Dengue Fever

What is it?
Dengue fever is a type of arbovirus, which is short for arthropod-borne virus. The virus that causes dengue fever is carried by Aedes egypti mosquitoes, and is transmitted to humans through their bite. An organism that carries a disease, without actually developing the disease, is called a vector.

Who gets it?
The risk for being bitten by a mosquito that is carrying dengue fever is higher in Africa, Southeast Asia and China, the Indian subcontinent, the Middle East, South and Central America, the Caribbean Islands, Australia, and the South and Central Pacific. Dengue fever is considered "endemic" to certain regions, which means it is native to, or naturally occurring, in these areas. Dengue fever is more likely to occur during or shortly after the rainy season, when the mosquito population is larger. It also most commonly affects children under the age of 10. Dengue fever is rarely seen in the United States.

What causes it?
When a mosquito that is carrying dengue fever bites a person, the virus travels through the body's glands. Once in the glands, it multiplies and can enter the bloodstream. Dengue fever is not contagious, which means one person cannot pass it directly to another.

What are the symptoms?
It takes around five to eight days after being bitten by an infected mosquito for the virus to multiply. Then, symptoms including high fever, headache, chills, swollen lymph nodes, red eyes and eye pain, severe joint and muscle pain, flushed face, lower back pain, and general weakness appear suddenly. These symptoms last for two to three days. Afterward, the fever drops and the patient experiences heavy sweats, but feels better for around one day. This is followed by an increase in temperature, a rash, and a headache. The rash consists of small red bumps that begin on the arms and legs, but then spread to the back, abdomen, and chest. The soles of the feet and palms of the hands also turn red and swell. Symptoms usually last for up to 10 days, but the patient is weak and extremely tired for up to a month afterward. In more severe cases, patients have fever and headache, then develop a cough. The dengue virus causes the blood vessels to swell and leak, creating small purple colored spots on the skin, called petechiae. The skin may appear bruised in areas where the bleeding is worse. Bleeding into the stomach causes severe abdominal pains and vomiting of a black, grainy substance that looks like coffee grounds. This severe bleeding, called hemorrhaging, occurs when the blood runs out of clotting factors. The damaged blood vessels eventually become so large that they are unable to supply the needed blood flow and the oxygen it carries to the body's tissues. This causes the body to go into shock, and can damage major organs such as the heart and kidneys. Severe cases of dengue fever are called dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). The body produces antibodies, which are disease-fighting cells, that protect the patient who has had dengue fever from being reinfected for around one year. However, more severe cases of dengue

How is it diagnosed? The arbovirus that causes dengue fever can be diagnosed by a blood test. Because the immune system recognizes the virus. causing more severe symptoms. Almost all patients with dengue fever have a complete recovery. The health information written by our authors is intended to be a supplement to the care provided by your physician. Most people who have had dengue fever are more likely to have recurring similar viral infections over the years. See a healthcare professional immediately if you have been in an area endemic to dengue fever and you have any illness with fever that lasts for more than two days. What is the treatment? Dengue fever.fever often occur in patients who have already had the virus. This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. it overreacts. Blood transfusions are given in cases of severe blood loss. must run its course. You can avoid mosquito bites by using a mosquito repellent spray or lotion on your body and clothes and staying in well-screened areas. like other arbovirus infections. and oxygen must be given to patients with dengue shock syndrome (DSS). . It is not intended nor implied to be a substitute for professional medical advice. Avoid leaving any containers of standing water outside where mosquitoes can breed. Treatment is focused on medications to lower fever and reduce pain. Self-care tips There are ways to protect yourself if you are traveling to a country that is known to have a high population of dengue fever-carrying mosquitoes. Your sleeping area should have mosquito netting over the bed. and bed rest. Those with DSS have a good prognosis if they receive immediate medical treatment. fluids to prevent dehydration. then are reinfected at a later time.

