From the Guidelines
Dengue fever is a viral infection transmitted by Aedes mosquitoes, characterized by high fever, severe headache, pain behind the eyes, muscle and joint pain, and rash, with a mortality rate that can be reduced to <0.5% with appropriate clinical management 1.
Key Characteristics of Dengue Fever
- The disease is caused by the dengue virus and is common in tropical and subtropical regions.
- Initial symptoms typically appear 4-10 days after infection and may last for 2-7 days.
- Most people recover completely, but some develop severe dengue, which can be life-threatening.
Diagnosis and Management
- There is no specific antiviral treatment for dengue fever, so management focuses on relieving symptoms with acetaminophen (paracetamol) for fever and pain, while avoiding aspirin and NSAIDs due to bleeding risk 1.
- Patients should rest, stay hydrated, and seek medical attention if symptoms worsen.
- Warning signs of severe dengue include severe abdominal pain, persistent vomiting, bleeding gums, rapid breathing, and fatigue.
Prevention
- Prevention involves eliminating mosquito breeding sites, using insect repellent, wearing protective clothing, and installing screens on windows and doors.
- Currently, a dengue vaccine (Dengvaxia) is available in some countries but is only recommended for those with prior dengue infection 1.
Important Considerations
- Dengue and Zika virus diagnostic testing should be performed on patients with a clinically compatible illness and risk for infection with both viruses, using nucleic acid amplification tests (NAATs) and immunoglobulin M (IgM) antibody testing 1.
- The interpretation of results should consider the epidemiology of viruses known to be circulating at the location of exposure and clinical findings.
From the Research
Definition and Overview of Dengue
- Dengue is a mosquito-borne arboviral infection of increasing public health importance 2
- It is a life-threatening mosquito-borne viral infection widely spread in tropical areas 3
- Dengue fever is a common infectious disease in the tropical and subtropical zones, with more than 100 million symptomatic cases per year 4
Transmission and Symptoms
- Dengue virus transmission occurs from an infected Aedes mosquito to humans 3
- The disease characteristically takes a triphasic course (febrile phase, critical phase, recovery phase) 4
- Symptoms include high-grade fever, headache, arthralgia, and backache, and in some cases, the upper respiratory tract and gastrointestinal tract are also involved 3
Management and Treatment
- Dengue is managed supportively because there are no proven curative treatments 3
- The cornerstone of care during the critical period of dengue is prudent fluid resuscitation, with the first fluid of preference being a crystalloid 3
- Prophylactic transfusion of platelets is not advised 3
- Treatment is symptomatic, as no treatment directed against the cause of the disease is available, and includes adequate volume replacement and, in patients with hemorrhage, the transfusion of blood products 4
Complications and Prevention
- Dengue manifests various complications such as dengue encephalopathy, encephalitis, stroke, ocular involvement, acute transverse myelitis, myalgia, and cerebellar syndrome, but the most commonly seen is liver involvement 3
- Preventive steps include vaccination after a documented initial infection and the meticulous avoidance of mosquito bites 4
- Climate change and global mobility have led to a worldwide increase in dengue fever 4