Dengue Fever: Texts

Text A

Text B

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

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.

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 C

Steps to take when seeing a suspected case of dengue fever Step 1: Notify your nearest Public Health Unit immediately upon clinical suspicion. Step 2: Take a comprehensive travel history and determine whether the case was acquired overseas or locally. Step 3: Note the date of onset of symptoms to identify the correct diagnostic test, as suitable laboratory tests depend on when the blood sample is collected during the illness. • Another useful test is full blood count. Cases often have leukopenia and/or thrombocytopenia. The table below shows which test to order at which stage of illness:

TEST TYPE PCR IgM IgGNSIELISA

Days after onset of symptoms

0-5 days 0-9 days From day 5onwards

From day 8onwards

Step 4: Provide personal protection advice. • The patient should stay in screened accommodation and have someone stay home to look after them.

• The patient should use personal insect repellent particularly during daylight hours to avoid mosquito bites.

• All household members should use personal insect repellent during daylight hours.

• Advise family members or associates of the case who develop a fever to present immediately for diagnosis.

Dengue Fever: Texts

Text D

END OF PART A

Prior to discharge:

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

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.

• 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.

Dengue Fever

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. The different types of dengue virus?

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2. How fever presents in patients?

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3. How dengue fever is transmitted?

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4. The stages at which to conduct tests for dengue fever?

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5. Monitoring and assessing a patient’s condition?

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6. What advice to give patients to avoid mosquito bites?

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7. advice for patients regarding medication?

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Questions 8 - 13

Complete each of the sentences, 8 - 13, with a word or short phrase from one of the texts.

8. How long after being bitten by an infected mosquito does high fever occur?

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9. What might patients with dengue fever complain of?

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10. Which test should only be ordered 5 days after symptoms appear?

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11. What other test is also useful when checking for dengue fever?

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12. Who is at risk of seizures during the febrile stage of dengue?

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13. What takes places in the most lethal cases of dengue?

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Questions 14 - 20

Answer each of the questions, 14 - 20, with a word or short phrase from one of the texts.

14. How long does the most serious stage of dengue last?

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15. Dengue fever does not spread Answer.

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16. In many Answer dengue infections cause almost no symptoms.

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17. Within three days of symptoms beginning a PCR or Answer can be ordered.

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

medications or Answer.

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

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

PART B

1. The instructions state that disinfectant should be used Select

one:

A. via the process of mechanical cleaning.

B. in combination with physical cleaning.

C. only at the time of manual cleaning.

2. The purpose of this email to staff is to

Selectone:

A. advise them on the importance of clear documentation.

B. warn them about the dangers of incorrect diagnoses.

C. inform staff of their obligations to a patient's family.

3. The guidelines are providing information about

Select one:

A. when a basal test should be conducted.

B. the steps for conducting a basal test.

C. who should perform a basal test.

4. The safety update states that during the past 12 months Select

one:

A. at least1,000 errors were reported.

B. an average of 3.1 errors were reported.

C. more errors than last year were reported.

5. The policy extract states that doctors and specialists who visit the hospital must

Selectone:

A. wait for the emergency officer to provide advice on safety procedures.

B. follow the instructions of the area warden or emergency officer.

C. listen to the emergency officer until the area warden arrives.

6. This email suggests some staff have been looking at patient records Select one:

A. outside of normal work hours.

B. when they didn’t relate to them.

C. without their manager’s approval.

Part C Extract – 1 Nutrition and Diet

7. The writer says that research into nutrition and health requires

Select one:

A. further study.

B. innovative ideas.

C. additional resources.

D. greater independence.

8. In the second paragraph, what surprised Lisa Bero and her team when conducting

their review?

Select one:

A. the emphasis on opinions over facts.

B. the dependence on industry sponsorship.

C. the quality of the reports they had access to.

D. the positivity of the nutrition industry.

9. The phrase ‘has been at odds’ is used to underline

Select one:

A. mistrust around sponsorship.

B. a desire to end scientific subsidies.

C. disagreement amongst researchers.

D. public misunderstanding about nutrition.

10. What does Dr Marion Nestle believe about nutrition and food studies?

Select one:

A. A lot of company sponsorship comes from the drinks sector.

B. Companies sometimes fabricate their own research.

C. The public doesn’t trust most companies.

D. Many companies use health as a way to advertise their products.

11. Dr David Katz expresses the opinion that when it comes to nutrition research

Select one:

A. more studies need to be undertaken.

B. there are too many opinions confusing the issue.

C. nutritionists don’t really know what a healthy diet looks like.

D. it shouldn’t matter who pays for it as long as it is in the public’s interest.

12. What is Dr Katz worried about?

Select one:

A. The exclusion of companies from research at the expense of public health.

B. The lack of development in many products used by the general public.

C. The involvement of pharmaceutical companies in research areas.

D. The declining quality of several types of medication.

13. In the final paragraph, Dr Andrew Brown makes the point that

Select one:

A. science is mainly interested in the process of gathering information.

B. there aren’t a lot of sensible solutions being offered at the moment.

C. researchers should be made more responsible for their studies.

D. opponents of industry-funded research aren’t helping the issue.

14. Dr Brown uses the phrase ‘bigger fish to fry’ to highlight

Select one:

A. there are more important issues than who pays for research.

B. the scientific community and the business sector can’t agree.

C. science isn’t interested in the significance of any new findings.

D. the problems associated with nutrition studies are getting worse.

Extract – 2 : Cofee

15. In the first paragraph, what do we learn about drinking coffee?

Select one:

A. Having more than four cups a day can be harmful.

B. It is healthier than scientists had previously believed.

C. Beneficial effects reduce if you drink four or more cups a day.

D. People who drink coffee usually live longer than those who don’t.

16. What concern does Professor Eliseo Guallar have about coffee

consumption? Select one:

A. No clear conclusions can be made about the benefits of drinking coffee.

B. There may be health risks attributable to products taken with coffee.

C. Not enough doctors are recommending coffee's health benefits.

D. There haven’t been enough studies conducted about coffee.

17. In the second paragraph, the word ‘they’ refers

to Select one:

A. observational data.

B. people drinking coffee.

C. recent reviews.

D. Poole’s team.

18. Dr Luciano Navarini’s views could be considered controversial because he

Select one:

A. agrees with Eliseo Guallar.

B. is employed by a coffee producer.

C. thinks coffee is good for you.

D. suggests people drink more coffee when tired.

19. The phrase ‘largely reassuring’ in the fourth paragraph expresses the idea

that Select one:

A. there is an important link between some diseases and regular coffee consumption.

B. drinking coffee daily appeared beneficial for certain types of diseases.

C. there are no negative effects associated with drinking coffee.

D. routinely drinking coffee makes people feel better.

20. What does Elvira Gonzalez de Mejia suggest about ongoing

research? Select one:

A. Separating coffee’s components for its potential healing benefits could be harmful.

B. There are too many studies taking place, which is causing problems in the industry.

C. It’s better to have coffee as a whole food in itself, but to avoid drinking too much.

D. There are similarities between research into coffee and medical marijuana.

21. In the sixth paragraph, Dr Simon Drew indicates

that Select one:

A. may contain components that can be used medicinally.

B. could contain similar properties to those found in aspirin.

C. is beneficial for people who suffer from headaches.

D. produces antioxidants when the beans are roasted.

22. The writer uses Dr Drew’s comments in the final paragraph to express the

idea that Select one:

A. there currently isn’t enough optimism about coffee.

B. brewing coffee doesn’t produce enough beneficial chemicals.

C. roasting coffee produces too many chemical compounds.

D. further research into coffee still needs to be done.