Four persons reportedly died of dengue and 160 cases of infection were registered in various hospitals in Mumbai from June to September 2003. Water from flower pots should be changed at least once a week 2. How to avoid it: 1. The last two are undertaken to confirm infection. This is the test that most people undergo. skin. but it can confirm if the person is infected by dengue. All containers storing water should be covered with a tight lid 3. bitter taste. gums. ears. It indicates acute infection. which is transmitted by the bite of an infected female Aedes aegypti mosquito. it is common for a surge in reports of dengue infections just after the monsoon. The BMC is organising a campaign to create awareness about the disease and the necessary precautions to prevent infection. All large water tanks. Instances of it proving fatal are extremely low. Water stored in barrels. tight fitting cover. anorexia. muscle�and joint pain. should have single piece cast iron. undertaken only in rare cases." In view of the dengue scare in the city. It has an accuracy of 80-90% and is referred to as the preliminary test. Very expensive and hence. IgG antibodies: IgM antibodies appear in blood at the end of eight days and persist for 1-3 months. Hence. 2003 | 18:53 IST Dengue fever is a self-limiting disease. retro orbital pain and photophobia. These mosquitoes gather around stagnant water. May go into shock due to blood loss. but this could not be confirmed as none of them underwent the second (confirmatory) test. How to detect if you are infected: 1) Serological test to detect IgM. insomnia. Quite expensive. BMC's Deputy Executive Health Officer Dr J G Thanekar said. Most of the cases were reported from the suburbs of Malad and Borivali. 2) Dengue Haemorrhagic Fever or Dengue Shock Syndrome: Infected person complains of high fever. The Brihanmumbai Municipal Corporation is not sure how many of the people who died or those admitted in hospitals were actually infected by dengue. Rarely do people go in for a second blood test (as they are alerted by the first one and begin medication). The fever comes within eight days of the mosquito bite. intense headache. A suitable ladder should be provided to enable civic staff to climb and examine the tanks at frequent .Dengue fever and how to avoid it Vijay Singh in Mumbai | October 10. There are two types of dengue: 1) Classical Dengue Fever: Infected person complains of high fever. 3) Polymerized Chain Reaction: This test involves amplification of the DNA (Deoxyribo Nucleic Acid). conducted only by the Pune-based National Institute of Virology. drums etc should be replaced by fresh stock (at least) once a week 4. "The four people may have died of dengue. Can be undertaken 10 days after the first blood test. 2) Isolation of virus in blood: This is a sophisticated test. like those in buildings. bleeding from nose.

Treatment of Dengue Fever: There is no vaccination for dengue fever. Water fountains should be kept dry once a week 7. Hypotension is a more frequent complication of DHF than severe hemorrhage. and an estimated 50 million–100 million cases of dengue fever occur each year throughout the world. you will get dengue fever. Many patients will have nausea.htm What is Dengue Fever?: Dengue fever and dengue hemorrhagic fever (DHF) are viral diseases transmitted by Aedes mosquitoes. cans. .5 billion persons now live in areas at risk of infection. legs. Symptoms of Dengue Fever: Dengue fever is characterized by the sudden onset of a high fever. These symptoms appear (usually) after an incubation period of 4-7 days. More than 2. Acetaminophen products are recommended for managing fever (not aspirin or ibuprofen). aegypti is most active. the prompt infusion of intravenous fluids is necessary to maintain adequate blood pressure. Surface wells should be well-maintained so that mosquitoes do not breed in the vicinity 8. the mortality rate is less then 15%. bottles.rediff. and face. sometimes fatal hemorrhagic disease called DHF. If the infection is treated on time. How Can I Avoid Getting Dengue Fever?: The best way to avoid getting dengue fever is to avoid getting bitten by mosquitoes. The rash appears 3-5 days after the onset of the fever and can spread from the torso to the arms. usually Ae. The overflow pipe should be protected by a net that can keep away mosquitoes. 5. severe frontal headache. Breeding sites include artificial water containers such as discarded tires. 6. and develop a rash. and cisterns. vomiting. In severe cases. especially during the day when the Ae. uncovered barrels. coconut shells. If you get bitten by a mosquito carying the virus. flower vases or pots. etc should be disposed off or destroyed. vital signs must be monitored frequently. Use insect repellent that contains DEET for maximum effect and wear long-sleeved shirts and long Staying in rooms which are air-conditioned or have a good working fan will also help. Discarded container-like objects like tyres. Rain water collected on terraces/roofs should be cleared (at least) once a week Dengue is also known as Break Bone Fever. The mosquito carrying the virus prefers to feed on humans during the daytime and is found in or near human habitations. Because shock may develop suddenly. URL for this article: http://www. aegypti. buckets. How Can I Get Infected With Dengue Fever?: Dengue fever is transmitted by mosquitoes which carry the virus from one infected person to another (very similar to malaria). and joint and muscle pain. Patients should be encouraged to rest and take abundant fluids. Dengue can also present as a severe.intervals.

