Dengue Fever

Dengue fever is a tropical disease caused by a virus carried by mosquitoes. The virus can cause fever, headaches, rashes, and pain throughout the body. Most cases of dengue fever are mild and go away on their own after about a week.

Dengue fever rarely strikes in the United States (the last cases were reported in Texas in 2005), but if you plan to travel to a foreign country — especially one in the tropics — it’s wise to guard against dengue fever. Wearing insect repellant, covering sleep areas with netting, and avoiding the outdoors at dusk and dawn (when mosquitoes are most active) can help lower the chances of infection.

About Dengue Fever

Dengue (DEN-gee) fever is caused by four similar viruses spread by mosquitoes of the genus Aedes, which are common in tropical and subtropical areas worldwide.

When an Aedes mosquito bites a person who has been infected with a dengue virus, the mosquito can become a carrier of the virus. If this mosquito bites someone else, that person can be infected with dengue fever. The virus can’t spread directly from person to person.

Many kids with dengue fever don’t have symptoms; others have mild symptoms that appear anywhere from 4 days to 2 weeks after being bitten by an infected mosquito. Symptoms typically last for 2 to 7 days. Once kids have had the illness, they become immune to that particular type of the virus (although they can still be infected by any of the other three types).

In rare cases, dengue fever can lead to a more serious form of the disease called dengue hemorrhagic fever (DHF). DHF can be life threatening and needs to be treated right away.

Signs & Symptoms

In the past, dengue fever was known as “breakbone fever,” which might give you an idea of the symptoms it can cause — that is, if a person ends up having any symptoms at all. The fever isn’t actually breaking any bones, but it can sometimes feel like it is.

Common signs and symptoms of dengue fever include:

• high fever, possibly as high as 105°F (40°C)
• pain behind the eyes and in the joints, muscles and/or bones
• severe headache
• rash over most of the body
• mild bleeding from the nose or gums
• bruising easily

Symptoms are generally mild in younger children and those who are infected with the disease for the first time. Older kids, adults, and those who have had a previous infection may have moderate to severe symptoms.

People with DHF will have the regular symptoms of dengue fever for 2 to 7 days. After the fever eases, other symptoms get worse and can cause more severe bleeding; gastrointestinal problems like nausea, vomiting, or severe abdominal (belly) pain; and respiratory problems like difficulty breathing. Dehydration, heavy bleeding, and a rapid drop in blood pressure (shock) can follow if DHF goes untreated. These symptoms are life threatening and need immediate medical care.

Diagnosis

If you think your child’s symptoms might be caused by dengue fever, call a doctor right away. You should also call a doctor if your child has recently been to a region that has dengue fever and develops a fever or severe headache.

To make a diagnosis, the doctor will examine your child and evaluate the symptoms. The doctor will ask about your child’s medical history and recent travels, and send a sample of your child’s blood to be tested for the disease.

Treatment

No specific treatment is available for dengue fever. Mild cases can be treated by giving lots of fluids to prevent dehydration and getting plenty of rest. Pain relievers with acetaminophen can ease the headaches and pain associated with dengue fever. Pain relievers with aspirin or ibuprofen should be avoided, as they can make bleeding more likely.

Most cases of dengue fever go away within a week or two and won’t cause any lasting problems. If someone has severe symptoms of the disease, or if symptoms get worse in the first day or two after the fever goes away, seek immediate medical care. This could be an indication of DHF, which is a medical emergency.

To treat severe cases of dengue fever at a hospital, doctors will deliver intravenous (IV) fluids and electrolytes (salts) to replace the fluids lost through vomiting or diarrhea. This is usually enough to effectively treat the disease, as long as fluid replacement therapy begins early. In more advanced cases, doctors may have to perform a transfusion to replace lost blood.

In all cases of dengue infection, regardless of how serious symptoms are, efforts should be made to keep the infected person from being bitten by mosquitoes. This will help prevent the illness from spreading to others.

Prevention

There is no vaccine to prevent dengue fever, so if children live in or will be visiting areas where dengue fever is likely, the only way to protect them from the disease is to minimize their chances of being bitten by an infected Aedes mosquito.

In such cases, take these precautions:

• Use screens on doors and windows, and promptly repair broken or damaged screens. Keep unscreened doors and windows shut.
• Have kids wear long-sleeved shirts, long pants, shoes, and socks when they go outside, and use mosquito netting over their beds at night.
• Use insect repellant as directed on your child. Choose a repellant with DEET or oil of lemon eucalyptus.
• Limit the amount of time kids spend outside during the day, especially in the hours around dawn and dusk, when mosquitoes are most active.
• Don’t give mosquitoes places to breed. Mosquitoes lay their eggs in water, so get rid of standing water in things like containers and discarded tires, and be sure to change the water in birdbaths, dog bowls, and flower vases at least once a week.

By taking these precautions and keeping your kids away from areas that have a dengue fever epidemic, the risk of contracting dengue fever is small for international travelers.