INTRODUCTION

Dengue Fever is caused by one of the four closely related, but antigenically distinct, virus serotypes
Dengue type 1, Dengue type 2, Dengue type 3, and Dengue type 4 of the genus Flavivirus and
Chikungunya virus. Infection with one of these serotype provides immunity to only that serotype of
life, to a person living in a Dengue-endemic area can have more than one Dengue infection during their
lifetime. Dengue fever through the four different Dengue serotypes are maintained in the cycle which
involves humans and Aedes aegypti or Aedes albopictus mosquito through the transmission of the
viruses to humans by the bite of an infected mosquito. The mosquito becomes infected with the Dengue
virus when it bites a person who has Dengue and after a week it can transmit the virus while biting a
healthy person. Dengue cannot be transmitted or directly spread from person to person. Aedes aegypti
is the most common aedes specie which is a domestic, day-biting mosquito that prefers to feed on
humans.
INTUBATION PERIOD:
Uncertain. Probably 6 days to 10 days
PERIOD OF COMMUNICABILITY: Unknown. Presumed to be on the 1st week of illness when
virus is still present in the blood
CLINICAL MANIFESTATIONS:
First 4 days:
>febrile or invasive stage --- starts abruptly as high fever, abdominal pain and
headache; later flushing which may be accompanied by vomiting, conjunctival
infection and epistaxis
4th to 7th day:
>toxic or hemorrhagic stage --- lowering of temperature, severe abdominal pain,
vomiting and frequent bleeding from GIT in the form of melena; unstable BP,
narrow pulse pressure and shock; death may occur; vasomotor collapse
7th to 10th day:
>convalescent or recovery stage --- generalized flushing with intervening areas of
blanching appetite regained and blood pressure already stable
MODE OF TRANSMISSION:
Dengue viruses are transmitted to humans through the infective bites of female Aedes mosquito.
Mosquitoes generally acquire virus while feeding on the blood of an infected person. After virus
incubation of 8-10 days, an infected mosquito is capable, during probing and blood feeding of
transmitting the virus to susceptible individuals for the rest of its life. Infected female mosquitoes may
also transmit the virus to their offspring by transovarial (via the eggs) transmission.
Humans are the main amplifying host of the virus. The virus circulates in the blood of infected humans
for two to seven days, at approximately the same time as they have fever. Aedes mosquito may have
acquired the virus when they fed on an individual during this period. Dengue cannot be transmitted
through person to person mode.
CLASSIFICATION:
1. Severe, frank type
>flushing, sudden high fever, severe hemorrhage, followed by sudden drop of
temperature, shock and terminating in recovery or death
2. Moderate
>with high fever but less hemorrhage, no shock present
3. Mild
>with slight fever, with or without petichial hemorrhage but epidemiologically
related to typical cases usually discovered in the course of invest or typical cases