The mosquitoes that transmit dengue live among humans and breed in discarded tires. the Pacific. flower pots. What is dengue fever? What is dengue hemorrhagic fever? Dengue fever is a flu-like illness spread by the bite of an infected mosquito.Dengue • • • • Dengue [DEN-ghee] is a flu-like viral disease spread by the bite of infected mosquitoes. . severe headache. Dengue is common in Africa. often fatal. Dengue hemorrhagic fever is a severe." Nausea. A rash usually appears 3 to 4 days after the start of the fever. and water storage containers close to human dwellings. Dengue hemorrhagic fever is a severe. Asia. Older children and adults are usually sicker than young children. Australia. Prevention centers on avoiding mosquito bites in areas where dengue occurs or might occur and eliminating breeding sites.000 feet. often fatal. and the Americas. and loss of appetite are common. pain behind the eyes. but the dengue risk is increasing for persons living along the Texas-Mexico border and in other parts of the southern United States. Infection with one virus does not protect a person against infection with another. cases occur in travelers returning from abroad. It is widespread in the Caribbean basin. Most U. Dengue occurs in most tropical areas of the world. The illness can last up to 10 days. How is dengue spread? Dengue is spread by the bite of an Aedes mosquito. old oil drums. What is the infectious agent that causes dengue? Dengue and dengue hemorrhagic fever are caused by any of the dengue family of viruses. There is no specific treatment for dengue. but complete recovery can take as long as a month. The severity of the joint pain has given dengue the name "breakbone fever. Where is dengue found? Dengue viruses occur in most tropical areas of the world. Dengue is most common in cities but can be found in rural areas. It is rarely found in mountainous areas above 4. The mosquito transmits the disease by biting an infected person and then biting someone else. complication of dengue. and muscle and joint pain.S. What are the signs and symptoms of dengue fever and dengue hemorrhagic fever? Dengue fever usually starts suddenly with a high fever. vomiting. complication of dengue fever. dengue mosquitoes bite during the day. Unlike the mosquitoes that cause malaria. rash.

and other southern states. as well as the type of infecting virus. mouth. but some can progress to dengue hemorrhagic fever. They should be kept away from mosquitoes for the protection of others. Bruising can be a sign of bleeding inside the body. Is dengue an emerging infectious disease? Yes. Tens of millions of cases of dengue fever and up to hundreds of thousands of cases of dengue hemorrhagic fever occur each year.Most dengue infections result in relatively mild illness. Without prompt treatment. In the United States. Risk factors for dengue hemorrhagic fever include a person's age and immune status. Florida. A few persons have become infected with dengue while living in the United States. the blood vessels can collapse. Who is at risk for dengue? Anyone who is bitten by an infected mosquito can get dengue fever. Some patients need transfusions to control bleeding. with a range of 3 to 14 days. dengue is one of the most common viral diseases spread to humans by mosquitoes. Dengue fever has reached epidemic levels in Central America and is threatening the United States. Persons with dengue fever should rest and drink plenty of fluids. the blood vessels start to leak and cause bleeding from the nose. and locally acquired dengue has been reported three times since 1980 in southern Texas. An infected person cannot spread the infection to other persons but can be a source of dengue virus for mosquitoes for about 6 days. How is dengue diagnosed? Dengue is diagnosed by a blood test. and gums. All types of dengue virus are re-emerging worldwide and causing larger and more frequent epidemics. Persons who were previously infected with one or more types of dengue virus are thought to be at greater risk for developing dengue hemorrhagic fever if infected again. Dengue hemorrhagic fever is fatal in about 5 percent of cases. What is the treatment for dengue and dengue hemorrhagic fever? There is no specific treatment for dengue. mostly among children and young adults. How soon after exposure do symptoms appear? The time between the bite of a mosquito carrying dengue virus and the start of symptoms averages 4 to 6 days. How common is dengue? In tropical countries around the world. . Aedes mosquitoes are found in Texas. especially in cities in the tropics. approximately 100 cases of dengue are reported each year in travelers returning from tropical areas. The emergence of dengue as a major public health problem has been most dramatic in the western hemisphere. causing shock (dengue shock syndrome). Dengue hemorrhagic fever is treated by replacing lost fluids. Many more cases probably go unreported. With dengue hemorrhagic fever.

