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Dengue Fever

Dengue Fever Facts

Dengue fever is a disease caused by viruses that are transmitted to people by mosquitoes. Dengue fever usually causes fever (high, about 104 F-105 F), skin rash (see Figure 1), and pain (headaches and often severe muscle and joint pains). The disease has also been termed "breakbone fever" or "dandy fever" because the unusually severe muscle and joint pains can make people assume distorted body positions or exaggerated walking movements in an effort to reduce their pain.

Picture of rash on legs due to dengue fever
Figure 1: Picture of rash on legs due to dengue fever

History of Dengue Fever Outbreaks

Dengue fever is endemic in tropical and subtropical areas. Dengue fever is estimated by the World Health Organization (WHO) to cause about 50-100 million infections per year worldwide. The U.S. Centers for Disease Control and Prevention (CDC) considers dengue fever to cause the majority of acute febrile illnesses in travelers returning to the U.S. The first clinical report of dengue fever was in 1789 by B. Rush, although the Chinese may have described the disease associated with "flying insects" as early as 420 AD. Africans described "ka dinga pepo" as cramp-like seizure caused by an evil spirit. The Spanish may have changed "dinga" to dengue since it means fastidious or careful in Spanish, which describes the gait of people trying to reduce the pain of walking.

Unfortunately, the disease incidence seems to be increasing. Researchers suggest the surge in dengue fever may be due to several factors:

  • Increased urban crowding with more sites for mosquitoes to develop
  • International commerce that contains infected mosquitoes, thus introducing the disease to areas previously free of the disease
  • Local and world environmental changes that allow mosquitoes to survive the winter months
  • International travelers who carry the disease to areas where mosquitoes have not been previously infected

Dengue has spread widely throughout the world; the WHO distribution map shows that dengue fever mainly occurs in tropical and subtropical areas. In the U.S., dengue fever has been detected in California, Florida, Texas, and Hawaii. Other areas where it has been detected or there has been an outbreak of the disease include the Philippines, Samoa, Brazil, Puerto Rico, Costa Rica, and New Delhi. However, as climates warm, experts suggest dengue will become more prevalent.

In 2015, an outbreak of dengue fever occurred in New Delhi, the worst in five years. To date, 1,872 people have tested positive for dengue fever; there have been seven deaths. State-run hospitals were so overcrowded that patients were sharing beds. An independent group (Brandeis Univ.) suggests the actual numbers of people in India with dengue are "vastly underreported."

Medically Reviewed by a Doctor on 9/21/2015

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Dengue Fever Symptoms and Signs

The symptoms and signs for dengue begin about three to 15 days after a mosquito bite transfers a virus (dengue virus serotype 1-4) to a person previously unexposed to the viruses. Fever and painful muscle and joint aches can occur during the first few hours of symptoms when headache, chills, rash, and swollen lymph nodes first appear. Pain behind the eyes is also a common symptom. These symptoms usually last about two to four days and then diminish, only to reappear again with a rash that covers the body and spares the face. The rash also may occur on the palms of the hands and the bottom of the feet, areas frequently spared in many viral and bacterial infections. The symptoms may last about one to two weeks with complete recovery, in most cases, in a few weeks. However, some people can develop more severe symptoms and complications, such as hemorrhagic areas in the skin, gums, and the gastrointestinal tract. This clinical problem is termed dengue hemorrhagic fever (DHF).

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