Dengue Hemorrhagic Fever
DEFINITIONS
Dengue fever or DF and dengue hemorrhagic fever or dengue
fever (dengue hemorrhagic fever abbreviated as DHF) is an infectious disease
caused by the dengue virus with clinical manifestations of fever, muscle pain
and/or joint pain accompanied by leukopenia, rash, lymphadenopathy,
thrombocytopenia and hemorrhagic tests. In DHF, plasma permeation occurs which
is characterized by hemoconcentration (increased hematocrit) or accumulation of
fluid in the body cavity. Dengue shock syndrome is characterized by shock or
shock (Nurarif & Kusuma 2015).
Dengue
Hemorrhagic Fever (DHF) is a disease that attacks children and adults caused by
a virus with manifestations in the form of acute fever, bleeding, muscle and
joint pain. Dengue is an acute Arbovirus infection (Artropod Born Virus) that
is transmitted by the Aedes Aegypti mosquito or by Aedes Aebopictus
(Wijayaningsih 2017).
Dengue
Hemorrhagic Fever (DHF) is transmitted through the bite of the Aedes aegypti
mosquito. DHF is a vector-based disease that is the leading cause of death in
many tropical countries. DHF Disease
are
endemic, often attack the community in the form of outbreaks and are
accompanied by a fairly high death rate, especially in those under 15 years old
(Harmawan 2018).
B. PHYSIOLOGICAL
ANATOMY
Blood
is a fluid in blood vessels that has the function of transporting oxygen,
carbohydrates and metabolites, regulating the balance of acids and bases,
regulating body temperature by conduction or transmission, carrying body heat
from heat production centers (liver and muscles) to be distributed throughout
the body, regulating hormones by carrying and conducting from the glands to the
target (Syaifuddin, 2016).
Blood
is the fluid inside the blood vessels that is red in color. This red color is
not constant, depending on the amount of oxygen and carbon dioxide in it. Blood
is in the body because of the work of the heart pump. As long as the blood is
in the vessels, the blood will remain diluted. But when it is outside the blood
vessels, it will clot. Blood function (Syaifuddin, 2016):
a.
As a transport system from the body, which is to deliver chemicals, oxygen, and
nutrients throughout the body.
b.
Transport the remaining metabolites to the disposal organs.
c.
Delivering hormones to the target organ.
d.
Transport enzymes, buffers, electrolytes throughout the body.
e.
Regulates temperature balance.
In
adults and children red blood cells, white blood cells, and blood clotting
cells are formed in the bone marrow. The active cellular marrow is called the
red marrow and the inactive marrow is called the yellow marrow. The bone marrow
is one of the largest organs in the body, almost the same size and weight as
the liver. 13 Blood consists of two components, namely the solid component
consisting of blood cells (red blood cells or erythrocytes, white blood cells
or leukocytes, and blood clotting cells or platelets) and the liquid component,
namely blood plasma, There are 3 types of blood cells, namely:
a.
Erythrocytes (red blood cells)
Erythrocytes
are blood cells that have been far deferred and have a special function for
oxygen transport. Because it contains hemoglobin that binds oxygen,
erythrocytes carry oxygen from the lungs to the tissues and carbon dioxide is
carried from the tissues to the lungs to be excreted through the respiratory
tract. Red blood cells: Deficiency of erythrocytes, Hb, and Fe will result in
anemia.
b.
Leukocytes (white blood cells)
White
blood cells: Functions to defend the body from disease attacks by eating or
phagocytosis of the disease. That is why leukocytes are also called phagocytes.
White blood cells that contain nuclei are between 6,000-9,000/mm³.
c.
Platelets (blood clotting cells)
Blood
plates in the form of protoplasmic discs are small which in the circulation are
colorless, the number can vary between 200,000-300,000 pieces/mm³. Platelets
are made in the bone marrow, lungs, and spleen with a size of approximately 2-4
microns. Its function plays an important role in the process of blood clotting
and hemostasis or stopping blood flow. When there is damage to the blood vessel
wall, platelets will gather there and close the leakage hole by sticking
together, grouping, and clotting or hemostasis. Then the blood clot process
occurs. The cell structure in the blood is:
a.
Cell membrane (cell membrane)
The
membrane of the elastic structure is very thin, the thickness is only 7.5-10nm.
Almost entirely consists of fine pieces of fat proteins that are the passage of
various substances in and out of the cell. This membrane is in charge of
regulating the life of the cell and receiving everything for the stimuli that
come along.
b.
Plasma
It
consists of several components, namely: 1) Water forms 90% of plasma volume, 2)
Plasma protein, which functions to maintain blood volume and pressure and fight
disease germs (immunoglobulins), 3) Salts and plasma minerals and gases
consisting of O2 and CO2 function to maintain osmotic pressure and blood pH so
that the normal function of body tissues, 4) Food substances as cell food, 5) Other substances such as hormones,
vitamins, and enzymes that function to help metabolism, 6) Antibodies and
antitoxins protect the body from bacterial infections.
C. ETIOLOGY
Dengue virus, belonging to the genus Flavivirus, the family
of flaviridae. There are 4 virus serotypes, namely DEN-1, DEN-2, DEN-3 and
DEN-4. All four were found in Indonesia with the most DEN-3 serotypes.
Infection of one serotype will cause antibodies to the serotype in question,
while antibodies formed against other serotypes are very lacking, so they
cannot provide adequate protection against the other serotype. A person living
in an endemic dengue area can be infected by 3 or 4 serotypes during his or her
lifetime. All four dengue virus serotypes can be found in various regions in
Indonesia (Nurarif & Kusuma 2015)
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