What is dengue fever?

Dengue fever is a disease caused by a family of viruses that are transmitted by

mosquitoes. It is an acute illness of sudden onset that usually follows a benign course
with symptoms such as headache, fever, exhaustion, severe muscle and joint
pain, swollen glands(lymphadenopathy), and rash. The presence (the "dengue triad") of
fever, rash, and headache (and other pains) is particularly characteristic of dengue.
Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and
red palms and soles.

Dengue (pronounced DENG-gay) strikes people with low levels of immunity. Because it
is caused by one of four serotypes of virus, it is possible to get dengue fever multiple
times. However, an attack of dengue produces immunity for a lifetime to that particular
serotype to which the patient was exposed.

Dengue goes by other names, including "breakbone" or "dandy fever." Victims of dengue
often have contortions due to the intense joint and muscle pain, hence the name
breakbone fever. Slaves in the West Indies who contracted dengue were said to have
dandy fever because of their postures and gait.

Dengue hemorrhagic fever is a more severe form of the viral illness. Manifestations
include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae(small
red or purple blisters under the skin), bleeding in the nose or gums, black stools, or easy
bruising are all possible signs of hemorrhage. This form of dengue fever can be life-
threatening and can progress to the most severe form of the illness,dengue shock
syndrome.

What areas are at high risk for contracting dengue fever?

Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred
recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and
Central America. Cases have also been imported via tourists returning from areas with
widespread dengue, including Tahiti, Singapore, the South Pacific, Southeast Asia, the
West Indies, India, and the Middle East (similar in distribution to the areas of the world
that harbor malaria and yellow fever). Dengue is now the leading cause of acute febrile
illness in U.S. travelers returning from the Caribbean, South America, and Asia.

A 2009 outbreak of dengue fever in Key West, Fla., showed that three patients who did
not travel outside of the U.S. contracted the virus. Subsequent testing of the population
of Key West has shown that up to 55 of the people living in the area have antibodies to
dengue. As of July 17, 2010, 17 individuals have been identified that acquired dengue in
Key West in 2010.

Dengue fever is common, and statistics show it may be increasing in Southeast Asia.
Thailand, Vietnam, Singapore, and Malaysia have all reported an increase in cases.
According to the U.S. Centers for Disease Control and Prevention (CDC), there are an
estimated 100 million cases of dengue fever with several hundred thousand cases of
dengue hemorrhagic fever requiring hospitalization each year. Nearly 40% of the world's
population lives in an area endemic with dengue.

How is dengue fever contracted?

The virus is contracted from the bite of a striped Aedes aegypti mosquito that has
previously bitten an infected person. The mosquito flourishes during rainy seasons but
can breed in water-filled flower pots, plastic bags, and cans year-round. One mosquito
bite can inflict the disease.

The virus is not contagious and cannot be spread directly from person to person. There
must be a person-to-mosquito-to-another-person pathway.

What are dengue fever symptoms and signs?

After being bitten by a mosquito carrying the virus, the incubation period ranges from
three to 15 (usually five to eight) days before the signs and symptoms of dengue appear.
Dengue starts with chills, headache, pain upon moving the eyes, andlow backache.
Painful aching in the legs and joints occurs during the first hours of illness. The
temperature rises quickly as high as 104 F (40 C), with relative low heart rate
(bradycardia) and low blood pressure (hypotension). The eyes become reddened. A
flushing or pale pink rash comes over the face and then disappears. The glands (lymph
nodes) in the neck and groin are often swollen.
Fever and other signs of dengue last for two to four days, followed by a rapid drop in
body temperature (defervescence) with profuse sweating. This precedes a period with
normal temperature and a sense of well-being that lasts about a day. A second rapid rise
in temperature follows. A characteristic rash appears along with the fever and spreads
from the extremities to cover the entire body except the face. The palms and soles may
be bright red and swollen.

What is the treatment for dengue fever?

Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to
treat it. For typical dengue, the treatment is purely concerned with relief of the symptoms
(symptomatic). Rest and fluid intake for adequate hydration is important. Aspirin
and nonsteroidal anti-inflammatory drugs should only be taken under a doctor's
supervision because of the possibility of worsening hemorrhagic
complications. Acetaminophen (Tylenol) and codeine may be given for severe headache
and for the joint and muscle pain (myalgia).

What is the prognosis for typical dengue fever?

Typical dengue is fatal in less than 1% of cases. The acute phase of the illness with
fever and myalgias lasts about one to two weeks. Convalescence is accompanied by a
feeling of weakness (asthenia), and full recovery often takes several weeks.

What is dengue hemorrhagic fever?

Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children
under 10 years of age. It causesabdominal pain, hemorrhage (bleeding), and circulatory
collapse (shock). DHF is also called Philippine, Thai, or Southeast Asian hemorrhagic
fever and dengue shock syndrome.

