Dengue (DENG-gay) fever is a serious illness that occurs most often in tropical and subtropical regions of the world. It is caused by a virus that passes from person to person through the bite of a mosquito. Its symptoms are high fever, severe headache, joint pain, muscle and bone pain, rash, and mild bleeding.
Dengue fever, also known as breakbone fever, is a disease caused by four closely related dengue viruses. The main symptoms of dengue fever are high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash, and mild bleeding. Symptoms of infection typically emerge about 4 to 7 days after being bitten by an infected mosquito. They usually last about 3 to 10 days. Generally, young children and those who have never had dengue fever before experience a milder version of the illness than older children and adults.
According to the World Health Organization (WHO), about 2.4 million people experienced infections with dengue fever each year. Additionally, WHO estimates that 3.9 billion people, living in 128 countries around the world, are at risk for infection with dengue viruses. Dengue fever is most common in Southeast Asia and the western Pacific Islands, but has also been increasing rapidly in the Caribbean and Latin America. According to WHO, an estimated 500,000 people with severe dengue are hospitalized each year, many of whom are children. About 2.5 percent of those infected with dengue fever die annually.
Most dengue cases in U.S. citizens occur in inhabitants of Puerto Rico, the U.S. Virgin Islands, Samoa, and Guam, which are endemic for the virus. Dengue and DHF have been a particular challenge in Puerto Rico, where outbreaks have been reported since 1915 and large, island-wide epidemics have been documented since the late 1960s. In 2010, 26,766 cases of suspected dengue infections were reported in Puerto Rico, according to the CDC. The fever occurs most frequently in highly populated areas, such as cities, with poor control of stagnant water and mosquito populations.
The virus does not spread directly from person to person. The bite of a mosquito, usually the female Aedes mosquito, is required to transmit the disease. The insect takes in the virus with its meal of blood when it bites an infected person. Because the virus remains in the mosquito for the rest of its life, the mosquito can pass the infection when it bites people who do not have dengue fever. In areas with large populations of mosquitoes, dengue fever epidemics can occur.
Diagnosing dengue fever can be tricky, because its symptoms can easily be confused with other diseases such as malaria, leptospirosis, and typhoid fever. Doctors typically diagnose dengue fever from a patient's history of symptoms and risk factors, including whether that person has been to locations where dengue fever is found. Doctors look for fever with a high temperature, pain, and a rash, known as the dengue triad. To help confirm the diagnosis, doctors may order blood tests or tests on spinal fluid to look for antibodies to the virus.
Dengue fever disease usually clears up on its own. Supportive care, such as fever reducers and painkillers may be used. Dengue fever often involves excessive loss of body fluids through sweating, vomiting, or diarrhea, requiring patients to drink plenty of fluids to avoid dehydration * . Over-the-counter medicine such as acetaminophen * (Tylenol) can relieve pain and fever while the disease runs its course. If patients develop vomiting and severe abdominal pain after the fever declines, they should contact their doctor immediately. Patients suspected of developing DHF are monitored closely and have undergo blood tests to check for signs of hemorrhagic conditions. If they develop DHF, they will generally be hospitalized, where they can be monitored and treated with fluid replacement therapy.
There are no vaccines to prevent infection with dengue virus. The most effective protective measures against dengue are actions taken to avoid mosquito bites and reduce mosquito populations. Using pesticides, stocking lakes and ponds with fish that eat mosquito larvae, and covering or eliminating small pools of standing water in which the insects breed can help keep mosquito levels in check. People can protect themselves from bites by using insect repellent, wearing clothing that covers much of the body, and avoiding outdoor activity. Applying mosquito repellent containing 20 to 30 percent DEET * to exposed skin and clothing decreases the risk of mosquito bites.
See also Bites and Stings • Fever • Travel-Related Infections: Overview • Viral Infections
Centers for Disease Control and Prevention. “Dengue.” http://www.cdc.gov/Dengue/ (accessed April 16, 2016).
World Health Organization. “Dengue.” http://www.who.int/topics/dengue/en/ (accessed April 16, 2016).
Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 800-232-4636. Website: http://www.cdc.gov . (accessed April 16, 2016).
World Health Organization. Ave. Appia 20, 1211 Geneva 27, Switzerland. Telephone: 41 22 791 2111. Website: http://www.who.int/en (accessed April 16, 2016).
* dehydration (dee-hi-DRAY-shun) is a condition in which the body is depleted of water, usually caused by excessive and unreplaced loss of body fluids, such as through sweating, vomiting, or diarrhea.
* acetaminophen (uh-see-teh- MIH-noh-fen) is a medication commonly used to reduce fever and relieve pain.
* DEET is the active ingredient in many insect repellents. It is the abbreviation for N,N-diethyl-meta-toluamide.