Dengue fever is a mosquito-borne viral infection that is common in tropical and subtropical regions around the world (mostly in urban areas). It is caused by the dengue virus, of which there are four different serotypes (DEN-1, DEN-2, DEN-3, DEN-4), and it is transmitted by the Aedes mosquitoes, primarily Aedes aegypti. It is estimated that there are over 5 million cases per year.
Clinical Features:
Symptoms appear most commonly 4-7 days after bite and vary widely, from asymptomatic to mild symptoms to severe dengue, which can be life-threatening.
The most common symptoms include: high fever (usually acute onset); headache, especailly pain behind the eyes; joint and muscle pain; fatigue; nausea; vomiting; skin itching and rash (appears 2-5 days after the onset of fever); mild bleeding (eg nose or gum bleed); easy bruising.
Most cases get better in 1-2 weeks.
Severe dengue (dengue hemorrhagic fever) (about 5% of cases) symptoms include: severe abdominal pain; persistent vomiting; rapid and shallow breathing; bleeding gums; dehydration; fatigue; blood in the vomit or stools; internal bleeding (can lead to shock and be fatal).
Diagnosis is usually based on symptoms and laboratory tests.
Musculoskeletal symptoms:
Most commonly: arthralgia (usually ankles, knees, and elbows), myalgia (95%), myositis and hypokalemia (some will develop hypokalemic periodic paralysis).
Muscle pain may persist following recovery from acute phase.
Treatment:
Supportive care to manage symptoms: hydration; pain relief (eg acetaminophen).
Hospitalization in severe cases to manage fluids and electrolyte balance.
Prevention:
Public health measures consist of education and measures to control the mosquito population (eg sanitation; removal of standing water; spraying programs).
Personal prevention is to prevent mosquito bite: using mosquito repellent; wearing long-sleeved shirts and long pants; using window and door screens; sleeping under mosquito nets.
Dengvaxia® dengue vaccine: only recommended for children 9 through 16 years old only when they have been previously infected with dengue and they live in areas where dengue is common.
Qdenga vaccine can be used for those who have not been previously infected.
Dengue Fever Infographic
Severs Disease and Dengue Fever:
Case report by Ahsan et al (2025) reported a case of Severs disease in a 11 year old boy with dengue fever. It is not clear if the finding of Sever’s disease is a manifestation of the enthesitis that may sometime happen in an infectious disease or if its just a coincidental finding occurring at the same time as the Dengue fever.
Other viral hemorrhagic fevers:
| Arenaviridae: | Bunyaviridae: | Filoviridae: | Flaviviridae: |
| Chapare hemorrhagic fever | Crimean-Congo hemorrhagic fever | Ebola | Dengue fever |
| Venezuelan hemorrhagic fever | Hemorrhagic fever with renal syndrome | Marburg hemorrhagic fever | Kyasanur forest disease |
| Argentine hemorrhagic fever | Rift Valley fever | Omsk hemorrhagic fever | |
| Lassa fever | Hantavirus pulmonary syndrome | Yellow fever | |
| Lujo hemorrhagic fever | Severe fever and thrombocytopenia syndrome | ||
| Lymphocytic choriomeningitis |
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