Dengue fever outbreak in Karachi, 2005-A clinical experience

Dengue Fever is the most common arboviral disease in the world, and presents cyclically in tropical and subtropical regions of the world. In Pakistan there has been at least one confirmed outbreak in 1994. This is a series of 72 cases seen between September and December 2005 that were diagnosed as dengue fever, the case definition being acute fever with thrombocytopenia, leukopenia and high ALT, and with or without overt bleeding. There was no other explanation for the clinical and lab. investigations. Young adults were affected, males more often than females. Clinical presentation was fever, vomiting, abdominal pain, myalgia and minor to severe bleeding from the nose, gums, gastro intestinal tract or into the skin. Low platelets and TLC, and raised ALT were the salient laboratory features. Management consisted of judicious fluid replacement and fever reduction. Most patients recovered completely, except one young patient who presented with hypovolemic shock, and died of hemorrhage. Dengue viral infection must be regarded as a public health problem, and serious efforts undertaken for public awareness, surveillance and vector control