PRO/SOAS> Dengue – Sri Lanka (04): rise in cases

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Sun 14 May 2023
Source: Outbreak News Today [edited]

The National Dengue Control Unit (NDCU) in Sri Lanka reports a total
of 33 656 dengue cases, including 20 deaths since the beginning of the
year [2023]. This includes about 4000 cases reported during the first
2 weeks of this month [May 2023], raising grave concerns of a
potential epidemic.

The NDCU further explained that the ongoing inclement weather
conditions only further aggravate the breeding of mosquitos.

The NDCU said the high-risk areas for dengue are as follows: Colombo
Municipal Council jurisdiction – Gothatuwa, Piliyandala, Kaduwela,
Maharagama, Battaramulla-; and Gampaha district – Wattala, Negombo,
Biyagama, Ragama, Ja-Ela.

Dengue is a viral infection transmitted by the bite of an infected
mosquito. There are 4 closely related but antigenically different
serotypes of the virus that can cause dengue (DEN1, DEN 2, DEN 3, DEN

Dengue has a wide spectrum of infection outcomes (asymptomatic to
symptomatic). Symptomatic illness can vary from dengue fever (DF) to
the more serious dengue hemorrhagic fever (DHF).

– Dengue Fever (DF) – is marked by an onset of sudden high fever,
severe headache, pain behind the eyes, and pain in muscles and joints.
Some may also have a rash and varying degrees of bleeding from various
parts of the body (including nose, mouth, and gums or skin bruising).

– Dengue Hemorrhagic Fever (DHF) – is a more severe form, seen only in
a small proportion of those infected. DHF is a stereotypic illness
characterized by 3 phases; febrile phase with high continuous fever
usually lasting for less than 7 days; critical phase (plasma leaking)
lasting 1-2 days usually apparent when fever comes down, leading to
shock if not detected and treated early; convalescence phase lasting
2-5 days with the improvement of appetite, bradycardia (slow heart
rate), convalescent rash (white patches in red background), often
accompanied by generalized itching (more intense in palms and soles),
and diuresis (increase urine output).

– Dengue Shock Syndrome (DSS) — Shock syndrome is a dangerous
complication of dengue infection and is associated with high
mortality. Severe dengue occurs as a result of 2ary infection with a
different virus serotype. Increased vascular permeability, together
with myocardial dysfunction and dehydration, contribute to the
development of shock, with resultant multi-organ failure.

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