Alternating decision trees for early diagnosis of dengue fever m. Dengue begins with a nonspecific, acute febrile illness lasting 2 to 7 days febrile phase, often accompanied by muscle, joint, andor bone pain, headache, retroorbital pain, facial erythema, injected oropharynx, macular or maculopapular rash, leukopenia, and petechiae or other minor bleeding manifestations. The goal of these tests is to provide early detection of the disease, distinguish between the different viral dengue, and predict which people are at highest risk of developing the more severe forms of. On the basis of these studies, revised guidelines on dhf were issued in. The emergence of a global health problem dengue and dengue hemorrhagic fever dhf are caused by one of four closely related, but antigenically distinct, virus serotypes den1, den2, den3, and den4, of the genus flavivirus 1.
The virus seems to have no detrimental effect on the mosquito, which remains infected for life. Dengue is a highly endemic infectious disease of the tropical countries and is rapidly becoming a global burden. Dengue presents initially as undifferentiated fever, with symptoms becoming more pathognomonic in. Treat the symptoms of dengue and see your healthcare provider. Leptospirosis and louseborne relapsing fever most closely mimic yellow fever and can manifest as jaundice, hemorrhage, and dic in severe cases. The size and spread of the dengue pandemic, the unpredict. Efficient and accurate diagnosis of dengue is of primary importance for clinical care i. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Jun 21, 2019 other viral hemorrhagic fevers with dengue and crimeancongo hemorrhagic fever being the most similar in presentation also remain among the differential diagnoses for severe yellow fever during the intoxication period and are important to consider, as they require unique isolation precautions. In 1927 and 1928, several outbreaks in greece and turkey affected more than a million people and killed up to 1500. Dengue is an endemic viral disease affecting tropical and subtropical regions around the world, predominantly in urban and semiurban areas. Dengue infectious diseases merck manuals professional edition. Combining igm and ns1 detection into one test, such as the dengue. Done given that dengue hemorrhagic fever now redirects here, perhaps we need a bit more information on the nature of the bleeding in dhf.
Infection may be asymptomatic or present with a broad range of clinical manifestations including a mild febrile illness to a lifethreatening shock syndrome. Feb 16, 2018 diagnosing dengue fever can be difficult, because its signs and symptoms can be easily confused with those of other diseases such as malaria, leptospirosis and typhoid fever. Description of the clinical picture of dengue hemorrhagic feverdengue shock syndrome dhfdss in adults. It can be lifethreatening, and are caused by four closely related virus serotypes of the genus flavivirus, family flaviviridae. Dengue fever is a mosquitoborne virus disease that has rapidly spread to several regions in recent times. Dengue fever can easily be confused with nondengue illnesses, particularly in nonepidemic situations. Dengue hemorrhagic fever and dengue shock syndrome some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and sometimes fatal form of the disease. We also provide relatively little information on the sites of fluid accumulation, e.
Systems are being developed that can combine environmental monitoring data on mosquito. Yellow fever is an haemorrhagic disease caused by a virus that belongs to the genus flavivirus flaviviridae family and is transmitted by mosquitoes. If you think you have dengue pdf icon pdf 1 page see a healthcare provider if you develop a fever or have symptoms of dengue. Mosquitoborne dengue fever threat spreading in the americas. Dengue, management, diagnosis, fever, nausea and vomiting, rash, aches and pains, headache, eye pain, muscle ache or joint pain, warning signs, tourniquet test positive, leukopenia, abdominal pain or tenderness, persistent vomiting, mucosal bleed. Dengue fever df and its more serious forms, dengue hemorrhagic fever dhf and dengue shock syndrome dss, are becoming important public health problems and were formally included within the disease portfolio of the united nations development programme. There are four dengue virus denv types denv1, denv2, denv3, and denv4, all of which are capable of inducing severe disease dengue hemorrhagic fever dhf dengue shock syndrome dss. For patients with suspected dengue virus disease, naats are the preferred method of laboratory diagnosis. Defi niti on dengue fever and dengue hemorrhagic fever dhf are acute febrile diseases transmitted by mosquitoes, which occur in the tropics. Dengue presents initially as undifferentiated fever, with symptoms. Niaidsupported scientists are working to understand the pathology of dengue disease and to develop costeffective, sensitive, and specific diagnostic tests for use in dengue endemic countries. Pdf infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms. Dengue fever 3 associated problems dengue can occasionally affect several other body systems,15 either in isolation or along with the classic dengue symptoms.
