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DENGUE HEMORRHAGIC
FEVER
ALTERNATIVE NAMES
!   Hemorrhagic dengue
!   Dengue shock syndrome
!   Philippine hemorrhagic fever
!   Thai hemorrhagic fever
!   Singapore hemorrhagic fever
Dengue Hemorrhagic Fever is an acute
infectious viral disease usually affecting
infants and young children. It is carried
by mosquitoes and caused by any of
four related dengue viruses. This disease
used to be called break-bone fever
because it sometimes causes severe
joint and muscle pain that feels like
bones are breaking.
TRANSMISSION
People get dengue virus infections from the
bite of an infected Aedes mosquito.
Mosquitoes become infected when they bite
infected humans, and later transmit infection
to other people they bite. The two main
species of mosquito, Aedes aegypti and
Aedes albopictus, have been responsible for
all cases of dengue transmitted in this
country. Dengue is not contagious from
person to person. The transmitter of the
disease is a day-biting mosquito which lays
eggs in clear water container, such as flower
vases, cans, rain barrels, old rubber tires, etc.
The adult mosquitoes rest in dark places of
the house.
SYMPTOMS
Typical uncomplicated (CLASSIC) DENGUE usually
start with fever within 5 to 6 days after you have
been bitten by an infected mosquito and
includes the following:
!   High fever, up to 40 degrees Celsius
!   Severe headache
!   Retro-orbital (behind the eye) pain
!   Severe joint and muscle pain
!   Nausea and vomiting
!   Rash (The rash may appear over most of your
body 3 to 4 days after the fever begins. A
second rash may appear later in the disease)
Symptoms of DENGUE HEMORRHAGIC FEVER includes
all of the symptoms of classic dengue, plus :
!   Marked damage to blood and lymph vessels
!   Bleeding from the nose, gums, or under the skin,
causing purplish bruises (This form of dengue
disease causes some deaths)
Symptoms of DENGUE SHOCK SYNDROME (the
most severe form of dengue disease) includes
all of the symptoms of classic dengue and
dengue hemorrhagic fever, plus :
!   Fluids leaking outside of blood vessels
!   Massive bleeding
!   Shock
SIGNS AND TEST
Physical Examination may reveal the following:
!   Low blood pressure
!   A weak, rapid pulse
!   Rash
!   Red eyes
!   Red throat
!   Swollen glands
!   Enlarged Liver (hepatomegaly)
Tests may include the following:
!  
Hematocrit
!  
Platelet count
!  
Electrolytes
!  
Coagulation studies
!  
Liver enzymes
!  
Blood gases
!  
Tourniquet test (causes petechiae below the tourniquet)
!  
X-ray of the chest (may demonstrate pleural effusion)
!  
Serologic studies (demonstrate antibodies to Dengue viruses)
!  
Serum studies from samples taken during acute illness and
convalescence (increase in titer to Dengue antigen)
COMPLICATION
Most people who develop dengue fever recover completely
within 2 weeks. Some, however, may go through several
weeks to months of feeling tired and/or depressed. Others
develop severe bleeding problems. This complication,
dengue hemorrhagic fever, is a very serious illness which can
lead to shock (very low blood pressure) and is sometimes
fatal, especially in children and young adults.
Other complications are the following:
!  
Shock
!  
Encephalopathy
!  
Residual brain damage
!  
Seizures
!  
Liver damage
TREATMENT
There is no specific treatment for classic dengue
fever, and like most people you will recover
completely within 2 weeks. To help with recovery,
health care experts recommends:
!   Getting plenty of bed rest
!   Drinking lots of fluids
!   Taking medicine to reduce fever
PREVENTION
The best way to prevent dengue fever is to take
special precautions to avoid contact with
mosquitoes. When outdoors in an area where
dengue fever has been found ;
!   Use a mosquito repellant
!   Dress in protective clothing (long-sleeved
shirts, long pants, socks, and shoes)
!   Because Aedes mosquitoes usually bite during
the day, be sure to use precautions especially
during early morning hours before daybreak
and in the late afternoon before dark.
Other precautions includes;
!   Keeping unscreened windows and doors closed
!   Keeping window and door screens repaired
!   Getting rid of areas where mosquitoes breed, such as
standing water in flower pots, containers, birdbaths,
discarded tires, tin cans, bottles or drain accumulated
water from trees, etc.
!   Cover water storage containers to prevent breeding of
mosquitoes
!   Clean house gutters to prevent stagnation of rain water
!   Isolate patients suffering from Dengue H-Fever for at
least 5 days
!   Report to the nearest health center any suspected case
of Dengue H-Fever in the neighborhood