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A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011.

A.D.A.M. Medical Encyclopedia.

Dengue fever

O'nyong-nyong fever; Dengue-like disease; Breakbone fever

Last reviewed: August 24, 2011.

Dengue fever is a virus-caused disease that is spread by mosquitoes.

See also: Dengue hemorrhagic fever

Causes, incidence, and risk factors

Dengue fever is caused by one of four different but related viruses. It is spread by the bite of mosquitoes, most commonly the mosquito Aedes aegypti, which is found in tropic and subtropic regions. This includes parts of:

  • Indonesian archipelago into northeastern Australia

  • South and Central America

  • Southeast Asia

  • Sub-Saharan Africa

  • Some parts of the Caribbean

Dengue fever is being seen more often in world travelers.

Dengue fever should not be confused with Dengue hemorrhagic fever, which is a separate disease that is caused by the same type of virus but has much more severe symptoms.

Symptoms

Dengue fever begins with a sudden high fever, often as high as 104 - 105 degrees Fahrenheit, 4 to 7 days after the infection.

A flat, red rash may appear over most of the body 2 - 5 days after the fever starts. A second rash, which looks like the measles, appears later in the disease. Infected people may have increased skin sensitivity and are very uncomfortable.

Other symptoms include:

Signs and tests

Tests that may be done to diagnose this condition include:

  • Antibody titer for dengue virus types

  • Complete blood count (CBC)

  • Polymerase chain reaction (PCR) test for dengue virus types

Treatment

There is no specific treatment for dengue fever. You will need fluids if there are signs of dehydration. Acetaminophen (Tylenol) is used to treat a high fever. Avoid taking aspirin.

Expectations (prognosis)

The condition generally lasts a week or more. Although uncomfortable, dengue fever is not deadly. People with the condition should fully recover.

Complications

Calling your health care provider

Call your health care provider if you have traveled in an area where dengue fever is known to occur and have developed symptoms of the disease.

Prevention

Clothing, mosquito repellent, and netting can help reduce exposure to mosquitoes. Traveling during periods of minimal mosquito activity can also be helpful.

Mosquito abatement programs may reduce the risk of infection.

References

  1. Naides SJ. Arthropod-borne viruses causing fever and rash syndromes. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 390.
  2. Vaughn DW, Barrett A, Solomon T. Flaviviruses (yellow fever, dengue dengue hemorrhagic fever, Japanese encephalitis, West Nile encephalitis, St. Louis encephalitis, tick-borne encephalitis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone: 2009:chap 153.

Review Date: 8/24/2011.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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What works?

  • No good evidence that corticosteroids are helpful in dengue shock syndrome No good evidence that corticosteroids are helpful in dengue shock syndrome
    The dengue virus is transmitted by mosquitoes and can cause either a mild illness with fever or a more severe illness with fever and bleeding (dengue haemorrhagic fever). The bleeding is generally seen as tiny red spots on the skin but can occasionally be more severe affecting the nose, gums, and gut. In its most severe form it can cause shock, collapse, and sometimes death (dengue shock syndrome). The current treatment for dengue shock syndrome is to give fluids directly into the bloodstream, but corticosteroids have been suggested as drugs that may help due to their anti‐inflammatory properties. This review of trials found only four small trials (with 284 participants) that were not of good quality and which showed no benefit overall. Further trials would be needed before this drug were used in these patients, as there is the potential for adverse effects due to the drugs' properties of suppressing the immune system and potentially leaving people open to other infections.
See all (1)...

Figures

  • Mosquito, adult feeding on the skin.
    Dengue fever.

Drugs of interest

  • Acetaminophen
    Acetaminophen is used to relieve mild to moderate pain from headaches, muscle aches, menstrual periods, colds and sore throats, toothaches, backaches, and reactions to vaccinations (shots), and to reduce fever. Acetaminophen may also be used to relieve the pain of osteoarthritis (arthritis caused by the breakdown of the lining of the joints). Acetaminophen is in a class of medications called analgesics (pain relievers) and antipyretics (fever reducers). It works by changing the way the body senses pain and by cooling the body.
  • Aspirin
    Prescription aspirin is used to relieve the symptoms of rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), osteoarthritis (arthritis caused by breakdown of the lining of the joints), systemic lupus erythematosus (condition in which the immune system attacks the joints and organs and causes pain and swelling) and certain other rheumatologic conditions (conditions in which the immune system attacks parts of the body). Nonprescription aspirin is used to reduce fever and to relieve mild to moderate pain from headaches, menstrual periods, arthritis, colds, toothaches, and muscle aches. Nonprescription aspirin is also used to prevent heart attacks in people who have had a heart attack in the past or who have angina (chest pain that occurs when the heart does not get enough oxygen). Nonprescription aspirin is also used to reduce the risk of death in people who are experiencing or who have recently experienced a heart attack. Nonprescription aspirin is also used to prevent ischemic strokes (strokes that occur when a blood clot blocks the flow of blood to the brain) or mini-strokes (strokes that occur when the flow of blood to the brain is blocked for a short time) in people who have had this type of stroke or mini-stroke in the past. Aspirin will not prevent hemorrhagic strokes (strokes caused by bleeding in the brain). Aspirin is in a group of medications called salicylates. It works by stopping the production of certain natural substances that cause fever, pain, swelling, and blood clots. Aspirin is also available in combination with other medications such as antacids, pain relievers, and cough and cold medications. This monograph only includes information about the use of aspirin alone. If you are taking a combination product, read the information on the package or prescription label or ask your doctor or pharmacist for more information.

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