Dengue
• Dengue virus is transmitted by Aedes mosquitoes. It is endemic in Asia, the Pacific, Africa, South and Central America, and the Caribbean.
• Most cases in the US involve travelers, but local outbreaks have occurred in Texas and Florida (Key West).
There are five different dengue virus serotypes (DENV 1-5); infection with one does not protect against others. Higher immune response can happen on subsequent exposures to DENV serotypes.DIAGNOSIS
Clinical Presentation
Incubation period is 4-10 days. Fever, headache, myalgia, bone pain, rash, leukopenia, and thrombocytopenia are the predominant symptoms. Increased vascular permeability and plasma leakage lead to dengue hemorrhagic fever characterized by bleeding manifestations. Hypotension and circulatory collapse occur in dengue shock syndrome.
Diagnostic Testing
Virus can be detected by PCR during the first 5 days, and by acute and convalescent serology later in the course of illness.
TREATMENT
Maintenance of adequate intravascular volume is critical. There is no antiviral treatment; avoid aspirin and NSAIDs.50