Dengue fever in a rural hospital: issues concerning transmission\ud

Introduction: Dengue is either endemic or epidemic in almost every country located in the tropics. Within northern Australia, dengue occurs in epidemics; however, the Aedes aegypti vector is widespread in the area and thus there is a threat that dengue may become endemic in future years. Case presentation: An 18 year old male was admitted to a rural north Queensland hospital with the provisional diagnosis of dengue fever. No specific consideration was given to the risk that this patient posed to other patients, including a 56 year old male with chronic myeloid leukaemia and prior exposure to dengue. Discussion: Much media and public attention has been given to dengue transmission in the scope of vector control in the community. Hospital-based dengue transmission from patient-to-patient requires consideration so as to minimise unnecessary morbidity and mortality. Vector control within the hospital setting appears to be an appropriate preventative measure in the context of the presented case. Transfusion and transplantation-related transmission of dengue between patients are important considerations. Vertical dengue infection is also noted to be possible. Conclusion: Numerous changes in the management of dengue-infected patients can be made that are economically feasible. Education of healthcare workers is essential to ensure the safety of all patients admitted to hospitals in dengue-affected areas. Bed management in particular is one area that may benefit from increased attention.\u