Dengue Fever: Diagnosis and Treatment

Viroj Wiwanitkit

Disclosures

Expert Rev Anti Infect Ther. 2010;8(7):841-845. 

In This Article

Abstract and Introduction

Abstract

Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied.

Introduction

Dengue is a significant mosquito-borne infection. An arbovirus named dengue virus is the causative agent. Due to the nature of the mosquito-borne infection, dengue has become a significant public health threat in many developing tropical countries. Dengue had been present throughout tropical regions of the world for more than 50 years.[1] Of several tropical regions, Southeast Asia is accepted as the area with the highest prevalence of this disease. A severe hemorrhagic form of dengue infection has become a leading infectious cause of death for local people in Southeast Asia. Francisco Pinheiro, a former researcher from the Division of Disease Prevention and Control, and the Special Program for Vaccines and Immunization, Pan American Health Organization (DC, USA), said that the highest incidence of dengue could be seen in Southeast Asia, particularly in Vietnam and Thailand, which together account for more than two-thirds of the overall reported cases in Asia.[2] Hence, several groups are now carrying out research and development on dengue infection in this area.

At present, due to the efficient mosquito-borne method by which the virus is transported, dengue is not confined within the tropical region, but is sporadically reported from many nontropical countries. It is accepted that it is now a global issue. In South Asia, there have been many reports of dengue epidemiology coming in from India. An increased incidence among the pediatric population in the over-populated areas can be seen.[3] Dengue infection has also been reported in nontropical regions of Asia, such as East Asia and China.[4] Luo et al. noted that epidemics of dengue fever are closely related to the situation of neighboring countries, especially those is Southeast Asia. This indicated the possibility of importation of viruses from these countries, with the epidemics usually arising due to immigration of dengue patients from endemic areas.[5] Similarly, dengue infections also already extend to Australia and dengue has been accepted as a significant emerging infection of concern in Australia.[6] Outbreak of dengue infection in North Queensland gave great concern to the local CDC.[7] In Queensland, it is advised that general practitioners report all clinically suspected cases of dengue in any arriving travelers.[8] For Africa, America,[9–11] Europe[12–14] and Africa[15–17] the increase in reported cases of dengue highlights the necessity to prepare to combat this viral disease.

Focusing on the natural characteristics of dengue, this acute febrile illness can be deadly in cases of severe manifestation, causing dengue hemorrhagic shock. Patients usually visit the physician on the second or third day after the first appearance of fever, and after self-treatment of the illness by some self-prescribed antipyretic drugs.[18] However, after unsuccessful self-treatment, the patients usually end up visiting the physician with a chief complaint of an unexplained high fever and malaise. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease.

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