- Clinical science
Dengue is a viral disease transmitted by mosquitoes (especially Aedes aegypti) and is widely distributed throughout the tropics and subtropics. Dengue classically presents with high fever, headache, body aches, exanthem, and generalized lymphadenopathy. Symptoms usually subside within one week. Some cases progress to the more severe dengue hemorrhagic fever (DHF) with thrombocytopenia, spontaneous bleeding, and potentially shock (dengue shock syndrome). Treatment is supportive. There is no prophylactic dengue vaccination.
- Distribution: tropical regions; worldwide, particularly Asia (e.g., Thailand)
- Most common viral disease affecting tourists in tropical regions
- ∼ 400 million infections per year worldwide
Epidemiological data refers to the US, unless otherwise specified.
- Dengue virus (Serotype: DENV 1–4)
- RNA virus of the genus Flavivirus
- Vector-borne: mosquitoes most commonly from the species Aedes aegypti
Classic dengue fever
- Incubation period: 2–14 days
- Children are usually asymptomatic
- Starts with fever and malaise that lasts ∼ 1 week
- Severe arthralgia and myalgia; (often referred to as “break-bone fever”)
- Severe headache and retro-orbital pain
- Maculopapular, measles-like exanthem (typically appears 2–5 days following fever)
- Generalized lymphadenopathy
If symptoms appear more than 2 weeks after returning from a dengue-endemic region, it is very unlikely that dengue is the cause!
- Occurs in 1–2% of cases
- Generally develops as the initial fever subsides (∼ 1 week after onset)
- Clinical manifestations
- Dengue shock syndrome (DSS): DHF + shock
Dengue hemorrhagic fever is more frequent in individuals who experience a repeat infection with a second serotype, especially serotype 2!
- Laboratory tests
- Best test for confirming infection: serology (IgM, IgG)
- Especially ; (exhibits similar symptoms with an emphasis on bilateral polyarthralgia)
The differential diagnoses listed here are not exhaustive.
- Avoid exposure, use of mosquito repellent (see also → )
- A tetravalent attenuated live vaccine (CYD-TDV) has been available since 2015.