Evaluation of the ns1 rapid test and the who dengue classification schemes for use as bedside diagnosis of acute dengue fever in adults. Current and historical conditions indexed list of current and historical nationally notifiable conditions. Fever, body aches, gastro intestinal symptoms, headache, and skin rash and chest symptoms. Symptoms typically begin three to fourteen days after infection. Baculovirus are one of the most popular and efficient eukaryotic expression system. Alternating decision trees for early diagnosis of dengue fever. Dengue is now endemic in more than 100 countries, including pakistan. Diagnosis and characterization of dengue fever in children the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Naats should be performed on serum specimens collected 7 days or less after symptom onset. An estimated 50 million dengue infections occur annually. Aedes aegypti prefers to lay its eggs in artificial water containers, to live in close proximity to humans, and to feed off people rather than other vertebrates. Author summary dengue is a reemerging disease caused by dengue viruses denv and half of the worlds population is now at risk of dengue infection. Dengue fever breakbone, dengue hemorrhagic fever dengue fever is a mosquitoborne disease caused by one type of dengue virus.
Currently, there is no vaccine available for the prevention of dengue virus infection due to four viral serotypes. May 03, 2019 evaluation of the ns1 rapid test and the who dengue classification schemes for use as bedside diagnosis of acute dengue fever in adults. Dengue fever is a disease spread by the aedes aegypti mosquito and caused by one of four dengue viruses that are closely related. Dengue virus denv have progressively spread geographically throughout the tropics, resulting in a global pandemic with tens of millions of infections annually, including several hundred thousand hospitalizations for dengue hemorrhagic fever dhf and dengue shock syndrome dss 1. Can result in death with dengue hemorrhagic fever, which primarily affects children. Be sure to describe international trips in detail, including the countries you visited and the dates. During fever defervescence, usually on days 37 of illness, an increase in vascular. The threat of dengue in europe has increased in the last few years. Serum metabolome changes in adult patients with severe. Infection with one of these serotypes does not provide cross. However, major uncertainties exist in dengue diagnosis and this has. Primarily tropical but spreads to other areas in summer. Clinical and laboratory diagnosis of dengue virus infection oxford. Guide for diagnosis, surveillance, prevention and control of dengue haemorrhagic fever was published in 1975.
The affected patients usually present with high fever almost all cases 28 and present a positive tourniquet test. Dengue is a febrile illness caused by a flavivirus transmitted by aedes aegypti or aedes albopictus mosquitoes while taking a blood meal. Dengue fever, also known as breakbone fever, is a mosquitoborne infectious tropical disease caused by the dengue virus. The endemic area for dengue fever extends over 60 countries, and approximately 2. Dengue virus infection is a serious health problem infecting 2. Listing a study does not mean it has been evaluated by the u. Your doctor will likely ask about your medical and travel history. Health experts have known about dengue fever for more than 200 years. Mar 12, 2020 dengue is an infection caused by a virus. In a small proportion of cases, the disease develops into severe dengue, also known as dengue. The molecular mechanisms that trigger transition from df to dhf are not well understood. This disease used to be called breakbone fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking.
Dengue infection can cause death of patients in its. Niaidsupported scientists are working to understand the pathology of dengue disease and to develop costeffective, sensitive, and specific diagnostic tests for use in dengueendemic countries. Symptoms include fever, headache, muscle and joint pains, and a. Department of health and human services centers for. Dengue fever is a virus transmitted to humans through bites from the aedes mosquito, a daybiting mosquito. Sponge patients skin with tepid water when temperature is high. Diagnosis and characterization of dengue fever in children. It is caused by any of the 4 serotypes of dengue virus and is transmitted within humans through female aedes mosquitoes. Among the viral proteins, the envelope protein e is the most studied one, due to its high antigenic potencial. The disease is often diagnosed incorrectly because the symptoms are similar to influenza and other viruses. The viruses that cause dengue fever are related to those that.
