuss of the caput and cervix sense pain.A There are two classs of concern which are primary and secondary concern. Primary concern go on when medical status non associated with the concern. If the concern associated with infections, febrility, head hurt or other medical status, it is known as secondary concern. ( Discovery Communications, Inc, 2010 ) In dandy fever patient, it is secondary concern because it caused by high febrility.

Nausea ( Expatriate Malaysia, 2010 )

Nausea is a uncomfortableness of tummy and esthesis of holding an impulse to purge. ( David C. Dugdale, 2009 )

Vomiting ( Expatriate Malaysia, 2010 )

The contents of the tummy forced up through the gorge and out of the oral cavity. The causes could be signals from the oral cavity, tummy, bowel and blood stream, which may incorporate infections. Therefore, dengue virus infection can do purging. ( David C. Dugdale, 2009 )

Red eyes, hurting in the eyes ( Expatriate Malaysia, 2010 )

When the blood vas in Conjunctiva dilated, the eyes will look ruddy. However, dilation of blood vas in sclerotic coat which is known as white of the oculus and episclera which is connective tissue bed between the sclerotic coat and the conjunctiva besides can do inflammation of the oculus. Normally, weariness, allergic reactions and infections can do dilation of blood vas. Eye hurting besides can be caused by infection where the hurting will be happening around the oculus, in the oculus, or behind the oculus. ( Kathryn Colby, MD, PhD, 2006 ) Therefore, dengue infections may accompanied by weariness can do inflammation and hurting of the oculus.

Enlarged Lymph Nodes ( Expatriate Malaysia, 2010 )

Lymph is the extracellular fluid that produced from the filtration of blood in human organic structure. Lymphatic system tracts are distributed with lymph nodes where it acts as a filter for the lymph. Neck, underarm and inguen are the major portion of lymph nodes. Immune cells are located in these lymph nodes. Examples of the immune cells are lymph cells, macrophages, and dendritic cells. The map of dendritic cells is to adhere to the antibodies that bind to their specific antigens. This procedure will make a web which will be helpful to pin down antigens. Degradation of the dust and extraction of stuff that contains antigens will be done by macrophages. Therefore, both T-and B-cells that localized in lymph nodes and are exposed to this antigenic stuff will acknowledge this stuff. These cells will be held in the lymphoid nodes and tissues where they multiply and differentiate. If any diseases attack human such as dandy fever febrility, these cells become effector cells and fight the disease. During this procedure the node will be enlarged. ( Encyclopedia of Nursing & A ; Allied Health, 2010 )

Deep musculus and joint strivings ( Expatriate Malaysia a, 2010 )

During first hr of unwellness, the patient can experience musculus and joint strivings because when the febrility additions, the skeletal musculus protein degraded. Largely, patient with dandy fever febrility will hold complication with articulation and musculus hurting. Therefore, the name ‘breakbone febrility ‘ becomes another name for dandy fever febrility. ( mcrh.org, n.d. )

Thrombocytopenia ( rizwansaeed, 2010 )

Thrombocytopenia happen when low sum of thrombocyte in organic structure caused by bone marrow fail to bring forth thrombocyte or thrombocyte removed from blood in high rate. Platelets are cells in the blood that involve in curdling procedure. It will aggregate each other and besides to the surface of blood vas wall when ( Heather E Eaton, hypertext transfer protocol: //www.virologyj.com/content/7/1/41 ) there is harm to any portion of the organic structure. The normal degree of thrombocyte count in the circulating blood is between 150 and 400 million per millilitre of blood. The mean life span of a thrombocyte in the blood is 10 yearss. ( DrA ClaireA Harrison & A ; Professor Samuel Machin, 2006 )

Harmonizing to Dr Anil Handoo, 2009, largely if thrombopenia occurs because bone marrow fails to bring forth equal sum of thrombocyte during dandy fever febrility, there will be bone marrow suppression caused by dandy fever virus.

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