Dengue Fever disease, is a disease caused by a virus

Dengue Fever disease is a disease caused by a virus that is transmitted by mosquitos. It is an acute illness of sudden onset that usually follows a benign course with headache, fever, prostration, severe joint and muscle pain, swollen glands (lymphadenopathy) and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue.

Dengue (pronounced DENG-gay) strikes people with low levels of immunity. An attack of dengue produces immunity for a year or more. Once this outbreak ebbs, more people will be resistant to the viral disease and the cycle will begin again.

Dengue goes by other names including breakbone or dandy fever. Victims of dengue often have contortions due to the intense joint and muscle pain. Hence, the name "breakbone fever." Slaves in the West Indies who contracted dengue were said to have "dandy fever" because of their postures and gait.



Dengue is endemic throughout the tropics and subtropics. Outbreaks have, for example, occurred in the Caribbean, including Puerto Rico, the US Virgin Islands, and Cuba. Cases have also been imported via tourists returning from areas with endemic dengue including Tahiti, the South Pacific, SE Asia, the West Indies, India and the Middle East.

Dengue Fever disease is thriving elsewhere in SE Asia. Thailand, Vietnam, Singapore and Malaysia have all reported an increase in cases. In Thailand, dengue fever killed 31 people in the first three months of 1998.



It comes from a virus (the dengue virus) carried by the striped Aedes aegypti mosquito. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots, plastic bags and cans year round. One mosquito bite can inflict the disease. The incubation period ranges from 3 to 15 (usually 5 to 8) days before the signs and symptoms of dengue appear.



Dengue starts with chills, headache, pain upon moving the eyes, and low backache. Painful aching in the legs and joints occurs during the first hours of illness. The temperature rises quickly as high as 104° F (40° C), with relative low heart rate (bradycardia) and low blood pressure (hypotension). The eyes become reddened. A flushing or pale pink rash comes over the face and then disappears. The glands (lymph nodes) in the neck and groin are often swollen.

Fever and other signs of dengue last for 2 to 4 days, followed by rapid drop in temperature (defervescence) with profuse sweating. This heralds a period with normal temperature and a sense of well-being that lasts about a day. A second rapid rise in temperature follows. A characteristic rash appears simultaneously with the fever and spreading from the extremities to cover the entire body except the face. The palms and soles may be bright red and swollen.



Typical dengue does not result in death. Convalescence is accompanied by a feeling of weakness (asthenia) and takes several weeks.

For typical dengue, the treatment is purely of the symptoms (symptomatic). Complete bed rest is important. Aspirin should be avoided. Acetaminophen (TYLENOL and others) and codeine may be given for severe headache and for the joint and muscle pain (myalgia).



Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10. It causes abdominal pain, hemorrhage (bleeding) and circulatory collapse (shock). DHF is also called Philippine, Thai, or Southeast Asian hemorrhagic fever and dengue shock syndrome.

DHF starts abruptly with high continuous fever and headache. There are respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs 2 to 6 days after the start of symptoms with sudden collapse, cool clammy extremities (the trunk is often warm), weak thready pulse, and blueness around the mouth (circumoral cyanosis).

In DHF, there is bleeding with easy bruising, blood spots in the skin(petechiae), spitting up blood (hematemesis), blood in the stool (melena), bleeding gums and nosebleeds (epistaxis). Pneumonia is common and inflammation of the heart (myocarditis) may be present.

Patients with DHF must be monitored closely for the first few days since shock may occur or recur precipitously. Cyanotic (bluish) patients are given oxygen. Vascular collapse (shock) requires immediate fluid replacement. Blood transfusions may be needed to control bleeding.

The mortality with DHF is appreciable. It ranges from 6 to 30%. Most deaths occur in children. Infants under a year of age are especially at risk of dying from DHF.