Dengue virus is found in many tropical parts of the world including the caribbean, central and south america, asia and africa. It is also known as breakbone fever, since it can be extremely painful. There are four dengue virus denv types denv1, denv2, denv3, and denv4, all of which are capable of inducing severe disease dengue hemorrhagic fever dhfdengue shock syndrome dss. Based on its clinical presentation, yellow fever may be mistaken for other infectious diseases present in tropical regions. Dengue fever must be considered in the differential diagnosis of a patient presenting with an encephalopathy of unknown etiology, in an area where the a. Clinical and serologic study of cuban children with dengue hemorrhagic feverdengue shock syndrome dhfdss. You can help us to reduce the impact of dengue fever by playing your part in a global effort to map the disease. Early diagnosis of dengue, the most common mosquitoborne disease globally, remains challenging. Merging this number with the average annual number of officially. Laboratory test for the diagnosis of dengue ecovec.
Dengue management dos and donts x dont use corticosteroids. Control the fever give acetaminophen every 6 hours maximum 4 doses per day. Dengue presents initially as undifferentiated fever, with symptoms becoming more. Around the time the fever begins to subside usually 37 days after symptom onset, the patient may develop warning signs of severe disease. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. The regions also supported research on the pathophysiology and clinical and laboratory diagnosis of dengue. Jacques joubert, craig barnett, in neuroepidemiology in tropical health, 2018. Dengue fever df and its more serious forms, dengue hemorrhagic fever dhf and dengue shock syndrome dss, are becoming important public health problems and were formally included within the disease portfolio of the united nations development. Dengue, also known as breakbone fever, is the fastest spreading vectorborne viral infection transmitted between humans by the female aedes aegypti ae mosquito. Since the second edition of dengue haemorrhagic fever. Clinical features and pitfalls in the laboratory diagnosis of dengue in travellers. Done agree and have merged all content was basically covered here. Each year hundreds of people get infected with dengue in pakistan.
Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. Pdf clinical and laboratory diagnosis of dengue virus infection. Laboratory diagnosis and diagnostic tests dengue ncbi. Dengue red book 2015 red book online aap pointofcare. Dengue fever usually results in abrupt onset of high fever, headache, myalgias, arthralgias, and generalized lymphadenopathy, followed by a rash that appears with a 2nd temperature rise after an afebrile period. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. Introduction dengue is the most rapidly spreading mosquito borne viral disease in the world. Dengue is a febrile illness caused by infection with one of four dengue viruses denv transmitted by aedes aegypti or aedes albopictus mosquitoes during the taking of a blood meal. Characterization of dengue infections by using hematological and. Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. Dengue hemorrhagic fever is a rare but more severe form of dengue infection that can be fatal if not recognized and treated with supportive care. Laboratory confirmation can be made from a single acutephase serum specimen obtained early. On the basis of these studies, revised guidelines on dhf were issued in 1980, 1986 and 1998.
The incidence of dengue has multiplied many times over the last five. Do not give ibuprofen, aspirin, or aspirin containing drugs. Dengue disease varies from mild fever to severe conditions of dengue hemorrhagic fever and shock syndrome. Yellow fever virus envelope protein expressed in insect. Wichmann o, stark k, shu py, niedrig m, frank c, huang jh. Denv can cause a spectrum of clinical manifestations ranging from mild dengue fever df to the potentially lethal dengue hemorrhagic fever dhf. Until 1930, dengue fever was endemic in the countries of southern europe where the vector ae. Dengue and dengue hemorrhagic fever in the americas. Dengue is a mosquitoborne disease caused by a flavivirus. Done im not sure why dengue shock syndrome has its own page, while dengue virus is discussed in this article. Jul 24, 2009 diagnosis and characterization of dengue fever in children the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Diagnosing dengue fever can be difficult, because its signs and symptoms can be easily confused with those of other diseases such as malaria, leptospirosis and typhoid fever. Dengue fever is common in tropical areas, so take extra precautions if you travel somewhere with this type of climate.