OVERVIEWDengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called "break-bone" fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking, hence the name. Health experts
have known about dengue fever for more than 200 years. Worldwide, more than 100 million cases of dengue infection occur each year.
CAUSEDengue fever can be caused by any one of four types of dengue virus: DEN-1, DEN-2, DEN-3, and DEN-4. You can be infected by at least two, if not all four types at different times during your lifetime, but only once by the same type.
TRANSMISSIONYou can get dengue virus infections from the bite of an infected Aedes mosquito. Mosquitoes become infected when they bite infected humans, and later transmit infection to other people they bite. Two main species of mosquito, Aedes aegypti and Aedes albopictus, have been responsible for all cases of dengue transmitted in this country. Dengue is not contagious from person to person.
SYMPTOMSSymptoms of typical uncomplicated (classic) dengue usually start with fever within 5 to 6 days after you have been bitten by an infected mosquito and include
• High fever, up to 105 degrees Fahrenheit
• Severe headache
• Retro-orbital (behind the eye) pain
• Severe joint and muscle pain
• Nausea and vomiting
• Rash
The rash may appear over most of your body 3 to 4 days after the fever begins. You may get a second rash later in the disease.
Symptoms of dengue hemorrhagic fever include all of the symptoms of classic dengue plus
• Marked damage to blood and lymph vessels
• Bleeding from the nose, gums, or under the skin, causing purplish bruises This form of dengue disease can cause death. Symptoms of dengue shock syndrome-the most severe form of dengue disease-include all of the symptoms of classic dengue and dengue hemorrhagic fever, plus
• Fluids leaking outside of blood vessels
• Massive bleeding
• Shock (very low blood pressure)
This form of the disease usually occurs in children (sometimes adults) experiencing their second dengue infection. It is sometimes fatal, especially in children and young adults.
DIAGNOSISYour health care provider can diagnose dengue fever by doing two blood tests, 2 to 3 weeks apart. The tests can show whether a sample of your blood contains antibodies to the virus. In epidemics, a health care provider often can diagnose dengue by typical signs and symptoms.
TREATMENTThere is no specific treatment for classic dengue fever, and like most people you will recover completely within 2 weeks. To help with recovery, health care experts recommend
• Getting plenty of bed rest
• Drinking lots of fluids
• Taking medicine to reduce fever
CDC advises people with dengue fever not to take aspirin. Acetaminophen or other over-thecounter pain-reducing medicines are safe for most people. For severe dengue symptoms, including shock and coma, early and aggressive emergency treatment with fluid and electrolyte replacement can be lifesaving.
PREVENTIONThe best way to prevent dengue fever is to take special precautions to avoid contact with mosquitoes. Several dengue vaccines are being developed, but none is likely to be licensed by the Food and Drug Administration in the next few years. When outdoors in an area where dengue fever has been found
• Use a mosquito repellant containing DEET, picaridin, or oil of lemon eucalyptus
• Dress in protective clothing-long-sleeved shirts, long pants, socks, and shoes
Because Aedes mosquitoes usually bite during the day, be sure to use precautions especially during early morning hours before daybreak and in the late afternoon before dark. Other precautions include
• Keeping unscreened windows and doors closed
• Keeping window and door screens repaired
• Getting rid of areas where mosquitoes breed, such as standing water in flower pots, containers, birdbaths, discarded tires, etc.
COMPLICATIONSMost people who develop dengue fever recover completely within 2 weeks. Some, however, may go through several weeks to months of feeling tired and/or depressed.
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