In the month of July, Sri Lankan health authorities have reported more than 27,000 dengue fever cases, almost triple the number of cases reported in July 2016 (10,715) bringing the 2017 year-to-date total to 114,215, including more than 300 deaths.

Image/CDC
In addition to the Colombo area, Gampaha has also reported greater than 20,000 cases. Approximately 45.04% of dengue cases were reported from the Western province.
This situation warrants regular removal of possible mosquito breeding sites from the environment. It is also important to seek medical attention in the event of fever by day three of the illness.
Dengue is a viral infection transmitted by the bite of an infected mosquito. There are four closely related but antigenically different serotypes of the virus that can cause dengue (DEN1, DEN 2, DEN 3, DEN 4).
- Dengue Fever (DF) – marked by an onset of sudden high fever, severe headache, pain behind the eyes, and pain in muscles and joints. Some may also have a rash and varying degree of bleeding from various parts of the body (including nose, mouth and gums or skin bruising).Dengue has a wide spectrum of infection outcome (asymptomatic to symptomatic). Symptomatic illness can vary from dengue fever (DF) to the more serious dengue hemorrhagic fever (DHF).
- Dengue Hemorrhagic Fever (DHF) – is a more severe form, seen only in a small proportion of those infected. DHF is a stereotypic illness characterized by 3 phases; febrile phase with high continuous fever usually lasting for less than 7 days; critical phase (plasma leaking) lasting 1-2 days usually apparent when fever comes down, leading to shock if not detected and treated early; convalescence phase lasting 2-5 days with improvement of appetite, bradycardia (slow heart rate), convalescent rash (white patches in red background), often accompanied by generalized itching (more intense in palms and soles), and diuresis (increase urine output).
- Dengue Shock Syndrome (DSS) — Shock syndrome is a dangerous complication of dengue infection and is associated with high mortality. Severe dengue occurs as a result of secondary infection with a different virus serotype. Increased vascular permeability, together with myocardial dysfunction and dehydration, contribute to the development of shock, with resultant multiorgan failure.
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We did a study on ‘Correlation of clinical presentation and laboratory confirmation of dengue patients.’ The proportion of laboratory confirmed dengue patients were 56%. Mean platelet count and PCV in laboratory confirmed dengue patients were 60 269/mm and 41% (range 27-61%) and in non-dengue patients were 106 318/mm and 41.6% (range 29-53%). Based on WHO criteria for diagnosis of dengue, headache (48/56), retro-orbital pain (30/56), limb pain (51/56) and external bleeding (29/56) showed significant association with dengue. Neck pain (10/56), and lymphadenopathy (3/56) did not show significant association with dengue. The infection was confirmed as dengue fever in 11% and dengue hemorrhagic fever in 89% based on WHO criteria. https://goo.gl/GKiqaZ