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$Unique_ID{BRK03651}
$Pretitle{}
$Title{Dengue Fever}
$Subject{Dengue Fever Breakbone Fever Dandy Fever Duengero Seven Day Fever
Dengue Hemorrhagic Fever Dengue Shock Syndrome Colorado Tick Fever Typhus
(Typhoid Fever) Yellow Fever Other Hemorrhagic Fevers}
$Volume{}
$Log{}
Copyright (C) 1988, 1989 National Organization for Rare Disorders, Inc.
514:
Dengue Fever
** IMPORTANT **
It is possible the main title of the article (Dengue Fever) is not the
name you expected. Please check the SYNONYMS listing on the next page to
find alternate names and disorder subdivisions covered by this article.
Synonyms
Breakbone Fever
Dandy Fever
Duengero
Seven Day Fever
Includes:
Dengue Hemorrhagic Fever
Dengue Shock Syndrome
Information on the following disorders can be found in the Related
Disorders section of this report:
Colorado Tick Fever
Typhus (Typhoid Fever)
Yellow Fever
Other Hemorrhagic Fevers
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Dengue Fever is an acute viral infection characterized by fever. It is
caused by a bite from mosquitoes carrying dengue virus. The primary form of
Dengue Fever is characterized by a skin rash and a high fever with severe
pain in the head and muscles.
The secondary forms of this disorder are called Dengue Hemorrhagic Fever
and Dengue Shock Syndrome. These usually are caused by a secondary infection
with a different type of Dengue virus (Type 2), but may also be caused by the
same virus that causes Dengue Fever. Several days after onset fever,
bleeding under the skin and in the intestines occurs. A marked fall in blood
pressure (shock) occurs in very severe cases.
Symptoms
Dengue Fever is a disorder transmitted by mosquitoes carrying dengue virus.
The disorder is characterized by a sudden onset of symptoms. There is an
incubation period of 5 to 8 days after the mosquito bite occurs. The patient
has chills or chilly sensations, with a fever. Pain behind the eyeballs
(postorbital) occurs on moving the head. The head, lower back, legs and
joints ache. The patient feels very weak. The temperature rises rapidly,
sometimes to as high as 40C or 104F, accompanied by a relatively slow heart
beat (bradycardia) and abnormally low blood pressure. The lymph glands in
the neck, shoulder, and groin are usually enlarged. Two or three days after
the first fever, a rash of flat or elevated (maculopapular) spots appears,
particularly on the face. A second temperature rise follows. The presence
of Dengue virus in the blood (viremia) can confirm the diagnosis. The
patient subsequently develops immunity against this type of Dengue virus.
However, reinfection with a different type of this virus is possible.
Secondary forms of Dengue Fever are Dengue Hemorrhagic Fever, and Dengue
Shock Syndrome. These forms of the disorder primarily affect children
between 3 and 6 years of age who have been infected a second time with dengue
virus, and infants 7 to 8 months of age. These forms of the disorder are
characterized by sudden fever, headache, nausea, vomiting, and abdominal
pain. Coughing, throat infection and difficulty in breathing also occur.
Shock may occur 2 to 6 days after the beginning of the fever, with sudden
collapse, cool clammy extremities (the trunk is often warm), a weak pulse,
and bluish discoloration of the skin around the mouth (cyanosis). In serious
cases, a tendency to bleed excessively occurs, either as purpura or in
pinpoint spots (petecchiae). The bleeding may appear in many parts of the
body. Blood vessels become dilated and congested, and swelling (edema) may
also occur. Gastrointestinal bleeding may lead to vomiting of blood
(hematemesis) and passing of dark stools stained with blood pigment (melena).
Causes
Dengue Fever is transmitted by a mosquito infected with a Dengue virus.
These viruses belong to a group of 4 B arboviruses (flaviviruses).
Affected Population
Dengue Fever occurs mainly in subtropical or tropical climates including
southern Asia, South America (particularly Brazil), and the Caribbean
including Puerto Rico and the U.S. Virgin Islands. The virus has also been
imported into the U.S. by tourists from these areas.
Dengue Hemorrhagic Fever, and Dengue Shock Syndrome usually occur in
children between 3 and 6 years of age. Infants between 7 and 8 months of age
may also develop these conditions even after receiving antibodies for Dengue
Fever prenatally from a previously infected mother. The afflicted infants do
not have antibodies to the Dengue Type 2 virus.
Related Disorders
The Dengue virus is a B Arbovirus which has 4 distinct serogroups.
