1 ) Identify 2 ) What are the disease transmitted by this to human beings?

A patient presented to the Department of Pathology with chief complaints of Shortness of breath, Fever and body aches. Her blood profile: HB : 12 gm%, Platelets : 53,000/cumm, DLC : N: 25, L: 73, M: 02 ( on Cell counter) Peripheral blood smear examined. Probable diagnosis and further course of management?

D E N G U E F E V E R Key facts ■Dengue is a mosquito-borne viral infection. ■ The infection causes flu-like illness, and occasionally develops into a potentially lethal complication called severe dengue. ■The global incidence of dengue has grown dramatically in recent decades. About half of the world's population is now at risk. ■ Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas. ■ Severe dengue is a leading cause of serious illness and death among children in some Asian and Latin American countries. ■ There is no specific treatment for dengue/ severe dengue, but early detection and access to proper medical care lowers fatality rates below 1%. ■ Dengue prevention and control depends on effective vector control measures. ■ A dengue vaccine has been licensed by several National Regulatory Authorities for use in people 9-45 years of age living in endemic settings. Dengue is a mosquito-borne viral disease that has rapidly spread in all regions of WHO in recent years. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. This mosquito also transmits chikungunya, yellow fever and Zika infection. Dengue is widespread throughout the tropics, with local variations in risk influenced by rainfall, temperature and unplanned rapid urbanization. There are 4 distinct, but closely related, serotypes of the virus that cause dengue (DEN-1, DEN-2, DEN-3 and DEN-4). Recovery from infection by one provides lifelong immunity against that particular serotype. However, cross-immunity to the other serotypes after recovery is only partial and temporary. Subsequent infections by other serotypes increase the risk of developing severe dengue. Transmission The Aedes aegypti mosquito is the primary vector of dengue. The virus is transmitted to humans through the bites of infected female mosquitoes. After virus incubation for 4–10 days, an infected mosquito is capable of transmitting the virus for the rest of its life. Infected symptomatic or asymptomatic humans are the main carriers and multipliers of the virus, serving as a source of the virus for uninfected mosquitoes. Patients who are already infected with the dengue virus can transmit the infection (for 4–5 days; maximum 12) via Aedes mosquitoes after their first symptoms appear. The Aedes aegypti mosquito lives in urban habitats and breeds mostly in man-made containers. Unlike other mosquitoes Ae. aegypti is a day-time feeder; its peak biting periods are early in the morning and in the evening before dusk. Female Ae. aegypti bites multiple people during each feeding period. Characteristics Dengue fever is a severe, flu-like illness that affects infants, young children and adults, but seldom causes death. Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms: severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. Symptoms usually last for 2–7 days, after an incubation period of 4–10 days after the bite from an infected mosquito. Severe dengue is a potentially deadly complication due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs occur 3–7 days after the first symptoms in conjunction with a decrease in temperature (below 38°C/100°F) and include: severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, restlessness and blood in vomit. The next 24–48 hours of the critical stage can be lethal; proper medical care is needed to avoid complications and risk of death. Treatment There is no specific treatment for dengue fever.

A MALE PATIENT AGED 45YRS, COMPLAINT OF ITCHY ERUPTION WITH NO BUMPS.. HISTORY OF INTERMITTENT FEVER, AND SEVERE FALL IN PLATLETS....RISE IN ESR... HEADACHE STILL ON GOING, LATHARGY, INDOLENCE, STIFF JOINTS AND RESTRICTED MOBILITY... MENTALS- VERY CALM, SELF DEPANDENT..SOFT SPOKEN... SATIETY OF THOUGHTS, MOANS WHEN RISES AND SITS... CONTINOUS RUBBING OF THIGHS, WITH SANSATION AS IF BLOOD HAVE STOPPED GOING AWAY FROM THERE... AGGRAVATION bathing, rest, exertion slightest, evening, working... AELIORATION WARMTH, RUBBING, TALKING, STANDING, SUNLIGHT, EATING AFTER.... WHAT CAN BE THE DIFFERENTIAL DIAGNOSIS AND MANAGEMENTS...@Dr. Akshay Ingole @Dr. Md Shahbaz Ali @Dr. Ram Raj Tiwary @Dr. Debasish Sasmal @Dr. Rajan N. Iyer @Dr. Mohd Shafi @Dr. Suryakant Bheda @Dr. Sanjay Kumar Mallick @Dr. Rakesh Sapra @Renu Singh @Dr. Venkatesh K. N. @Dr. Yashpal Chadha

ABC OF : DISEASES TRANSMITTED BY MOSQUITOES.   CHIKUNGUNYA, DENGUE,  DIROFILARIASIS, EASTERN EQUINE ENCEPHALITIS, FILARIASIS, JAPANESE ENCEPHALITIS, LA CROSSE ENCEPHALITIS, MALARIA,  SAINT LOUIS ENCEPHALITIS,  TULAREMIA, VENEZUELAN EQUINE ENCEPHALITIS,  WESTERN EQUINE ENCEPHALITIS, WEST NILE VIRUS, YELLOW FEVER,  AND ZIKA....... *(Not all of the above mentioned are prevalent in India). MAY BE USEFUL.