Dengue hemorrhagic fever • Decreased appetite

• Fever
- is a severe, potentially deadly • Headache
infection spread by certain • Joint aches
species of mosquitoes (Aedes • Malaise
aegypti). • Muscle aches
• Vomiting
Causes
Acute phase symptoms include:
Four different dengue viruses are known
to cause dengue hemorrhagic fever. • Restlessness followed by:
Dengue hemorrhagic fever occurs when o Ecchymosis
a person catches a different type dengue o Generalized rash
virus after being infected by another one o Petechiae
sometime before. Prior immunity to a o Worsening of earlier
different dengue virus type plays an symptoms
important role in this severe disease. • Shock-like state
o Cold, clammy extremities
Worldwide, more than 100 million cases o Sweatiness (diaphoretic)
of dengue fever occur every year. A
small number of these develop into Exams and Tests
dengue hemorrhagic fever. Most
infections in the United States are A physical examination may reveal:
brought in from other countries. It is
possible for a traveler who has returned • Enlarged liver (hepatomegaly)
to the United States to pass the infection • Low blood pressure
to someone who has not traveled. • Rash
• Red eyes
Risk factors for dengue hemorrhagic • Red throat
fever include having antibodies to • Swollen glands
dengue virus from prior infection and • Weak, rapid pulse
being younger than 12, female, or
Caucasian.
Tests may include:

• Arterial blood gases

Symptoms
Early symptoms of dengue hemorrhagic
fever are similar to those of dengue
fever, but after several days the patient
becomes irritable, restless, and sweaty.
These symptoms are followed by a
shock -like state.
Bleeding may appear as tiny spots of
blood on the skin (petechiae) and larger
patches of blood under the skin
(ecchymoses). Minor injuries may cause
bleeding.
Shock may cause death. If the patient
survives, recovery begins after a one-day
crisis period.
Early symptoms include:
• Coagulation studies
• Electrolytes
• Hematocrit
• Liver enzymes
• Platelet count
• Serologic studies (demonstrate
antibodies to Dengue viruses)
• Serum studies from samples
taken during acute illness and
convalescence (increase in titer
to Dengue antigen)
• Tourniquet test (causes petechiae
to form below the tourniquet)
• X-ray of the chest (may
demonstrate pleural effusion)
Treatment
Because Dengue hemorrhagic fever is
caused by a virus for which there is no
known cure or vaccine, the only Hemorrhagic dengue; Dengue shock
treatment is to treat the symptoms. syndrome; Philippine hemorrhagic fever;
Thai hemorrhagic fever; Singapore
• A transfusion of fresh blood or hemorrhagic fever
platelets can correct bleeding
problems Transmission
• Intravenous (IV) fluids and
electrolytes are also used to Dengue viruses are transmitted to
correct electrolyte imbalances humans through the bites of infective
• Oxygen therapy may be needed female Aedes mosquitoes. Mosquitoes
to treat abnormally low blood
oxygen
• Rehydration with intravenous
(IV) fluids is often necessary to
treat dehydration
• Supportive care in an intensive
care unit/environment

Outlook (Prognosis) WHO/TDR/Stammers

generally acquire the virus while feeding
With early and aggressive care, most on the blood of an infected person. After
patients recover from dengue virus incubation for eight to 10 days, an
hemorrhagic fever. However, half of infected mosquito is capable, during
untreated patients who go into shock do probing and blood feeding, of
not survive. transmitting the virus for the rest of its
life. Infected female mosquitoes may
Possible Complications also transmit the virus to their offspring
by transovarial (via the eggs)
• Encephalopathy transmission, but the role of this in
• Liver damage sustaining transmission of the virus to
• Residual brain damage humans has not yet been defined.
• Seizures
a contagious disease transmitted via
• Shock
the Aedes aegypti mosquito, infects
between 50 million and 100 million
When to Contact a Medical
people worldwide each year. Also
Professional
known as breakbone or dandy fever,
dengue fever is found in the tropical
Call your health care provider if you
and subtropical regions of the world.
have symptoms of dengue fever and
Exposure to the flavivirus that
have been in an area where dengue fever
causes dengue fever results in one
is known to occur, especially if you have
of three pathophysiologies: dengue
had dengue fever before.
fever, the more severe dengue
hemorrhagic fever (DHF) or dengue
Prevention
shock syndrome
There is no vaccine available to prevent
dengue fever. Use personal protection
such as full-coverage clothing, netting,
mosquito repellent containing DEET,
and if possible, travel during periods of
minimal mosquito activity. Mosquito
abatement programs can also reduce the
risk of infection.

Alternative Names