Update of dengue fever diagnosis and treatment plan

Recently, National Health Commission and the State Administration of Traditional Chinese Medicine issued the latest version of the Dengue Fever Diagnosis and Treatment Plan (2024), which was updated after ten years.

According to the chief expert of CDC, with the global warming, Aedes mosquitoes, the vector of dengue fever, have gained a broader living space, and they are also carrying this infectious disease to expand their territory. In China, dengue fever has been "northward" and there has been a small outbreak across the Yellow River.

In China, there is no vaccine for dengue fever and no effective antiviral drugs. For dengue cases, anti-mosquito isolation treatment should be taken.

After ten years, the dengue fever diagnosis and treatment plan was updated.

"Dengue Fever Diagnosis and Treatment Plan (2024)" was recently released. Based on the Guide to Dengue Fever Diagnosis and Treatment (2nd Edition, 2014), the scheme was formulated by combining the research progress and diagnosis and treatment experience at home and abroad.

Dengue fever is an acute infectious disease caused by dengue virus and spread by the bite of Aedes vector. Dengue fever is a systemic disease with complicated clinical manifestations, including sudden fever, systemic pain, rash, bleeding and leukopenia.

In mid-June, a dengue fever patient was admitted to the Department of Infection and Clinical Microbiology of Beijing Chaoyang Hospital. Li Ran, deputy director of the department, introduced that the patient started to have a fever on the way out of the country for five days. After returning to China, he found that white blood cells and platelets decreased, accompanied by a rash on the inner thigh, and finally he was admitted to the hospital for treatment.

As a self-limited disease, dengue fever usually has a good prognosis. A small number of severe cases of dengue fever can die due to organ failure. The factors affecting the prognosis include the patient’s age, basic diseases, serious complications, and previous history of dengue virus infection.

Dengue fever is "expanding the territory"

Dengue fever is widespread in tropical and subtropical areas where Aedes mosquitoes are distributed around the world, involving more than 100 countries and regions around the world. In Latin America, the Western Pacific, Southeast Asia and the Eastern Mediterranean, the spread of dengue fever can occur all the year round.

Although China has not yet formed a stable local epidemic focus of dengue fever, imported cases can be seen all the year round. Guangdong, Yunnan, Fujian, Zhejiang, Guangxi, Hainan and other provinces have experienced many local epidemics of dengue fever caused by imports, with high incidence in summer and autumn. People of all ages can get sick, mainly young and middle-aged.

In recent years, the local spread of dengue fever caused by China’s import is expanding, and it tends to spread from the subtropical region in the south to the temperate regions in the middle and north.

Liu Qiyong, chief expert of vector biology in China CDC, said in an interview with the Beijing News that dengue fever used to be a typical tropical infectious disease. Now it has crossed the Yangtze River and pushed to the Yellow River in China, and there was a small outbreak on the north bank of the Yellow River.

The reason for the "expansion" of dengue fever lies in climate change. With global warming, the vector of dengue fever has gained a wider warm zone, and the disease has been "northward".

There are no antiviral drugs and vaccines on the market.

The treatment principle of dengue fever is early detection, early diagnosis and early treatment.

Early identification and timely treatment of severe cases are the key to reduce mortality. Symptomatic supportive treatment is the main treatment, and there is no effective antiviral treatment at present. Cases should be treated with anti-mosquito isolation, and the isolation can be lifted if the course of disease exceeds 5 days and the body temperature naturally drops to normal for more than 24 hours or more.

Measures to kill adult mosquitoes should be carried out in the hospital ward, in the hospital and around the hospital; Install screen doors and screens in wards and duty rooms. Medical staff should do personal protection and use repellent to prevent mosquito bites.

Dengue fever should be distinguished from fever with rash diseases such as Zika virus disease, Chikungunya fever, measles, rubella, urticaria, scarlet fever, meningitis, typhus and tsutsugamushi disease. Fever with bleeding diseases such as hemorrhagic fever with renal syndrome, fever with thrombocytopenia syndrome, etc. Severe dengue fever should also be differentiated from other infectious shock, leptospirosis, yellow fever, Japanese encephalitis and other diseases.

There is no dengue vaccine listed in China.

The main preventive measures of the disease are mosquito control and cutting off the transmission route, such as carrying out patriotic health campaigns regularly, cleaning up the dead corner of health, eliminating the breeding ground of Aedes mosquitoes and reducing the density of mosquito vectors; Community residents use screens, screens, doors, mosquito nets and mosquito coils in their homes; Use mosquito repellent outside to avoid the bite of Aedes mosquitoes. For patients at home, we should guide them to implement anti-mosquito isolation measures to control the spread of dengue virus.

Beijing News reporter Dai Xuan

Editor Zhang Qian proofreads Lin Zhao.