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Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. Symptoms such as headache, fever, exhaustion, severe joint and muscle pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue fever. Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and in Paraguay in South America, and Costa Rica in Central America. Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue fever, the treatment is purely concerned with relief of the symptoms (symptomatic). The acute phase of the illness with fever and myalgias lasts about one to two weeks. Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock). The prevention of dengue fever requires control or eradication of the mosquitoes carrying the virus that causes dengue. There is currently no vaccine available for dengue fever.
Dengue hemorrhagic fever is a more severe form of the viral illness. Symptoms include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae (small red or purple splotches or blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome.
What geographic areas are at high risk for contracting dengue fever?
Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and Central America. Cases have also been imported via tourists returning from areas with widespread dengue, including Tahiti, Singapore, the South Pacific, Southeast Asia, the West Indies, India, and the Middle East (similar in distribution to the areas of the world that harbor malaria and yellow fever). Dengue is now the leading cause of acute febrile illness in U.S. travelers returning from the Caribbean, South America, and Asia. In 2011, Bolivia, Brazil, Columbia, Costa Rica, El Salvador, Honduras, Mexico, Peru, Puerto Rico, and Venezuela reported a large number of dengue cases. Paraguay reported a dengue fever outbreak in 2011, the worst since 2007. Hospitals were overcrowded, and patients had elective surgeries canceled due to the outbreak. The U.S. Centers for Disease Control and Prevention (CDC) reports that from 1946 to 1980, no cases of dengue acquired in the continental United States were reported. Since 1980, a few locally acquired U.S. cases have been confirmed along the Texas-Mexico border, temporally associated with large outbreaks in neighboring Mexican cities. A 2009 outbreak of dengue fever in Key West, Fla., showed that three patients who did not travel outside of the U.S. contracted the virus. Subsequent testing of the population of Key West has shown that up to 55 of the people living in the area have antibodies to dengue. In total, 28 people were diagnosed with dengue fever in this outbreak. Dengue fever is common, in at least 100 countries in Asia, the Pacific, the Americas, Africa, and the Caribbean. Thailand, Vietnam, Singapore, and Malaysia have all reported an increase in cases. According to the CDC, there are an estimated 100 million cases of dengue fever with several hundred thousand cases of dengue hemorrhagic fever requiring hospitalization each year. Nearly 40% of the world's population lives in an area endemic with dengue. The World Health Organization (WHO) estimates that 22,000 deaths occur yearly, mostly among children.
The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots, plastic bags, and cans year-round. One mosquito bite can cause the disease. The virus is not contagious and cannot be spread directly from person to person. There must be a person-to-mosquito-to-another-person pathway.
complications. Acetaminophen(Tylenol) and codeine may be given for severe headache and for joint and muscle pain (myalgia).
The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue. In nations plagued by dengue fever, people are urged to empty stagnant water from old tires, trash cans, and flower pots. Governmental initiatives to decrease mosquitoes also help to keep the disease in check but have been poorly effective. To prevent mosquito bites, wear long pants and long sleeves. For personal protection, use mosquito repellant sprays that contain DEET when visiting places where dengue is endemic. There are no specific risk factors for contracting dengue fever, except living in or traveling to an area where the mosquitoes and virus are endemic. Limiting exposure to mosquitoes by avoiding standing water and staying indoors two hours after sunrise and before sunset will help. The Aedes aegypti mosquito is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas. There is currently no vaccination available for dengue fever. There is a vaccine undergoing clinical trials, but it is too early to tell if it will be safe or effective. Early results of clinical trials show that a vaccine may be available by 2015.