Dengue Fever

O'nyong-nyong fever; Dengue-like disease; Breakbone fever

Dengue fever is a virus-caused disease that is spread by mosquitoes.

Causes, incidence, and risk factors

Dengue fever is caused by one of four different but related viruses. It is spread by the bite of mosquitoes, most commonly the mosquito Aedes aegypti, which is found in tropic and subtropic regions. This includes parts of:

• Indonesian archipelago into northeastern Australia
• South and Central America
• Southeast Asia
• Sub-Saharan Africa
• Some parts of the Caribbean

Dengue fever is being seen more often in world travelers.

Dengue fever should not be confused with Dengue hemorrhagic fever, which is a separate disease that is caused by the same type of virus but has much more severe symptoms.

Symptoms

Dengue fever begins with a sudden high fever, often as high as 104 - 105 degrees Fahrenheit, 4 to 7 days after the infection.

A flat, red rash may appear over most of the body 2 - 5 days after the fever starts. A second rash, which looks like the measles, appears later in the disease. Infected people may have increased skin sensitivity and are very uncomfortable.

Other symptoms include:

• Fatigue
• Headache (especially behind the eyes)
• Joint aches
• Muscle aches
• Nausea
• Swollen lymph nodes
• Vomiting

Signs and tests

Tests that may be done to diagnose this condition include:

• Antibody titer for dengue virus types
• Complete blood count (CBC)
• Polymerase chain reaction (PCR) test for dengue virus types

Treatment

There is no specific treatment for dengue fever. You will need fluids if there are signs of dehydration. Acetaminophen (Tylenol) is used to treat a high fever. Avoid taking aspirin.

Expectations (prognosis)

The condition generally lasts a week or more. Although uncomfortable, dengue fever is not deadly. People with the condition should fully recover.

Complications

• Febrile convulsions
• Severe dehydration

Calling your health care provider

Call your health care provider if you have traveled in an area where dengue fever is known to occur and have developed symptoms of the disease.

Prevention

Clothing, mosquito repellent, and netting can help reduce exposure to mosquitoes. Traveling during periods of minimal mosquito activity can also be helpful.

Mosquito abatement programs may reduce the risk of infection.

References

1. Naides SJ. Arthropod-borne viruses causing fever and rash syndromes. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 390.
2. Vaughn DW, Barrett A, Solomon T. Flaviviruses (yellow fever, dengue dengue hemorrhagic fever, Japanese encephalitis, West Nile encephalitis, St. Louis encephalitis, tick-borne encephalitis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone: 2009:chap 153.