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Dengue Fever(Break Bone Fever)

Pronounced: Deng-ay

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.

You should contact your doctor immediately if you suspect that you have dengue fever.

Causes

Dengue fever is caused by one of four 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

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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 very mild symptoms. Primary symptoms are a high fever and at least two 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 nose or gum
  • Easy bruising
  • Nausea/vomiting

The fever tends to decline within 3-7 days after symptoms begin. As the fever decreases, warning signs of a severe infection may appear. Warning signs can include:

  • Severe abdominal pain
  • Persistent vomiting
  • Uncontrolled bleeding from gums or nose
  • Black tarry stool or blood in urine
  • Lethargy or restlessness
  • Difficulty breathing
  • Pale, cold, or clammy
  • Lightheadedness

A severe infection can lead to shock and organ failure.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will also ask about recent travel to high-risk areas.

Blood tests may be done to look for:

  • Dengue virus antibodies—a sign that the body has recognized and is attempting to fight the virus
  • Presence of dengue virus in the bloodstream
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:

  • Bedrest—Your body will need rest while you recover from your illness.
  • Hydrate—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.
  • Acetaminophen may be recommended to treat pain and fever. Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) are generally not recommended. 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 repellants 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.

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 (CDC) website. Available at: http://www.cdc.gov/dengue. Updated December 31, 2013. Accessed June 19, 2014.

Dengue. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 12, 2014. Accessed June 19, 2014.

Dengue. World Health Organization (WHO) website. Available at: http://www.who.int/topics/dengue/en. Accessed June 19, 2014.

Dengue fever. National Institute of Allergy and Infectious Diseases website. Available at: http://www.niaid.nih.gov/topics/denguefever/Pages/default.aspx. Accessed June 19, 2014.

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



Last reviewed May 2014 by David L. Horn, MD, FACP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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