Dengue Fever: Texts

Text A

Dengue: virus, fever and mosquitoes

Dengue fever is a viral disease spread only by certain mosquitoes – mostly Aedes aegypti or
“dengue mosquitoes” which are common in tropical areas around the world.

There are four types of the dengue virus that cause dengue fever – Dengue Type 1, 2, 3 and 4. People
become immune to a particular type of dengue virus once they’ve had it, but can still get sick from the
other types of dengue if exposed. Catching different types of dengue, even years apart, increases the
risk of developing severe dengue. Severe dengue causes bleeding and shock, and can be life
threatening.

Dengue mosquitoes only live and breed around humans and buildings, and not in bush or rural areas.
They bite during the day – mainly mornings and evenings. Dengue mosquitoes are not born with
dengue virus in them, but if one bites a sick person having the virus in their blood, that mosquito can
pass it on to another human after about a week. This time gap for the virus to multiply in the mosquito
means that only elderly female mosquitoes transmit dengue fever. The mosquitoes remain infectious for
life, and can infect several people. Dengue does not spread directly from person to person.

Text B

Signs and Symptoms

Classic dengue fever, or “break bone fever,” is characterised by acute onset of high fever 3–14 days after
the bite of an infected mosquito. Symptoms include frontal headache, retro-orbital pain, myalgias,
arthralgias, hemorrhagic manifestations, rash, and low white blood cell count. The patient also may
complain of weight loss and nausea. Acute symptoms, when present, usually last about 1 week, but
weakness, malaise, and weight loss may persist for several weeks. A high proportion of dengue infections
produce no symptoms or minimal symptoms, especially in children and those with no previous history of
having a dengue infection.
 Dengue Fever: Texts

Text D

Prior to discharge:

• Tell patients to drink plenty of fluids and get plenty of rest.

• Tell patients to take antipyretics to control their temperature. Children with dengue are at risk for
febrile seizures during the febrile phase of illness.

• Warn patients to avoid aspirin and anti-inflammatory medications because they increase the risk of
haemorrhage.

• Monitor your patients’ hydration status during the febrile phase of illness. Educate patients and parents
about the signs of dehydration and have them monitor their urine output.

• Assess hemodynamic status frequently by checking the patient’s heart rate, capillary refill,
pulse pressure, blood pressure, and urine output. If patients cannot tolerate fluids orally, they may need
IV fluids.

• Perform hemodynamic assessments, baseline hematocrit testing, and platelet counts.

• Continue to monitor your patients closely during defervescence. The critical phase of dengue begins
with defervescence and lasts 24–48 hours.

END OF PART A
Reading test 3

Type all your answers in the Answer box provided.

One mark will be granted for each correct answer.
Answer ALL questions. Marks are NOT deducted for incorrect answers.
Part A
TIME: 15 minutes

 Look at the four texts, A-D, in the separate Reading Part A: Text
Booklet.
 For each question, 1-20, look through the texts A-D, to find the relevant
information.
 Type your answers in the Answer box provided.
 Answer all the questions within the 15-minute time limit.
 Your answers should be spelled correctly.

 Questions 1 - 7
 For each of the questions, 1 - 7, decide which text (A, B, C, or D) the
information comes from. You may use any letter more than once.

 In which text can you find information about

1. In which text can you find information about the different types of dengue virus? A
2. In which text can you find information about how fever presents in patients? B
3. In which text can you find information about how dengue fever is transmitted? A
4. In which text can you find information about the stages at which to conduct tests for C
dengue fever?
5. In which text can you find information about monitoring and assessing a patient’s C
condition?
6. In which text can you find information about what advice to give patients to avoid D
mosquito bites?
7. In which text can you find information about advice for patients regarding medication? D
 Questions 8 - 14
Complete each of the sentences, 8 - 14, with a word or short phrase
from one of the texts.
Each answer may include words, numbers, or both.

8. How long after being bitten by an infected mosquito does high fever occur? 3–14 days
9. What might patients with dengue fever complain of? weight loss and nausea
10. Which test should only be ordered 5 days after symptoms appear? IgM
11. What other test is also useful when checking for dengue fever? FBC
12. Who is at risk of seizures during the febrile stage of dengue? Children
13. What takes places in the most lethal cases of dengue? bleeding and shock
14. How long does the most serious stage of dengue last? 1 week

Questions 15 - 20
Answer each of the questions, 15 - 20, with a word or short phrase
from one of the texts.
Each answer may include words, numbers or both.

15. Dengue fever does not spread _______________

directly

16. In many ______________

children dengue infections cause almost no symptoms.

17. Within three days of symptoms beginning a PCR or ____________

NS1 elisa can be ordered.

18. To avoid haemorrhage patients mustn’t take anti-inflammatory medications

or aspirin
________________.

19. Advise patients be cared for by someone at home in ________________

screened accommodation.

20. Patients must be made aware of the need to check their ______________________.
hemodynamic