Discard items that can collect rain or run-off water. Eliminate mosquito breeding sites in areas where dengue might occur: • • Preventive Measures to avoid Dengue Fever Few easy-to-remember Tips to avoid Dengue Fever. Eliminate mosquito breeding sites around homes. allowing more mosquitoes to live closer to more people. especially along the Texas-Mexico border. . Eliminating mosquito breeding sites in these areas is another key prevention measure.discard all unwanted items getting gathered around the living area to avoid the breeding of mosquitoes.Take prompt medical advice once fever starts. .S.Keep the water stores CLEAN and CLOSED. . Prevention centers on avoiding mosquito bites when traveling to areas where dengue occurs and when in U. areas. report your travel history to your doctor.keep yourself well covered when outside. Rapid growth of cities in tropical countries has led to overcrowding. If you have symptoms of dengue. Increased jet air travel is helping people infected with dengue viruses to move easily from city to city. especially old tires. where dengue might occur. When indoors. With the increase in all types of virus. The increase in non-biodegradable plastic packaging and discarded tires is creating new breeding sites for mosquitoes. the occurrence of dengue hemorrhagic fever becomes more likely. and substandard sanitation. Regularly change the water in outdoor bird baths and pet and animal water containers. How can dengue be prevented? There is no vaccine to prevent dengue. Dengue hemorrhagic fever is also on the rise. .Several factors are contributing to the resurgence of dengue fever: • • • • • No effective mosquito control efforts are underway in most countries with dengue. When outdoors during times that mosquitoes are biting. Avoid mosquito bites when traveling in tropical areas: • • • • • Use mosquito repellents on skin and clothing. urban decay. wear long-sleeved shirts and long pants tucked into socks. Use bednets if sleeping areas are not screened or air-conditioned. Avoid heavily populated residential areas.Use mosquito repellents. . stay in air-conditioned or screened areas. Public health systems to detect and control epidemics are deteriorating around the world. . Persons who have been infected with one or more forms of dengue virus are at greater risk for the more severe disease.

be sure to tell your doctor where you were traveling. It is recommended to take in plenty of fluids to avoid dehydration. and the government has taken steps to reduce the spread of the disease. How to Avoid Dengue Fever: There is no vaccine against dengue fever. Persons who have been infected with one or more forms of dengue virus are at greater risk for this more severe form of the disease. but tourists should also take their own precautions. Symptoms of Dengue: The symptoms of dengue may appear from any time between three days and two weeks from being infected. Usually symptoms clear up in about two weeks but some people may feel tired and sluggish for several weeks. The illness is avoided by taking preventive measures: • • • wear clothing that covers your skin use an insect repellent containing DEET (Compare prices) stay in areas with air-conditioning and/or screens and mosquito nets Dengue Hemorrhagic Fever: Hemorrhagic Fever is a complication of dengue. . as well as many parts of Asia. including Central and South America. Mexico has also seen a rise in cases of dengue.Dengue Fever on the Rise: Cases of dengue fever are on the rise in many parts of the world. muscle and joint pain Rash Gastrointestinal problems Dengue Fever Treatment: Dengue fever is treated with rest. What is Dengue Fever?: Dengue fever is a flu-like illness which is caused by being bitten by an infected mosquito. and acetaminophen to bring down the fever. • • • • Sudden onset of fever Severe headache. If you become ill after returning from a trip.

