Definition:

Dengue fever and dengue hemorrhagic fever(DHF) are

acute febrile diseases which occur in the tropics, can be life-threatening, and are
caused by four closely related virus serotypes of the genus Flavivirus,
family Flaviviridae. (single-stranded nonsegmented RNA viruses)

 dengue virus 1 (DENV-1)

 dengue virus 2 (DENV-2)
 dengue virus 3 (DENV-3)
 dengue virus 4 (DENV-4)

  It is also known as breakbone fever, since it can be extremely painful.

Dengue is transmitted to humans by mosquitoes of the genus Aedes:

  Aedes (aegypti 
 or more rarely the Aedes albopictus mosquito.

The mosquitoes that spread dengue usually bite at dusk and dawn but
may bite at any time during the day, especially indoors, in shady areas, or when
the weather is cloudy.

 Dengue has an incubation period of 3-14 days

 Humans serve as the primary reservoir for dengue

Risk factors
 Living or traveling in tropical areas. Being in tropical and subtropical areas
around the world — especially in high-risk areas increases your risk of exposure
to the virus that causes dengue fever. Dengue virus transmission occurs year-
round, although the risk is highest during a recognized dengue fever outbreak.

 Prior infection with a dengue fever virus. Previous infection with a dengue

fever virus increases your risk of a more severe form of the disease. This is
especially true for children. If you've had dengue fever before, you can get it
again if you become infected with another one of the four dengue-causing
viruses. Having antibodies to a virus in your blood from a previous infection
usually helps protect you. But in the case of dengue fever, it actually increases
your risk of severe disease — dengue hemorrhagic fever — if you're infected
again.

 Blood transfusion Dengue may also be transmitted via infected blood products
(blood transfusions, plasma, and platelets)
SIGNS AND SYMPTOMS:
 Dengue fever 
With the mild form of the disease, you may experience some or all of these signs
and symptoms:
 High fever, up to 105 F (40.6 C)
 A rash over most of your body, which may subside after a couple of days and
then reappear
 Severe headache, backache or both
 Pain behind your eyes
 Severe joint and muscle pain
 Nausea and vomiting
Sign and symptoms usually begin about four to seven days after being bitten by
a mosquito carrying a dengue virus. Mild dengue fever rarely causes death, and your
symptoms will usually subside within a week after starting.
 Dengue hemorrhagic fever 
Dengue hemorrhagic fever — a more severe form of the disease than initial
dengue fever — can cause signs and symptoms of dengue fever plus:
 Significant damage to your blood and lymph vessels
 A decrease in the number of blood cells that help your blood clot (platelets)
 Bleeding from the nose and mouth
 Bleeding under the skin, which gives the appearance of bruising
 Death
 Dengue shock syndrome — Dengue shock syndrome — the most severe form
of the disease — may cause signs and symptoms of mild dengue fever plus:
 Severe abdominal pain
 Frequent vomiting
 Disorientation
 Fluid (plasma) leakage from blood vessels
 Heavy bleeding
 A sudden drop in blood pressure (shock)
 Death
3 STAGES:

 First 4 days febrile or invasive stage

 Starts abruptly as high fever abdominal pain and headache
 later flushing which may be accompanied by vomiting, conjunctival
infection and epistaxis.

 4th-7th Days- toxic or hemorrhagic stage

 lowering of temperature
 severe abdominal pain
 vomiting
 frequent bleeding from gastrointestinal tract in the form of hematemesis or
melena.
 Unstable BP, narrow pulse pressure and shock
 Death may occur
 Tourniquet test which may be positive on the 3rd day may become
negative due to low or vasomotor collapse

 7th-10th Days Convalescent or Recovery stage

 Generalized flushing with interventing areas of blanching, appetite
regained and BP already stable