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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.
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.
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.
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.
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.
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.
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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
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
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).
Source: Health Alert, A Bulletin from the Infection Control Service, St. Luke's Medical Center.
http://www.healthypinoy.com/health/articles/dengue.html
PREVENTIONS
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.
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.