《2009WHO登革熱的指南》內(nèi)容預(yù)覽

Investigation

A full blood count should be done at the first visit. A hct test in the early febrilephase establishes the patient’s own baseline hct. A decreasing white blood cell countmakes dengue very likely. A rapid decrease in platelet count in parallel with a rising hct issuggestive of progress to the plasma leakage/critical phase. In the absence of thepatient’s baseline, age-specific population hct levels could be used as a surrogate duringthe critical phase.

Disease notification

In dengue-endemic countries, cases of suspected, probable and confirmed dengue should benotified for appropriate public health measures. Suggested criteria for early notification ofsuspected cases are that the patient lives in or has travelled to a dengue-endemic area, hasfever for three days or more, has low or decreasing white cell counts, and/or hasthrombocytopaenia ± positive tourniquet test. In dengue-endemic countries, the later thenotification, the more difficult it is to prevent dengue transmission.

Management decisions

Patient may be sent home (Group A), be referred for in-hospital management (Group B), orrequire emergency treatment and urgent referral (Group C).

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