Dengue fever

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 4, 2016
StartDiseasesDengue fever

Dengue fever is a condition that is frequently found in parts of Asia and other tropical regions in the world. Most people experience symptoms for about a week, but some people develop life-threatening symptoms as a result of the infection. While a cure isn't available, treatment can help control the symptoms of dengue fever.

Contents

Definition & Facts

Dengue fever is a disease that is caused by one of four viruses. The viruses are transmitted by mosquito bites throughout tropical and subtropical regions of the world. Humans develop an immunity to the virus after being infected, but can still become infected with any one of the three remaining viruses that cause the disease.

After the first infection, people with additional infections are at a higher risk of developing dengue hemorrhagic fever. Dengue hemorrhagic fever is severe form of the disease, and other complications may develop as a result of this complication. Additionally, children under the age of one are most at-risk for complications.

Symptoms & Complaints

The first sign of dengue fever is a sudden, high grade fever and rash. The rash typically appears within two to five days, and may be followed by a second rash. General discomfort, headache, tiredness and skin sensitivity are common symptoms of dengue fever. Muscle pain and joint pain are usually present and may be severe enough to require medication. Nausea and vomiting frequently occur, and those with severe nausea or vomiting can easily become dehydrated.

Excessive sweating is also a common symptom of the virus. Nosebleeds and bleeding gums are distinctive symptoms of dengue fever. People who bleed easily as a result of the infection may also bruise easily.

A small number of people develop complications after becoming infected with dengue fever. Common complications include severe dehydration and febrile convulsions, which are seizures that are caused by a high fever. Febrile convulsions are most common in children under the age of five.

Rarely, dengue hemorrhagic fever develops in some people with dengue fever. The syndrome can cause damage to the lymph nodes or blood vessels in the body. Dengue hemorrhagic fever can be fatal if the disease progresses to dengue shock syndrome. The symptoms of dengue shock syndrome also include massive blood loss and shock.

Causes

Dengue fever is caused by the arbovirus. The virus requires a carrier, also called a vector, to transmit the disease to a person. The virus enters the body when a person is bitten by an infected mosquito. After the bite occurs, the virus spreads to the body's glands and enters the bloodstream.

The virus cannot be transmitted from person to person, but the host can spread the disease to multiple people. The mosquitoes that transmit the disease often thrive in densely populated areas where standing or stagnant water is present. Poor sanitation can cause outbreaks of dengue fever in tropical and subtropical regions. Children and those living in poverty-stricken areas are at the greatest risk of developing dengue fever, and are also at the greatest risk of developing complications as a result of the disease.

Diagnosis & Tests

Dengue fever is typically diagnosed by reviewing recent travel history and by the symptoms of the disease. The symptoms of dengue fever are very similar to other tropical diseases, such as malaria, making the disease difficult to positively identify unless distinctive symptoms are present. The most distinctive symptoms of dengue fever, such as a sudden, high fever and bleeding, are used to diagnose the disease in most cases.

Blood tests are also used to identify the virus. To positively identify the virus with a blood sample, the blood is tested for the presence of antibodies. Antibodies are cells that help fight disease in the body. Two kinds that the body produces to fight against dengue fever include immunoglobulin G (IgG) and immunoglobulin M (IgM). If the antibodies that fight dengue fever are present, the test is positive for the virus.

Rapid diagnostic tests are available in North America and in some regions where the virus is endemic. In regions where rapid tests aren't available, the symptoms of dengue fever are often resolved before the test results are available.

Treatment & Therapy

Currently, no cure exists for dengue fever and no medications are known to shorten the duration of the virus. The most common treatments for the disease include medications to reduce fever and pain. Those that are dehydrated often receive fluids through an IV, and people that experience blood loss may receive blood transfusions. Oxygen therapy and other therapies are provided to those who experience shock.

Bed rest, adequate fluids and over the counter or prescription medications are used to control mild or moderate symptoms of the disease. People with dengue fever should avoid ibuprofen, aspirin, naproxen and any other medicines that worsen bleeding. Acetaminophen is recommended to control fever and pain associated with dengue fever. Careful blood pressure monitoring is necessary for some people, and those with severe cases of dengue fever often require hospitalization.

Prevention & Prophylaxis

To prevent dengue fever, spend time outdoors when the mosquitoes are less active. If possible, sleep in a room with air conditioning while traveling in the affected regions, or sleep in rooms that are screened. Install mosquito netting around beds, and apply insect repellent to all exposed skin and clothing while spending time outdoors. Wear long-sleeved or protective clothing to further prevent the risk of mosquito bites.

Eliminate standing water outdoors, and clean pet dishes and other necessary items that hold water, such as bird baths, on a regular basis. Indoors, clean containers that hold water, such as vases, weekly. People who are diagnosed with dengue fever should remain indoors as much as possible, and the person should sleep under mosquito netting until the virus resolves. Sleeping under mosquito netting helps reduce the risk of transmitting the disease to others in the home and region.