Dengue Fever

About Dengue Fever

Dengue fever, transmitted by Aedes aegypti and Aedes albopictus mosquitoes, is the most rapidly spreading mosquito borne viral disease. Approximately half the global population lives in dengue endemic areas, with an estimated 100 to 400 million infections annually. The disease was first described by Benjamin Rush during a Philadelphia epidemic in 1780. Classic dengue fever presents with sudden high fever up to 40C 104F, severe headache typically behind the eyes retro orbital pain, muscle and joint pain breakbone fever, nausea, vomiting, rash, and mild bleeding nosebleeds, gum bleeding. Symptoms last approximately 2 to 7 days. A small percentage of cases progress to severe dengue dengue hemorrhagic fever or dengue shock syndrome when plasma leakage occurs, usually around the time the fever breaks defervescence. Warning signs include severe abdominal pain, persistent vomiting, bleeding gums, blood in vomit or stool, drowsiness, restlessness, liver enlargement, and rapid breathing. These indicate possible plasma leakage and are a medical emergency; call your local emergency number or seek emergency care. Severe dengue can cause shock and death within hours if untreated. Diagnosis is made through NS1 antigen test in the first 5 days or IgM antibody test after day 5. There are four dengue serotypes DENV 1 to 4, and infection with one serotype provides lifelong immunity to that serotype but increases severity of subsequent infection with a different serotype through antibody dependent enhancement ADE. The Dengvaxia vaccine is only for people with previous dengue infection, and its manufacturer has been discontinuing it. The Qdenga vaccine TAK 003 was first licensed in 2022 and is approved in a number of countries. No specific antiviral treatment exists. Management is supportive with careful fluid management in severe cases, and aspirin and other NSAIDs are generally avoided because of bleeding risk.