In view of the early monsoon and high transmission period there is higher probability of out breaks of fevers and higher incidence of Dengue fevers in the months of July, August, September.
In this connection all the Medical Officers in the district are instructed to observe the month of JULY-16 as “ Dengue Awareness Month “.
The following activities shall be under taken by all the Medical officers regularly till September.
· The Medical officers shall maintain utmost vigilance for any fever out breaks in their area.
· Aedes Larval surveillance shall be taken up in all the villages with priority in the villages where there were confimed Dengue cases in the previous year.
· House to house aedes larval survey shall be conducted by MPHA and HS in all domestic and peridomestic water storage containers.
· House to house Aedes larval survey shall be conducted by ASHA in all domestic and peridomestic water storage containers.
· During the surveillence all the following sites which are breeding sources for aedes larva (Cement tanks , water coolers, overhead tank,sumps, old unused tyres, Stored water in buckets, Roof tops) shall be inspected
· During the surveillance, if aedes larva found all the containers shall emptied and dried and the house hold members are to be informed not to use the containers for another 24 hours
· The above activities shall be conducted in all villages after the conduction of immunisation sessions on Wedness day and Saturday
· Awareness activities like group meetings VHSNC committee meetings shall be conducted in all the villages where ther were positive dengue cases last year.
The following standard case definitions shall be complied with for a suspect, probable and confirmed dengue case
An acute febrile illness of 2-7 days duration with two or more of the following manifestations:
· Retroorbital pain,
· Haemorrhagic manifestations
· Non ELISA based NS1 antigen/IgM positive.
A positive test by RDT will be considered as probable due to poor sensitivity and specificity of
currently available RDTs)
A case compatible with the clinical description of dengue fever with at least one of the following:
· Demonstration of dengue virus NS1 antigen in serum sample by ELISA.
· Demonstration of IgM antibodies by IgM antibody capture ELISA in single serum
· IgG seroconversion in paired sera after 2 weeks with fourfold increase of IgG titre.
· Detection of viral nucleic acid by polymerase Chainreaction (PCR)
· Isolation of the dengue virus (virus culture +ve) from serum, plasm
When ever a Medical officer suspects a fever case as Dengue
· Apply the standard case definition of suspected dengue case.
· If any of the symptoms suggestive of a suspect case the patient should be refered to “NTR VIDYA PARISKHALU “ for Rapid diagnsostic test.
· If the RDT is positive take sera sample and sent to Dept. of Microbiology Government Medical College, for Elisa test.
· The sample should be cleary labelled with following details Name, age, Sex, Address, with mobile No. and send to the microbiology dept, Medeical College,Ananthapuramu through the special meseenger
· Information about suspected case should immediatly informed to concerned Dy.DM&HOS, Malaria subunit officer, Asst.Malaria Officer and District Malaria Officer.
· House to house survey and container surveillance shall be taken up in the respective village.
· If a case is confirmed as a dengue the following activities shall be taken up ( Pyrethrum spray, 4 weeks Anti Larval Oprations, Fogging operations)
· Appropriate referral shall be taken up based on the severity of the case.