Essential Facts About Dengue Fever

Dengue Fever is a mosquito-borne disease occurring in tropical and subtropical regions worldwide. The dengue virus is transmitted by the vector mosquito Aedes aegypti and is clinically characterized by high fever, skin rash, and muscle and joint pain.

In addition to the dengue virus, Aedes aegypti also transmits chikungunya, yellow fever, and Zika viruses. This highly domesticated mosquito species lives in close proximity to humans and prefers breeding in water containers typically found in and around residences. The peak transmission periods are at dawn (two to three hours after sunrise) and dusk (several hours before sunset).

There are four distinct yet closely related serotypes of the causative virus: DEN-1, DEN-2, DEN-3, and DEN-4.

Symptoms of Dengue Fever and Disease Progression

– Characteristic manifestations of dengue infection include:

• Sudden high fever lasting two to seven days
• Severe headache accompanied by retro-orbital pain (pain behind the eyes)
• Joint and muscle pain
• Skin rash
• Nausea and vomiting
• Mild bleeding manifestations (e.g., nosebleeds, bleeding gums, or easy bruising)

– Symptoms typically emerge four to seven days following an infective bite and may mimic other conditions presenting with fever, body aches, and cutaneous rash. Notably, up to 75% of dengue cases run an asymptomatic course.

High-Risk Groups for Dengue-Related Complications

Young children and individuals without prior infection tend to experience milder symptoms than older children and adults. Those with compromised immune systems, individuals experiencing a secondary dengue infection, and individuals with obesity are considered to be at a higher risk of developing severe dengue.

Therapeutic Management

There is no specific antiviral treatment for dengue fever. Early supportive care focusing on fluid rehydration significantly reduces the risk of complications. In severe cases of dengue, immediate hospitalization is required for intensive emergency care, including intravenous fluid and electrolyte management and/or blood transfusions.

Prevention and Control of Dengue Fever

– Dengue Vaccination

The Health Sciences Authority (HSA) has approved the dengue vaccine, Dengvaxia, for the prevention of dengue fever caused by dengue virus serotypes 1, 2, 3, and 4 in individuals aged 12 to 45 years. The vaccination regimen requires three doses administered over a 12-month period, at months 0, 6, and 12.

Benefits:

• Reduction of symptomatic dengue across all four serotypes – Vaccine efficacy: 81.9%
• Reduction of severe dengue manifestations – Vaccine efficacy: 5%
• Reduction in hospitalization risk – Vaccine efficacy: 81.3%

However, Dengvaxia is exclusively recommended for individuals with documented prior dengue infection. Consequently, a pre-vaccination dengue screening blood test or verifiable medical records confirming a positive dengue antibody status are required prior to immunization.

– Stay in well-screened or air-conditioned accommodations equipped with mosquito netting.

Mosquitoes carrying the dengue virus are most active from dawn until dusk, though they may also bite at night. Effective prevention includes using mosquito netting and staying in air-conditioned environments.

– Wear protective clothing, such as long sleeves and full-length trousers.

 When entering mosquito-prone areas, wear light-colored long-sleeved shirts, long trousers, socks, and closed-toe shoes.

– Apply approved insect repellent.

Permethrin can be applied to clothing, footwear, camping gear, and bed nets. You can also purchase pre-treated permethrin clothing. For direct skin application, use repellents containing at least 10% DEET. Individuals recently infected with dengue fever should also apply insect repellent regularly to prevent mosquitoes from biting and transmitting the virus to others, thereby reducing the spread of dengue fever.

– Eliminate standing water and potential mosquito breeding habitats.

You can eliminate the environments where mosquitoes typically lay their eggs. At least once a week, empty and thoroughly clean containers holding standing water, such as planter trays, pet bowls, and flower vases...

Medically reviewed by Dr. Nguyen Tung Long – Internal Medicine Physician, Sante Hospital

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