Dengue fever

Dengue fever is a notifiable disease. In dengue-endemic regions, suspected, probable, and confirmed cases of dengue infection should be reported to the relevant authorities as soon as possible.

Endemic in more than 100 countries, including countries in the Southeast Asian and Western Pacific regions, the Americas, Africa, and the Eastern Mediterranean. Asia represents approximately 70% of the global burden of disease.

Severe dengue fever is characterised by marked thrombocytopenia, severe haemorrhage, plasma leakage leading to shock or fluid accumulation with respiratory distress, and severe organ impairment.

Confirmatory tests include viral antigen or nucleic acid detection and serology. Difficult to distinguish clinically from Zika and chikungunya virus infections without diagnostic testing.

No specific antiviral agent has been developed. Meticulous fluid therapy and the identification of the critical phase are the most important aspects of management.

A tetravalent vaccine is available in approximately 20 countries. Multiple vaccine candidates are currently in clinical development.

A globally important arboviral infection transmitted by the Aedes genus of mosquito (primarily Aedes aegypti, but also A albopticus), an insect found in tropical and subtropical regions of the world. There are 4 antigenically distinct dengue virus serotypes: DENV-1, DENV-2, DENV-3, and DENV-4. They are RNA viruses that belong to the Flavivirus genus/Flaviviridae family, which also includes yellow fever virus, West Nile virus, Japanese encephalitis virus, Zika virus, and the St Louis encephalitis virus.[1]World Health Organization, Regional Office for South-East Asia. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever - revised and expanded edition. 2011 [internet publication]. https://apps.who.int/iris/handle/10665/204894 Dengue virus infection causes a wide range of severe and non-severe clinical manifestations.[2]World Health Organization, Special Programme for Research and Training in Tropical Diseases (TDR). Dengue: guidelines for diagnosis, treatment, prevention and control. New edition. 2009 [internet publication]. http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf