Dengue Fever.Care & specialists in United States

Dengue fever is a viral disease caused by one of four dengue virus serotypes and transmitted by day-biting Aedes mosquitoes. It causes sudden high fever, severe headache, retro-orbital pain, myalgia, arthralgia, rash, and a characteristic platelet drop. Most patients recover within a week but 0.5-1% develop severe dengue.

Dengue is transmitted through the bite of infected Aedes aegypti or Aedes albopictus mosquitoes that bite during the day. Vertical mother-to-fetus transmission can occur near delivery. Rare nosocomial routes include blood transfusion, organ transplantation, and needle-stick injury. Person-to-person spread does not occur directly.

Severe abdominal pain, persistent vomiting, mucosal bleeding (gums, nose, gut), lethargy or restlessness, hepatomegaly more than 2 cm, rapid platelet drop with rising hematocrit, and clinical fluid accumulation (ascites or pleural effusion) all warrant hospitalization. They mark the start of the critical phase around day 3-7.

Yes. Severe dengue with shock, respiratory distress, severe bleeding, or organ failure can be fatal. Mortality is under 1% with optimal supportive care but exceeds 20% without it. Early recognition and meticulous fluid management are the most important determinants of survival.

Dengue NS1 antigen test is the first-line test in the first 7 days; IgM antibodies become positive from day 4-5. RT-PCR is the most specific test where available. Daily complete blood count tracks platelet count and hematocrit. Concurrent testing for chikungunya, Zika, and malaria is essential.

Treatment is supportive: paracetamol for fever, oral fluids, rest, and serial monitoring. Aspirin and NSAIDs are contraindicated because they worsen bleeding. Hospitalization with intravenous fluid management is needed for warning signs or severe dengue. There is no specific antiviral therapy.

Yes. Each of the four dengue serotypes (DENV-1 to DENV-4) produces lifelong immunity to itself only. A second infection with a different serotype carries approximately 7-fold higher risk of severe dengue through antibody-dependent enhancement. People in endemic areas may have multiple infections in a lifetime.

Yes. TAK-003 (Qdenga) is licensed in many countries for ages 4-60 and offers approximately 80% protection against confirmed dengue in seropositive recipients. CYD-TDV (Dengvaxia) is licensed for ages 9-45 with documented prior dengue infection. Eligibility and recommendations vary by country.

Both CYD-TDV (Dengvaxia) and TAK-003 (Qdenga) are live attenuated vaccines and are contraindicated in pregnancy. Pregnant women should rely on strict mosquito-bite prevention. Prior to becoming pregnant, eligible women can discuss vaccination with their travel medicine provider.

Aspirin and NSAIDs inhibit platelet function and impair gastric mucosal protection, both of which raise bleeding risk in dengue. Dengue already lowers platelet counts and damages capillary integrity, so concomitant NSAID use can precipitate serious gastrointestinal or other hemorrhage. Paracetamol is the safe alternative.

Acute fever lasts 2-7 days. The critical phase begins as fever resolves and lasts 24-48 hours. Full recovery from acute illness takes 1-2 weeks, with fatigue and reduced exercise tolerance persisting for 2-6 weeks in some patients. Severe disease may extend hospitalization to 5-10 days.

Yes. Children are highly susceptible and historically have shown the highest rates of severe dengue in long-endemic Asian countries. Severe dengue in children may present subtly with lethargy and reduced oral intake rather than obvious bleeding; close clinical observation is essential.

Use DEET, picaridin, or IR3535 insect repellent during the day, wear long sleeves and trousers, stay in air-conditioned or screened accommodation, and eliminate standing water around the home. Vaccination is available for eligible individuals in many countries. Vector control by public health authorities is essential during outbreaks.

Some small clinical trials suggest modest improvement in platelet recovery with Carica papaya leaf extract, but high-quality evidence is limited and it should not replace standard supportive care and fluid management. Patients using papaya leaf preparations should still attend medical review and laboratory monitoring.

Both cause fever and myalgia, but dengue is mosquito-borne and produces retro-orbital pain, severe joint pain (break-bone fever), maculopapular rash, and a characteristic platelet drop. Influenza is droplet-spread, has prominent respiratory symptoms (cough, sore throat, nasal congestion), and responds to oseltamivir within 48 hours of onset.

Avoid strenuous exercise during the acute and critical phases. Light walking is appropriate once fever has resolved and warning signs have settled. Full return to high-intensity exercise should wait at least 1-2 weeks during convalescence, with normalization of CBC and clinician clearance for athletes.

Dengue is not contagious through normal contact, droplets, or sexual transmission. It requires the Aedes mosquito vector to complete the transmission cycle. Vertical transmission from mother to fetus near delivery and rare nosocomial transmission via transfusion or needle-stick are exceptions.

Dengue hemorrhagic fever is the legacy 1997 WHO classification for severe dengue with bleeding, hemoconcentration, and plasma leakage. The 2009 WHO classification renamed grades III and IV as 'severe dengue' to better guide bedside care. Both terms describe the most dangerous forms of dengue.

Dengue virus infects megakaryocytes and platelets, induces antibody-mediated platelet destruction, and triggers bone-marrow suppression. The platelet count typically falls dramatically over the febrile and critical phases, sometimes below 20,000/µL, before recovering as the infection resolves. Most patients do not need platelet transfusion.

Go to hospital immediately for severe abdominal pain, persistent vomiting, mucosal bleeding, lethargy, dizziness on standing, cold extremities, or any of the WHO warning signs. Patients with comorbidities, pregnancy, age over 65, or fast deterioration should also be assessed in hospital regardless of warning signs.

Most patients recover fully. Some experience post-dengue fatigue syndrome with weakness, hair loss, and reduced exercise tolerance for weeks to months. Severe dengue with prolonged shock or organ failure can have residual effects on kidney, heart, or brain function in a small minority of survivors.