• Dengue Fever

    (Break Bone Fever)

    Definition

    Dengue fever is a flu-like illness. 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.

    Causes

    Dengue fever is caused by 1 of 4 specific dengue viruses. They are passed to humans by infected mosquitoes. The bite can allow the virus to enter the bloodstream and spread through the body. Once in the body, the virus may cause dengue fever.
    Mosquito Bite
    Mosquito bite
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    Travel to tropical or subtropical areas can increase your chance of getting dengue fever. Areas with known dengue fever include:
    • 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
    • Occasionally in Florida (Key West) and Texas (bordering Mexico)

    Symptoms

    Young children or those with their first infection may have mild symptoms. Primary symptoms are a high fever and at least 2 of the following:
    • Severe headache
    • Severe eye pain
    • Chills and fever
    • Muscle and or bone pain
    • Red or purple spots in skin
    • Minor bleeding in the nose or gum
    • Easy bruising
    • Nausea/vomiting
    The fever tends to reduce within 3-7 days after symptoms begin. As the fever decreases, warning signs of a severe infection may appear, such as:
    • Severe abdominal pain
    • Persistent vomiting
    • Uncontrolled bleeding from gums or nose
    • Black tarry stools or blood in the urine
    • Lethargy or restlessness
    • Difficulty breathing
    • Pale, cold, or clammy skin
    • Lightheadedness
    A severe infection can lead to shock and organ failure.

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. You will also be asked whether you recently travelled to high-risk areas.
    Your body fluids may be tested. This can be done with blood tests.

    Treatment

    You may be referred to a specialist.
    There are no medications currently available that can provide a cure. Treatment is aimed at providing support while the body fights off and eliminates the virus. Supportive care may include:
    • Bed rest—Your body will need rest while you recover from your illness.
    • Hydration—Drink plenty of beverages throughout the day. This will help to replace fluids, sugars, and salts lost during the illness. If you are unable to drink enough, you may need to receive IV fluids.
    • Pain and fever relief—Acetaminophen may be advised to treat pain and fever. Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) are generally not advised. Talk to your doctor about any medications you are taking.

    Prevention

    If you are in an area with known dengue fever, the following steps may help decrease your risk of dengue fever:
    • Spend your time in locations that are protected by insect screens or are air-conditioned.
    • Cover your skin. Wear long-sleeved shirts and pants, and socks and shoes.
    • Use insect repellents on your skin and your clothing. Look for repellents that contain DEET.
    • Use proper mosquito netting at night. Look for netting treated with insecticide.
    • Stay inside or take extra precautions in the early morning, late afternoon, and early evening. Mosquitoes are most likely to bite during these times.
    • Do not leave standing water in buckets, flowers pots, or other containers. Mosquitoes breed in standing water.
    Vaccines are under development, but are not currently available or have limited availability outside of the US.

    RESOURCES

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

    Infectious Diseases Society of America http://www.idsociety.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

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

    References

    Dengue. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/dengue. Updated January 19, 2016. Accessed May 31, 2016.

    Dengue. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 8, 2016. Accessed May 31, 2016.

    Dengue. World Health Organization (WHO) website. Available at: http://www.who.int/topics/dengue/en. Accessed May 31, 2016.

    Dengue fever. National Institute of Allergy and Infectious Diseases website. Available at: http://www.niaid.nih.gov/topics/denguefever/Pages/default.aspx. Updated March 16, 2016. Accessed May 31, 2016.

    10/1/2013 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Reimer LJ, Thomsen EK, Tisch DJ, et al. Insecticidal bed nets and filariasis transmission in Papua New Guinea. N Eng J Med. 2013; 369(8):745-753.

    Revision Information

    • Reviewer: David Horn, MD
    • Review Date: 05/2016
    • Update Date: 05/31/2016
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