• Dengue Fever

    (Break Bone Fever)


    Dengue fever is a flu-like illness. It is caused by a virus. The infection is passed to humans through mosquito bites. Children and infants who are infected may have no symptoms or only a minor, flu-like illness. Adults who become infected may develop a more severe, life-threatening illness.
    You should contact your doctor immediately if you suspect that you have dengue fever.


    There are four types of dengue viruses that can cause this illness. The viruses are carried by Aedes mosquitoes. When an infected mosquito bites a human, the virus enters the individual’s bloodstream. It may then cause illness. The infection is not passed between humans.
    Mosquito Bite
    Mosquito bite
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    Risk Factors

    The following factors increase your chance of developing dengue fever:
      Travel to tropical or subtropical areas, such as:
      • Africa
      • India
      • Southeast Asia and China
      • Middle East
      • Countries in the Caribbean (including Puerto Rico) and Central and South America
      • Australia
      • Locations in the Central and South Pacific


    If you experience any of these, do not assume it is due to dengue fever. These symptoms may be caused by other, less serious health conditions. Symptoms of dengue fever may include:
    • Headaches
    • Severe pain behind the eyes
    • Fever, chills
    • Red throat
    • Nasal congestion
    • Muscle pain
    • Bone pain
    • Skin symptoms:
      • Reddened skin
      • Increased sensitivity of skin to touch
      • Skin rash
      • Purple spots on the skin
    • Loss of appetite
    • Nausea
    • Vomiting
    • Liver and spleen enlargement
    • Hepatitis
    • Bad taste in the mouth
    • Minor bleeding from gums, nosebleeds, blood in urine and stool
    • During recovery:
      • Low energy
      • Fatigue
      • Depression
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    A severe complication is dengue hemorrhagic fever-dengue shock syndrome. If you have this syndrome, you may develop:
    • Dangerously low blood pressure
    • Weak pulse
    • Abdominal pain
    • Sweatiness
    • Pale or blue skin and lips
    • Uncontrolled bleeding (hemorrhage) from gums, nose, urinary, and/or gastrointestinal tract


    Your doctor will ask about your symptoms and medical history. The doctor will also ask about recent travel to tropical areas. A physical exam will be done. Your doctor may refer you to a specialist.
    Tests may include the following blood tests:
    • Antibody tests—to see if your body is producing substances that fight the dengue fever viruses
    • Reverse transcriptase polymerase chain reaction test (RT-PCR)—to determine the presence and quantity of virus present in the bloodstream


    Talk with your doctor about the best plan for you. There are no medicines available that can provide a cure. Treatment addresses the symptoms. It also attempts to avoid potential complications. Possible treatments include:


    You will need to get extra rest while you recover from your illness.

    Adequate Hydration

    You should drink a lot of beverages to help replace fluids, sugars, and salts lost during the illness. If you are unable to drink enough, you may need to receive IV fluids through a needle in your arm.

    Medications to Decrease Fever and Pain

    You may use acetaminophen (Tylenol) to treat fever and pain. Do not use aspirin because it may increase the risk of bleeding.


    To help reduce your chances of getting dengue fever, take the following steps when traveling in areas where dengue fever is common:
    • Try to spend your time in locations that are protected by good screens or are air-conditioned.
    • Wear long-sleeved shirts and pants. Also, wear socks and shoes.
    • Use insect repellents (preferably those containing DEET) on your skin and your clothing.
    • Either stay inside or take extra precautions during the times of day when mosquitoes are most likely to bite. This is often early morning and late afternoon and early evening.
    • Mosquitoes breed in standing water. Do not leave standing water in buckets, flowers pots, or other containers.


    Centers for Disease Control and Prevention http://www.cdc.gov/

    National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/


    Public Health Agency of Canada http://www.phac-aspc.gc.ca/

    Capital Health http://www.cdha.nshealth.ca/


    Dengue epidemic – Puerto Rico, January – July 2010. Centers for Disease Control and Prevention. MMWR . 2010;598:78.

    Dengue fever. Centers for Disease Control and Prevention website. Available at http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=dengue.htm .

    Dengue fever. National Institute of Allergy and Infectious Diseases website. Available at: http://www.niaid.nih.gov/Factsheets/dengue.htm . Accessed July 3, 2005.

    Goldman L, Ausiello D. Cecil Textbook of Medicine . 22nd ed. Philadelphia, PA: WB Saunders Company; 2004.

    Mandell GL, Bennett J, Dolin R. Principles and Practice of Infectious Diseases . 5th ed. London: Churchill Livingstone, Inc.; 2000.

    Revision Information

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