More severe forms of the disease usually begin the same way as the mild form (dengue fever). and muscle and joint pain. then become worse after several days. Dengue fever signs and symptoms typically include: • • • • • • High fever. backache or both Pain behind your eyes Severe joint and muscle pain Nausea and vomiting Dengue fever rarely causes death. mouth and under the skin. Fifty million to 100 million cases of dengue infection occur worldwide each year. depending on the form of the disease. you need hospital care. Mild dengue fever causes high fever. A few cases have been reported in the United States — particularly in Texas. But if you have a severe form of the disease. up to 105 F A rash over most of your body. a sudden drop in blood pressure (shock) and death. These signs and symptoms can vary. which may subside after a couple of days and then reappear Severe headache. and symptoms usually get better after five to seven days. along the border with Mexico. Dengue hemorrhagic fever — a more severe form of the disease — can also cause: • • • • Significant damage to your blood and lymph vessels A decrease in the number blood cells that help your blood clot (platelets) Bleeding from the nose. More severe forms of the disease — dengue hemorrhagic fever and dengue shock syndrome — can additionally cause severe bleeding. Related Articles • • Dengue Fever Viral hemorrhagic fevers » More overview Articles No specific treatment for dengue fever exists. rash. and in Hawaii. and most people recover. Signs and symptoms Signs and symptoms of dengue fever usually begin four to seven days after you've been bitten by a mosquito carrying a dengue virus. creating the appearance of bruising Death Dengue shock syndrome — the most severe form of the disease — may also cause: .Dengue fever Introduction Dengue fever is a disease — ranging from a mild to severe — caused by four related viruses spread by a particular species of mosquito. Most cases of dengue fever occur in urban areas of tropical and subtropical regions.

They may be preceded by severe abdominal pain. the virus enters the mosquito's bloodstream. after fever has improved. These areas include many tropical and subtropical areas around the world. It then circulates before settling in the salivary glands. When the infected mosquito then bites another person. where it may cause the serious illness. If you've had dengue fever before If you've had dengue fever before. Two percent to 5 percent of those with a severe form of the disease die. you are also at greater risk of the severe form of the . If you're young. Having antibodies to a virus in your blood from a previous infection usually helps protect you. This happens when you're exposed to a different one of the four dengue viruses than one to which you were previously exposed. although the risk is highest during a recognized dengue fever outbreak. Modern supportive hospital care decreases this risk. Central and South America and the Caribbean. Mosquitoes transmit the virus back and forth between humans. Causes Dengue fever is caused by any one of four dengue viruses spread by the Aedes aegypti mosquito. This most often occurs in children. Recovery from dengue fever may include a long period of listlessness. When a mosquito bites a person infected with a dengue virus. for example: • • • • • • • Central and South America Southeast Asia The Caribbean Africa India The Middle East The South and Central Pacific Particularly high-risk areas include tropical Asia. Infection a second time is typically what causes the more severe form of the disease — dengue hemorrhagic fever. But in the case of dengue fever. You can become infected with dengue fever more than once. frequent vomiting and disorientation. Dengue virus transmission may occur year-round. These mosquitoes thrive in and near human habitations where they breed in even the cleanest water. So previous infection with a dengue fever virus increases your risk of a more severe form of the disease.• • • • Blood vessel fluid (plasma) leakage Heavy bleeding A sudden drop in blood pressure (shock) Death These signs and symptoms usually appear between the third and seventh day of illness. white or female If you are younger than age 12. fatigue and even depression. female or white. you can get it again if you become infected with another one of the four dengue viruses. Risk factors If you live or travel in tropical areas Living in or traveling to an area where dengue fever viruses are present puts you at risk of the disease. it actually increases your risk of severe disease — dengue hemorrhagic fever — if you're infected again. the virus enters that person's bloodstream.

