e viruses are known to cause dengue hemorrhagic fever.

Dengue hemorrhagic fever occurs when a person ti perspiration catches a different type dengue virus after being infected by another one sometime before. Prior immunity to a different dengue virus type plays an important role in this severe disease. Worldwide, more than 100 million cases of dengue fever occur every year. A small number of these develop into dengue hemorrhagic fever. ost infections in the !nited "tates are brought in from other countries. #t is possible, but uncommon, for a traveler who has returned to the !nited "tates to pass the infection to someone who has not traveled. $isk factors for dengue hemorrhagic fever include having antibodies to dengue virus from prior infection and being younger than 1%, female, or &aucasian. 'ack to (op"ymptoms )arly symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. (hese symptoms are followed by a shock *like state. 'leeding may appear as tiny spots of blood on the skin +petechiae, and larger patches of blood under the skin +ecchymoses,. inor in-uries may cause bleeding. "hock may cause death. #f the patient survives, recovery begins after a one*day crisis period. )arly symptoms include. Decreased appetite /ever 0eadache 1oint aches alaise uscle aches 2omiting Acute phase symptoms include. $estlessness followed by. )cchymosis 3enerali4ed rash Petechiae Worsening of earlier symptoms

"hock*like state &old, clammy e5tremities "weatiness +diaphoretic,