Dengue

Overview

Dengue is a viral infection spread by mosquito bites. Most people who get it have mild symptoms such as fever, headache, and muscle aches. Some people can develop a severe form of dengue that needs urgent hospital care.

Dengue is very common in tropical and subtropical areas of the world, including parts of South and Southeast Asia, Latin America, the Caribbean, and Africa. It can also occur in travel destinations and, less often, in Europe and the United States.

Anyone can get dengue if they are bitten by an infected mosquito. People living in or traveling to affected areas are at risk. Children, older people, and those with a previous dengue infection can be more likely to develop severe disease.

Symptoms

Common symptoms

• High fever that starts suddenly
• Severe headache, often behind the eyes
• Pain in muscles and joints (sometimes called 'breakbone fever')
• Nausea and vomiting
• Tiredness and weakness
• A red rash that may appear on the body and legs

Symptoms in children

• Mild fever and irritability
• Poor appetite and less interest in playing
• A rash, sometimes with small red spots
• Children with severe dengue may become drowsy, restless, or have severe stomach pain

Symptoms in older adults

• Fever may be less obvious
• Drowsiness or confusion
• Dizziness and low energy
• Severe abdominal pain or bleeding signs appear more quickly than in younger adults

Causes

Main causes

• Dengue is caused by the dengue virus, which has four different types (serotypes).
• It spreads through the bite of an infected Aedes mosquito, most often Aedes aegypti.
• These mosquitoes usually bite during the daytime, especially around dusk and dawn.
• The mosquito picks up the virus when it bites a person who already has dengue, then passes it on to the next person it bites.

Risk factors

• Living in or traveling to tropical and subtropical regions where dengue is common.
• Having had dengue before — a second infection can raise the risk of severe dengue.
• Being an infant, child, pregnant woman, or an older adult.
• Urban areas with poor water drainage and lots of standing water, where mosquitoes breed.

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you or your child have any warning signs, such as severe stomach pain, repeated vomiting, drowsiness, bleeding, or feeling very ill.

Book a routine appointment if:

• Make an appointment to see a doctor if you have a fever and have recently visited a dengue area, or if your symptoms are not improving after a few days.

Diagnosis

A doctor will ask about your symptoms, recent travel, and whether you have been in areas with dengue. If dengue is possible, they will arrange a blood test to confirm the infection.

Tests that may be done

• A blood test that looks for the dengue virus or proteins (antibodies) your immune system makes to fight it.
• A full blood count to check the level of blood-clotting cells (platelets) and to help doctors decide if you need hospital care.
• Sometimes tests to check how well your liver is working.

What to expect at your appointment

The doctor will explain your results and what they mean. If you are showing warning signs, they may recommend hospital care. If not, they will give you advice on how to recover safely at home and what symptoms to watch for.

Treatment

There is no specific medicine to kill the dengue virus. Treatment focuses on supporting the body while it fights the infection: managing fever, preventing dehydration, and watching for warning signs.

Self-care at home

• Rest as much as you can while you have a fever.
• Drink plenty of fluids, such as water, soup, or oral rehydration drinks (available from your pharmacist).
• Use a cool, damp cloth on your forehead and body to help lower fever.
• For pain and fever relief, ask your doctor or pharmacist what is safe for you to take.
• Do not take medicines that have not been recommended by a healthcare professional, as some can increase the risk of bleeding.

Medical treatments

If dengue becomes severe, treatment in hospital is given under medical supervision. This may include fluids through a drip (intravenous fluids), close monitoring of blood pressure and blood counts, and supportive care to help the body recover. Medicines are used only to manage symptoms, as prescribed by a doctor.

When is surgery considered?

Surgery is not used to treat dengue.

Living with this condition

During the illness, stay at home and rest. Drink plenty of fluids throughout the day, even if you are not thirsty. Use a mosquito net or repellent so you do not get bitten — a person with dengue can pass the virus to mosquitoes, which could then spread it to others.

Lifestyle tips

• Get plenty of sleep and avoid strenuous activity while you are unwell.
• Take cool showers or apply a cool cloth to keep fever down.
• Keep yourself comfortable — light clothing and a quiet room can help.
• Avoid alcohol and smoking, as they can make dehydration and recovery harder.

Diet and exercise

Eat light meals if you can, such as soups, rice, fruits, and vegetables. Drink fluids often — water is best. Do not overdo exercise; wait until health returns and you have your doctor's okay.

Mental health and emotional wellbeing

Being ill for a week or more can feel exhausting and worrying. You may feel anxious about symptoms getting worse. This is a normal reaction. Talk to your doctor or a trusted family member if you feel overwhelmed.

Prevention

Yes. The best way to prevent dengue is to avoid mosquito bites and stop mosquitoes from breeding around your home.

Vaccines

There is a dengue vaccine available in some countries, but it is not suitable for everyone and is not widely used for short-term travelers. Talk to your doctor about whether the vaccine is appropriate for you, especially if you live in or often travel to high-risk areas.

Screening programmes

Routine screening for dengue is not usually done for healthy people. Blood tests are used only when someone has symptoms and dengue is suspected.

Complications

If left untreated

• If warning signs are ignored, dengue can quickly become severe.
• Severe dengue can cause bleeding under the skin and from the gums or nose.
• It can lead to a dangerous drop in blood pressure (shock) that damages organs.
• In rare cases, severe dengue can be fatal if not treated promptly in hospital.

Long-term outlook

Most people with dengue feel better within one to two weeks. Even with severe dengue, most people get better with early hospital care. The most important thing is to seek medical help quickly if symptoms become worrying.

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