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Dengue hemorrhagic fever

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Illustrations

Mosquito, adult feeding on the skin
Mosquito, adult feeding on the skin
Mosquito, adult
Mosquito, adult
Mosquito, egg raft
Mosquito, egg raft
Mosquito, larvae
Mosquito, larvae
Mosquito, pupa
Mosquito, pupa
Antibodies
Antibodies

Alternative names    Return to top

Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever

Definition    Return to top

Dengue hemorrhagic fever is a severe, potentially fatal infection that occurs when someone with immunity to one type of Dengue virus is infected by a different type. It is spread by certain mosquitoes (Aedes aegypti) that bite primarily during the day. See also Dengue fever.

Causes, incidence, and risk factors    Return to top

Four different Dengue viruses have been implicated in both Dengue fever and Dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when the patient contracts a different Dengue virus after previous infection(s) by another type. Prior immunity to a different Dengue virus type is important in the production of this severe disease.

Worldwide, more than 100 million cases of dengue fever occur every year. A small percent of these develop into Dengue hemorrhagic fever. Most cases in the U.S. are brought in from other countries. It is possible for a traveler who has returned to the United States to pass the infection to someone who has not traveled.

Risk factors for Dengue hemorrhagic fever include having antibodies to dengue virus from prior infection and being younger than 12, female, or Caucasian.

Symptoms    Return to top

Early symptoms of Dengue hemorrhagic fever are similar to those of Dengue fever, but after several days the patient becomes irritable, restless, and sweaty. These symptoms are followed by a shock-like state.

Bleeding may appear as pinpoint spots of blood on the skin (petechiae) and larger patches of blood under the skin (ecchymoses). Bleeding may occur from minor injuries.

Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.

Early symptoms include the following:

Acute phase symptoms include the following:

Signs and tests    Return to top

Physical examination may reveal the following: Tests may include the following:

Treatment    Return to top

Because Dengue hemorrhagic fever is caused by a virus for which there is no known cure or vaccine, the only treatment is to treat the symptoms.

Expectations (prognosis)    Return to top

With early and aggressive care, most patients recover from Dengue hemorrhagic fever. However, half of untreated patients who go into shock do not survive.

Complications    Return to top

Calling your health care provider    Return to top

Call your health care provider if you have symptoms of Dengue fever and have been in an area where Dengue fever is known to occur.

Prevention    Return to top

There is no vaccine available to prevent Dengue fever. Use personal protection such as full-coverage clothing, mosquito repellent containing DEET, and netting, and travel during periods of minimal mosquito activity if possible. Mosquito abatement programs can also reduce the risk of infection.

Update Date: 12/27/2002

Updated by: Eleftherios Mylonakis, M.D., Division of Infectious Disease, Massachusetts General Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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