tired and even depressed for several weeks to months after being infected. blood vessel and brain damage. particularly adults. Motrin. .disease — dengue hemorrhagic fever. Those who survive may experience liver. treatment consists of supportive care in a hospital. That's because its signs and symptoms can be easily confused with those of other diseases. blood tests known as hemagglutination inhibition (HI) assay. your blood may reveal the virus itself. dengue fever can lead to dengue hemorrhagic fever and dengue shock syndrome. leptospirosis and typhoid fever. When to seek medical advice If you have any signs or symptoms of dengue fever. to avoid transmitting the disease to others. shock and — in about 2 percent to 5 percent of those with these conditions — death. you may also be kept away from mosquitoes. Complications Most people with dengue fever recover within five to 14 days. Screening and diagnosis Diagnosing dengue fever can be difficult. such as ibuprofen (Advil. Treatment No specific treatment for dengue fever exists. are needed to confirm a diagnosis of dengue fever. Blood tests Laboratory tests. If you have a mild form of the disease. If not. diagnosis of dengue fever is typically done by evaluating your signs and symptoms along with your medical and travel history. Avoid aspirin or other nonsteroidal anti-inflammatory drugs. your blood may be tested for evidence of a dengue virus. If severe. as well as seizures. In addition. as well as any contact you may have had with mosquitoes. may feel listless. your doctor will likely ask about these. Be sure to describe international trips in detail. your doctor will recommend making sure to drink enough fluids to avoid dehydration from vomiting and high fever.&nbsp. such as malaria. If you have any form of dengue fever. If you have dengue fever. Some. which can cause heavy bleeding. These tests may take several days. These can increase the risk of bleeding complications. To diagnose your condition. others) and naproxen sodium (Aleve). enzyme-linked immunosorbent assay (ELISA) and reverse transcriptase-polymerase chain reaction (RT-PCR) also can detect antigens. maintaining adequate blood pressure and replacing blood loss. usually using a sample of your blood. If you have a more severe form of the disease. including the countries you visited and the dates. others) for pain and fever. Still. and explain that you've recently traveled to a region in which the disease is known to occur. see your doctor. Medical history Your doctor will likely ask about your medical and travel history and any exposure to mosquitoes. antibodies or nucleic acids specific to the viruses. You can also take acetaminophen (Tylenol. Such care includes intravenous fluids and electrolyte replacement.

a more natural product. shoes. Terms of use. You can also buy clothing made with permethrin already in it. especially where there will be night-time exposure. dusk and early evening. To reduce your exposure to mosquitoes: • • • • • Avoid unnecessary outdoor activity when mosquitoes are most prevalent. Use bed netting if available. and camping gear and bed netting." "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research. A single copy of these materials may be reprinted for noncommercial personal use only. Keep in mind that chemical repellants can be toxic.Prevention No dengue fever vaccine exists. cover your infant's stroller or playpen with mosquito netting when outside. Patch screens if necessary. long pants." "Mayo Clinic. According to the Centers for Disease Control and socks and shoes when you go into mosquito-infested areas. the best way to avoid dengue fever is to avoid being bitten by mosquitoes that carry the disease. If you are living or traveling in an area where dengue fever is known to be. offers the same protection as DEET when used in similar concentrations." "Mayo Clinic Health Information. Instead. Apply permethrin-containing mosquito repellent to your clothing. Stay in air-conditioned or well-screened housing. Wear long-sleeved shirts. . whereas higher concentrations last longer. All rights reserved. such as at dawn. "Mayo. Choose the concentration based on the hours of protection you need — a 10 percent concentration of DEET is effective for about two hours. Don't use DEET on the hands of young children or on infants under 2 months of age." "MayoClinic. and use only the amount needed for the time you'll be outdoors. oil of lemon eucalyptus. Use repellent with a 10 percent to 30 percent concentration of DEET to your skin. Last Updated: 09/28/2007 © 1998-2007 Mayo Foundation for Medical Education and Research (MFMER).

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