Dengue

"Dengue Fever" redirects here. For the band of the same name, see Dengue Fever
(band).

Dengue fever (pronounced UK: /ˈdɛŋɡeɪ/, US: /ˈdɛŋɡiː/) and dengue hemorrhagic
fever (DHF) are acute febrile diseases which occur in the tropics, can be life-threatening,
and are caused by four closely related virus serotypes of the genus Flavivirus, family
Flaviviridae.[1] It is also known as breakbone fever. It occurs widely in the tropics,
including northern Argentina, northern Australia, the entirety of Bangladesh, Barbados,
Bolivia[2], Brazil, Cambodia, Costa Rica, Dominican Republic, Guatemala, Guyana,
Honduras, India, Indonesia, Jamaica, Laos, Malaysia, Mexico, Micronesia, Pakistan,
Panama, Paraguay[3], Philippines, Puerto Rico, Samoa[4], Singapore, Sri Lanka, Suriname,
Taiwan, Thailand, Trinidad, Venezuela and Vietnam, and increasingly in southern
China[5]. Unlike malaria, dengue is just as prevalent in the urban districts of its range as in
rural areas. Each serotype is sufficiently different that there is no cross-protection and
epidemics caused by multiple serotypes (hyperendemicity) can occur. Dengue is
transmitted to humans by the Aedes aegypti or more rarely the Aedes albopictus
mosquito, which feed during the day.[6]

The WHO says some 2.5 billion people, two fifths of the world's population, are now at
risk from dengue and estimates that there may be 50 million cases of dengue infection
worldwide every year. The disease is now endemic in more than 100 countries.[7]

Signs and symptoms

The disease manifests as a sudden onset of severe headache, muscle and joint pains
(myalgias and arthralgias—severe pain that gives it the nickname break-bone fever or
bonecrusher disease), fever, and rash.[8] The dengue rash is characteristically bright red
petechiae and usually appears first on the lower limbs and the chest; in some patients, it
spreads to cover most of the body. There may also be gastritis with some combination of
associated abdominal pain, nausea, vomiting, or diarrhea.

Some cases develop much milder symptoms which can be misdiagnosed as influenza or
other viral infection when no rash is present. Thus travelers from tropical areas may pass
on dengue inadvertently, having not been properly diagnosed at the height of their illness.
Patients with dengue can pass on the infection only through mosquitoes or blood products
and only while they are still febrile. The classic dengue fever lasts about two to seven
days, with a smaller peak of fever at the trailing end of the disease (the so-called
"biphasic pattern"). Clinically, the platelet count will drop until the patient's temperature
is normal. Cases of DHF also show higher fever, variable hemorrhagic phenomena,
thrombocytopenia, and hemoconcentration. A small proportion of cases lead to dengue
shock syndrome (DSS) which has a high mortality rate.