Intended for healthcare professionals

Clinical Review

Dengue fever

BMJ 2015; 351 doi: (Published 15 September 2015) Cite this as: BMJ 2015;351:h4661
  1. Senanayake A M Kularatne, senior professor of medicine
  1. 1Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  1. samkul{at}

This clinical review has been developed for The BMJ in collaboration with BMJ Best Practice, based on a regularly updated web/mobile topic that supports evidence based decision making at the point of care. To view the complete and current version, please refer to the dengue fever ( topic on the BMJ Best Practice website.

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

Dengue fever is a globally important arboviral infection transmitted by mosquitoes of the Aedes genus (primarily Aedes aegypti, but also A albopictus), an insect found in tropical and subtropical regions.1 Dengue infection causes a range of severe and non-severe clinical manifestations.2 The incubation period is 3-14 days (average 7 days).

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.

Who gets dengue fever?

Around two fifths of the world’s population (those in tropical and subtropical countries), or up to 2.5 …

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