Dengue fever

The bottom line

• Dengue fever is a globally important arboviral infection transmitted by the Aedes genus of mosquito (primarily A aegypti, but also A albopictus), found in tropical and subtropical regions

• The infection is endemic in more than 100 countries, particularly the South East Asia region, western Pacific region, and the Americas

• The incubation period is 3-14 days (average 7 days)

• Clinical features include fever, headache, myalgia/arthralgia, and skin flushing/rash, together with leucopenia, thrombocytopenia, and increased liver function

• Severe thrombocytopenia, haemorrhage, and plasma leakage are the key diagnostic features of the more severe forms of infection

• Confirmatory tests include detection of viral antigen or nucleic acid and serology

• Fluid therapy and the identification of the critical phase are the most important aspects of management

Sources and selection criteria

I searched Medline and PubMed from 1980 to date, limited to publications in English. My search strategy used a combination of key words, including “dengue”, “DHF”, “US”, “Africa”, “Europe”, “Asia”, “WHO”, and “Complications”. I supplemented these sources with selected systematic reviews. Additional information cited includes evidence based national guidelines, published consensus statements, and WHO publications.