WHO Launches Integrated Guidelines on Arboviral Diseases
The World Health Organization (WHO) has introduced its first comprehensive guidelines for the clinical management of arboviral diseases. These include dengue, chikungunya, Zika, and yellow fever. The guidelines aim to standardise treatment and improve patient outcomes globally. They also assist health policymakers in preparing for epidemics and pandemics in regions affected by mosquito-borne viruses.
About Arboviral Diseases
Arboviral diseases are viral infections transmitted mainly by Aedes mosquitoes. The key diseases are dengue, chikungunya, Zika, and yellow fever. The Aedes aegypti mosquito can spread several viruses simultaneously in the same area. Over 5.6 billion people worldwide live in regions at risk of these infections. Early symptoms often mimic common flu with fever, joint pain, and rash. This similarity complicates clinical diagnosis without laboratory tests. Severe complications can occur, sometimes leading to death.
Need for Integrated Clinical Guidelines
Outbreaks of arboviral diseases are increasing in frequency, severity, and geographic spread. This rise is driven by ecological changes, urbanisation, and social factors. The diseases often coexist in the same regions, making differential diagnosis challenging. Limited diagnostic resources in many areas add to the problem. WHO’s integrated guidelines provide a unified, evidence-based approach to diagnosis and treatment. They serve as a practical tool for frontline healthcare workers and health system planners to improve care and readiness.
Key Clinical Recommendations for Mild Cases
For non-severe arboviral infections, WHO recommends oral fluid therapy to prevent dehydration. Paracetamol or metamizole should be used for pain and fever relief. Non-steroidal anti-inflammatory drugs (NSAIDs) are discouraged due to bleeding risks. Corticosteroids are also avoided in mild cases. These measures help manage symptoms safely and reduce complications.
Management of Severe Arboviral Disease
Severe cases require hospitalisation and careful fluid management using crystalloid solutions. Colloids are not recommended. Monitoring capillary refill time and lactate levels guides hydration. The passive leg raise test helps assess fluid responsiveness in patients with shock. Corticosteroids and immunoglobulin therapies are avoided even in severe illness. Platelet transfusions are reserved for patients with active bleeding. For yellow fever-related liver failure, intravenous N-acetylcysteine is advised. Experimental treatments such as monoclonal antibody TY014 and sofosbuvir are limited to research settings.
Implications for Health Systems and Policy
The guidelines support policymakers and health administrators in epidemic preparedness. Standardised protocols enhance clinical care consistency and patient safety. They also improve resource allocation during outbreaks. As arboviral diseases expand to new areas, these guidelines will be vital in managing public health challenges. WHO plans to update the recommendations as new evidence becomes available.
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