Colorado Tick Fever (Mountain Fever; Mountain Tick Fever) is a virus
infection transmitted by ticks which is prevalent in the western United
States. Fever, headaches, muscle aches, and generalized discomfort
characterize the illness, which resolves spontaneously. (For more
information on this disorder, choose "Colorado Tick Fever" as your search
term in the Rare Disease Database.)
Epidemic Typhus (European Typhus; Classic Typhus; Louse-Born Typhus;
Jail Fever) is a severe infectious disorder which begins suddenly and is
characterized by prolonged high fever, persistent headache, and a rash of
elevated spots on the skin. Epidemic Typhus is caused by Rickettsia
prowazekii, an organism that resembles viruses and bacteria. This disorder
can be transmitted by lice.
Yellow Fever is an arbovirus infection characterized by sudden onset and
variable severity of symptoms. The disorder is characterized by a fever of
102 degrees to 104 F (39 degrees to 40 C), and an abnormally slow heart beat.
In a few severe cases, excessive amounts of protein are present in the urine.
In these few cases a yellow skin color (jaundice), bleeding and coughing up
blood also tend to occur. The virus which causes Yellow Fever is transmitted
by the bite of a mosquito. (For more information on this disorder, choose
"Yellow Fever" as your search term in the Rare Disease Database.)
Other Hemorrhagic Fevers which are characterized by internal bleeding are
caused by a variety of viruses. Some of these fevers that occur in Africa
and South America are: Lassa Fever, Machupo Fever (Bolivian Hemorrhagic
Fever), Junin Fever (Argentinian Hemorrhagic Fever), Lymphocytic
Choriomeningitis, Marburg Virus (Hemorrhagic Fever), and, Ebola Virus
(Hemorrhagic Fever). Blood tests may be used to identify the virus.
Therapies: Standard
Dengue Fever is diagnosed by testing a blood sample for presence of the
Dengue virus or its antibodies. However, a different type of the Dengue
virus might cause a second infection. Aspirin and codeine may be prescribed
for severe headache and muscle pain. Complete bedrest is important.
Patients should take measures to avoid additional mosquito bites in order to
prevent reinfection. Fluids should be given to compensate for dehydration.
Treatment for Dengue Hemorrhagic Fever depends on the patient's degree of
dehydration. Patients should be closely monitored to prevent shock. When
skin appears bluish in color, oxygen should be given. Collapse of blood
vessels and loss of fluid from the circulation (hemoconcentration) require
immediate fluid replacement, preferably with a solution like Ringer's
lactate. Plasma or human serum protein (albumin) should also be given if
there is no response in the first hour. Fresh blood or blood platelet
transfusions may control bleeding. Agitated patients may be given
paraldehyde, chloral hydrate, or diazepam.
Therapies: Investigational
Scientists have studied the effect of human interferon on Hemorrhagic Dengue
Fever. More research is needed before this drug will be available for more
general use in treating Dengue Fever. Additionally, scientists are trying to
develop a vaccine which may someday prevent this infectious disorder.
This disease entry is based upon medical information available through
June 1988. Since NORD's resources are limited, it is not possible to keep
every entry in the Rare Disease Database completely current and accurate.
Please check with the agencies listed in the Resources section for the most
current information about this disorder.
Resources
For more information on Dengue Fever, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
Centers for Disease Control (CDC)
Office of Public Inquiries
1600 Clifton Road NE
Atlanta, GA 30333
(404) 329-5354
NIH/National Institute of Allergy and Infections Diseases (NIAID)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5717
References
DENGUE FEVER IN THE UNITED STATES. A REPORT OF A CLUSTER OF IMPORTED CASES
AND REVIEW OF THE CLINICAL, EPIDEMIOLOGIC, AND PUBLIC HEALTH ASPECTS OF THE
DISEASE: M.D. Malison, et al.; JAMA (January 28, 1983: issue 249(4)). Pp.
496-500.
DENGUE VIRUS TYPE 2 VACCINE: REACTOGENICITY AND IMMUNOGENICITY IN
SOLDIERS: W.H. Bancroft, et al.; Journal Infect Dis (June 1984: issue
149(6)). Pp. 1005-1010.
DENGUE AND HEPATIC FAILURE: M.E. Alvarez, et al.; American Journal Med
(November 1985: issue 79(5)). Pp. 670-674.
EFFECT OF INTERFERONS ON DENGUE VIRUS MULTIPLICATION IN CULTURED
MONOCYTES/MACROPHAGES: H. Hotta, et al.; Biken Journal (December 1984: issue
27(4)). Pp. 189-193.