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Dengue hemorrhagic fever
Alternative namesHemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever
DefinitionDengue hemorrhagic fever is a severe, potentially fatal infection that occurs when someone with immunity to one type of Dengue virus is infected by a different type. It is spread by certain mosquitoes ( Aedes aegypti ) that bite primarily during the day. See also Dengue fever .
Causes, incidence, and risk factors
Four different Dengue viruses have been implicated in both Dengue fever and Dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when the patient contracts a different Dengue virus after previous infection(s) by another type. Prior immunity to a different Dengue virus type is important in the production of this severe disease.
Worldwide, more than 100 million cases of dengue fever occur every year. A small percent of these develop into Dengue hemorrhagic fever. Most cases in the U.S. are brought in from other countries. It is possible for a traveler who has returned to the United States to pass the infection to someone who has not traveled.
Risk factors for Dengue hemorrhagic fever include having antibodies to dengue virus from prior infection and being younger than 12, female, or Caucasian.
Early symptoms of Dengue hemorrhagic fever are similar to those of Dengue fever, but after several days the patient becomes irritable, restless , and sweaty. These symptoms are followed by a shock -like state.
Bleeding may appear as pinpoint spots of blood on the skin ( petechiae ) and larger patches of blood under the skin ( ecchymoses ). Bleeding may occur from minor injuries.
Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.
Early symptoms include the following:
Signs and testsPhysical examination may reveal the following:
Because Dengue hemorrhagic fever is caused by a virus for which there is no known cure or vaccine, the only treatment is to treat the symptoms.
Expectations (prognosis)With early and aggressive care, most patients recover from Dengue hemorrhagic fever. However, half of untreated patients who go into shock do not survive.
Calling your health care providerCall your health care provider if you have symptoms of Dengue fever and have been in an area where Dengue fever is known to occur.
PreventionThere is no vaccine available to prevent Dengue fever . Use personal protection such as full-coverage clothing, mosquito repellent containing DEET, and netting, and travel during periods of minimal mosquito activity if possible. Mosquito abatement programs can also reduce the risk of infection.
Update Date: 12/27/2002Eleftherios Mylonakis, M.D., Division of Infectious Disease, Massachusetts General Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT