Notifiable condition in the US. 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 120 countries, particularly the Southeast Asian and Western Pacific regions, the Caribbean, Latin America, and some regions in the US, Africa, and Middle East.
Severe dengue fever is characterized by marked thrombocytopenia, severe hemorrhage, 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 has been approved in some countries. Other 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. Dengue virus infection causes a wide range of severe and nonsevere clinical manifestations.
History and exam
- residence in/travel from dengue-endemic region within the past 2 weeks
- skin flushing/rash
- hemorrhagic signs
- abdominal distention
- pleuritic chest pain, dyspnea, cough
- signs of circulatory collapse
S.A.M. Kularatne, MBBS, MD, MRCP (UK), FRCP (London), FCCP (SL)
Chair of Medicine
Department of Medicine
Faculty of Medicine
University of Peradeniya
SAMK is an author of several references cited in this monograph.
John McBride, PhD, MBBS, DTM&H, FRACP, FRCPA
Professor of Medicine
James Cook University
Cairns Base Hospital Clinical School
JM declares that he has no competing interests.
Michael Jacobs, MA, PhD, MBBS, FRCP, DTM&H
Royal Free Hampstead NHS Trust
MJ declares that he has no competing interests.
Stephen Gluckman, MD
Professor of Medicine
Penn Global Medicine
Penn Center for Primary Care
SG declares that he has no competing interests.
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