DHF starts abruptly with high continuous fever and headache. There are respiratory and
intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain.
Shock occurs two to six days after the start of symptoms with sudden collapse, cool,
clammy extremities (the trunk is often warm), weak pulse, and blueness around the
mouth (circumoral cyanosis).

In DHF, there is bleeding with easy bruising, blood spots in the skin (petechiae), spitting
up blood (hematemesis), blood in the stool (melena), bleeding gums,
andnosebleeds (epistaxis). Pneumonia is common, and inflammation of the heart
(myocarditis) may be present.

Patients with DHF must be monitored closely for the first few days since shock may
occur or recur precipitously (dengue shock syndrome). Cyanotic (bluish) patients are
given oxygen. Vascular collapse (shock) requires immediate fluid replacement. Blood
transfusions may be needed to control bleeding.

The mortality (death) rate with DHF is significant. It ranges from 6%-30%. Most deaths
occur in children. Infants under a year of age are especially at risk of dying from DHF.

How can dengue fever be prevented?

The transmission of the virus to mosquitoes must be interrupted to prevent the illness.
To this end, patients are kept under mosquito netting until the second bout of fever is
over and they are no longer contagious.

The prevention of dengue requires control or eradication of the mosquitoes carrying the
virus that causes dengue. In nations plagued by dengue fever, people are urged to
empty stagnant water from old tires, trash cans, and flower pots. Governmental
initiatives to decrease mosquitoes also help to keep the disease in check but have been
poorly effective.

To prevent mosquito bites, wear long pants and long sleeves. For personal protection,
use mosquito repellant sprays that contain DEET when visiting places where dengue is
endemic. Limiting exposure to mosquitoes by avoiding standing water and staying
indoors two hours after sunrise and before sunset will help. The Aedes aegypti mosquito
is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at
any time of the day and is often hidden inside homes or other dwellings, especially in
urban areas.

There is currently no vaccine available for dengue fever. There is a vaccine undergoing
clinical trials, but it is too early to tell if it will be safe or effective. Early results of clinical
trials show that a vaccine may be available by 2012.

Dengue Fever At A Glance

• Dengue fever is a disease caused by a family of viruses that are transmitted by

mosquitoes.
• Symptoms such as headache, fever, exhaustion, severe joint and muscle pain,
swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of
fever, rash, and headache (and other pains) is particularly characteristic of dengue
fever.
• Dengue is prevalent throughout the tropics and subtropics. Outbreaks have
occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands,
Cuba, and Central America.
• Because dengue fever is caused by a virus, there is no specific medicine or
antibiotic to treat it. For typical dengue fever, the treatment is purely concerned with
relief of the symptoms (symptomatic).
• The acute phase of the illness with fever and myalgias lasts about one to two
weeks.
 • Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect
children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and
circulatory collapse (shock).
• The prevention of dengue fever requires control or eradication of the mosquitoes
carrying the virus that causes dengue.
• There is currently no vaccine available for dengue fever.

FONT SIZE
A
A
A
• « Previous
• 1
• 2
• 3
• 4
• 5
• Next »

• Dengue Fever Index

• Glossary

Dengue Fever (cont.)

Heartburn: Foods to Eat, Foods to Avoid Slideshow Pictures

Digestive Disease Myths Slideshow Pictures

Diverticulitis (Diverticulosis) Slideshow Pictures

In this Article
• What is dengue fever?
• What areas are at high risk for contracting dengue fever?
• How is dengue fever contracted?
• What are dengue fever symptoms and signs?
 • What is the treatment for dengue fever?
• What is the prognosis for typical dengue fever?
• What is dengue hemorrhagic fever?
• How can dengue fever be prevented?
• Where can people get more information on dengue fever?
• Dengue Fever At A Glance
• Patient Discussions: Dengue Fever - Describe Your Experience
• Dengue Fever Glossary
• Dengue Fever Index

What are dengue fever symptoms and signs?

After being bitten by a mosquito carrying the virus, the incubation period ranges from three to 15 (usually five to eight) d
appear. Dengue starts with chills, headache, pain upon moving the eyes, and low backache. Painful aching in the legs
The temperature rises quickly as high as 104 F (40 C), with relative low heart rate (bradycardia) and low blood pressur
flushing or pale pink rash comes over the face and then disappears. The glands (lymph nodes) in the neck and groin a

Fever and other signs of dengue last for two to four days, followed by a rapid drop in body temperature (defervescence
with normal temperature and a sense of well-being that lasts about a day. A second rapid rise in temperature follows. A
and spreads from the extremities to cover the entire body except the face. The palms and soles may be bright red and

What is the treatment for dengue fever?

Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the
symptoms (symptomatic). Rest and fluid intake for adequate hydration is important. Aspirin andnonsteroidal anti-inflam
doctor's supervision because of the possibility of worsening hemorrhagic complications. Acetaminophen(Tylenol) and c
the joint and muscle pain (myalgia).
What is Dengue Fever (DF)?
Dengue fever is an infection caused by a virus. It occurs commonly as dengue
fever. Occasionally a patient suffering formdengue may develop bleeding.
Common sites for bleeding are the nose, gums and skin. Sometimes, the patient
may have coffee-ground vomiting or black stools. This indicates bleeding in the
intestines. The patient with dengue fever who develops bleeding has dengue
hemorrhagic fever (DHF).

How does dengue spread?

Dengue fever is transmitted to people by the bite of an Aedesmosquito that is
infected with the dengue virus. The mosquito becomes infected
with dengue when it bites a person who hasdengue fever or DHF. Dengue fever
cannot be spread directly from person to person.

When should I suspect Dengue?

Dengue should be suspected when you have sudden onset of high fever, 39-
40°C, accompanied with severe headache, pain behind the eyes, body aches,
rashes on the skin and nausea or vomiting. The fever lasts for 5-7 days. In some
patients, fever comes down on the third or fourth day but it recurs.

Can dengue fever be treated at home?

Most patients with dengue fever can be treated at home. They should take
rest, drink plenty of fluids and eat nutritious food. Whenever available, Oral
Rehydration Salt (commonly used in treating diarrhea) should be used.
Sufficient fluid intake is very important. Generally the progression towards
dengue hemorrhagic fever or dengue shock syndrome occurs after 3-5 days of
fever. At this time, fever has often come down. This may mislead many of us to
believe that the patient is heading towards recovery. This is the most
dangerous period that requires high vigilance. It is best to consult a physician.
Indications for hospitalization are persistent vomiting, inability to take oral
fluids, persistent abdominal pain, restlessness, or bleeding from any site (nose,
gums, passage of black stools).

What is the treatment?

Like most viral diseases there is no specific cure for dengue fever. Antibiotics
do not help. Paracetamol is the drug of choice to bring down fever and joint
pain. Aspirin and Ibuprofen should be avoided since they can increase the risk
of bleeding.
Can people die from dengue fever?
People who suffer from dengue fever have no risk of death but some of them
develop Dengue Hemorrhagic Fever or Dengue Shock Syndrome. In some of
these cases death can occur. With proper treatment, the patients with these
conditions can recover fully. Proper treatment provided in time can save lives.

Is there a vaccine to prevent dengue fever?

A vaccine has been developed to prevent dengue fever but it is still under trial.
It is not yet available in the market.

How can the multiplication of mosquitoes be reduced?

Dengue mosquitoes breed in stored, exposed water collections. To prevent the
mosquitoes from multiplying, drain out the water from tanks, barrels, drums,
buckets, etc. Remove all objects containing water (e.g. plant saucers) from the
house. Collect and destroy discarded containers where water can collect, e.g.,
bottles, plastic bags, cans, tires, etc. If storage of water can't be helped, the
container should be covered with a tight fitting lid.

How can I prevent mosquito bites?

Dengue mosquitoes bite during the day time. The highest biting intensity is
about 2 hours after sunrise and before sunset. Wear full sleeves clothing and
long dresses to cover as much of your body as possible. Use repellents but be
careful in using them in young children and the elderly. Use mosquito coils and
electric vapor mats during daytime. Use mosquito nets to protect children, old
people and others who nap during the day.

What can the community do to prevent dengue?

The main strategy in the prevention and control of dengue issource reduction,
or prevention of breeding places. Every household can undertake simple
measures to prevent existing water collections from becoming breeding places
of Aedes aegypti. House cleaning by all members of the community will ensure
that no breeding places exist, preventing dengue form occurring.

Source: Health Alert, A Bulletin from the Infection Control Service, St. Luke's Medical Center.

http://www.healthypinoy.com/health/articles/dengue.html
PREVENTIONS

DENGUE HEMORRHAGIC FEVER is an acute infectious disease manifested initially with

fever.

Transmission

Aedes aegypti, the transmitter of the disease, is a day-biting mosquito which lays eggs in clear
and stagnant water found in flower vases, cans, rain barrels, old rubber tires, etc. The adult
mosquitoes rest in dark places of the house.

Signs and Symptoms

Sudden onset of high fever which may last 2 to 7 days.

Joint & muscle pain and pain behind the eyes.
Weakness
Skin rashes - maculopapular rash or red tiny spots on the skin called petechiae
Nosebleeding when fever starts to subside
Abdominal pain
Vomiting of coffee-colored matter
Dark-colored stools

Prevention and Control

Cover water drums and water pails at all times to prevent mosquitoes from breeding.
Replace water in flower vases once a week.
Clean all water containers once a week. Scrub the sides well to remove eggs of mosquitoes
sticking to the sides.
Clean gutters of leaves and debris so that rain water will not collect as breeding places of
mosquitoes.
Old tires used as roof support should be punctured or cut to avoid accumulation of water.
Collect and dispose all unusable tin cans, jars, bottles and other items that can collect and
hold water.