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Hcs/457 Week 4

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Communicable Disease Paper
The Dengue virus is known to be a mosquito-borne viral infection and is a major threat to health worldwide. It is a mosquito-borne infection that causes a severe flu-like illness and is also known as break bone fever. Fifty to one hundred million people are infected each year mostly in tropical and sub-tropical climates of the world. In the U.S, cases seen affected with the Dengue virus are mostly from Americans who traveled out of the country. Infection of the dengue virus causes dengue fever. The virus weakens the circulatory system and leads to a deadly hemorrhaging.
“Dengue fever is the most prevalent arthropod-borne viral illness in humans and is caused by family related to the virus that cause yellow fever, hepatitis C, and the Japanese St. Lou serotypes of DV causes spectrum of clinical disease ranging from an acute debilitating self-syndrome (dengue hemorrhagic fever/dengue shock syndrome)” (Diamond, Roberts, Edgil, Lu, Ernst, & Harris, 2000, Modulation of Dengue Virus Infection in Human Cells by Alpha, Beta, and Gamma Interface, pg.1, para. 2).
Environmental Factors
Humans are known to be the main carriers and multipliers of the virus. Dengue fever is caused by four different types of the dengue virus. It is transmitted by the bite of an Aedes mosquito directly from one person to another. Mosquitoes are known to breed mostly in man-made containers and are found in all continents of the world except Antarctica. The Aedes mosquitoes’ characteristics are known to have peak biting periods during the early morning and just before dusk. The first case of the dengue fever was reported in Key west, Florida in 2009. By 2010, 1.6 Million cases were reported in the Americas of which 49,000 were severe dengue. Statistics had suggested that the threat is higher for Americans living along the Texas-Mexico border and other southern parts of the United States than the rest of the country. The high humidity level of the southern parts of the United States increases the breeding factor of the mosquitos.
Lifestyle Influence and Socioeconomic Status
Most dengue fever cases in the United States were contracted while traveling abroad. According to the Centers for Disease Control and Prevention, most dengue cases in U.S. citizens occur in those inhabitants of Puerto Rico, the U.S. Virgin Islands, Samoa, and Guam, which are endemic for the virus. The most recent island-wide epidemic occurred in 2007, when more than 10,000 cases were diagnosed. In Puerto Rico, and most of the Caribbean Basin, the principle dengue vector Ae. aegypti is abundant year-round. Dengue transmission in the Puerto Rico follows a seasonal pattern. Low transmission season begins in March and lasts until June, and high transmission begins in August until November (CDC, 2013).
It is known that knowledge of dengue is insufficient in the low socioeconomic class. Preventive practices against the vector are prevalent in the high socioeconomic group. Hence, a greater focus should be conferred to the low socioeconomic areas in the community for future health education and campaigns.
Prevention and Disease Management
The dengue virus can be potentially deadly. Symptoms usually occur after three to four days of infection after the incubation period of the virus and can last up to 10 days. High fever is usually the first sign of a dengue fever infection ranging from 104 degrees Fahrenheit and beyond. In addition, severe headache, nausea, vomiting, rashes, swollen glands, muscle pain, severe abdominal pain, shortness of breath, pain behind the eyes, and fatigue are common symptoms. Bleeding may also occur in the nose and gums. Furthermore, serious damage to the lymph nodes and blood vessels can lead to failure of the circulatory system. Enlargement of the liver can lead to permanent liver failure that may progress to a massive bleeding, shock, and eventually death.
The National Institute of Health (NIH) recently has completed the phase 1 clinical trial of the dengue virus vaccine. Over the years, there is no specific treatment for a dengue infection. The most common treatment was hydration and acetaminophen and was treated similar to a flu type of infection. The vaccines were tested in a single dose of all four different types of the dengue vaccine DENV-1, DENV-2, DENV-3, and DENV-4. The vaccine is called TetraVax-DV. It was found that DENV-3 or TV003 vaccine was the most successful TetraVax-DV vaccine amongst the group of participants. It appeared to induce to most antibody response against the dengue virus.
A single dose of TV003 resulted in antibody response to all four dengue viruses in 45 percent of participants and against three of the four viruses in an additional 45 percent. Overall, an immune response to at least three viruses was seen in 90 percent of vaccines given TV003. (National Institutes of Health, 2013)
The public health department partakes in various programs that control the dengue vector through community participation. Awareness in the proper storage of water and treatment strategies and appropriate procedures in emptying water containers are among the community education provided by the public health department.
Conclusion
The Dengue vaccine developed by scientists at the National Institute of Health (NIH) has been found to be safe and has fuelled a strong immune response in most vaccine recipients. There has been a dramatic increase of incidence of Dengue in the last decades. It is necessary to promote global strategies among multi-sectoral partners to which an integrated approach to a trajectory management and continued control measures at all levels is achieved. Furthermore, its regulatory code is to standardized prevention and the assurance of coherent, sustainable, cost-effective and ecologically sound efforts.
Regardless of the complex clinical manifestation of Dengue, when correct and timely interventions are instituted, its control is rather simple, inexpensive, and highly effective in saving lives.

References
Centers for Disease Control and Prevention. (2013, October). Transmission of the Dengue Virus. Retrieved from http://www.cdc.gov/dengue/epidemiology/index.html
Diamond, M., Roberts, T., Edgil, D., Lu, B., Ernst, J., & Harris, E. (2000, June). Modulation of Dengue Virus Infection in Human Cells by Alpha, Beta, and Gamma Interface. Journal of Virology, 74(11), 4957-4966. Retrieved from http://jvi.asm.org
National Institute of Health. (2013, January). NIH- Developed Candidate Dengue Vaccine Shows Promise in Early Stage Trial.. Retrieved from http://www.niaid.nih.gov
World Health Organization. (2012, November). Dengue and Severe Dengue. Retrieved from http://www.who.int/mediacenter/factsheets/fs/117en/

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