Dengue Hemorrhagic Fever

Written by Seth Stoltzfus and Winnie Yu | Published on July 25, 2012
Medically Reviewed by George Krucik, MD


Dengue hemorrhagic fever is a severe and sometimes fatal infection that occurs tropical regions. It is most common in Southeast Asia and the western Pacific islands. The disease has been increasing rapidly in Latin America and the Caribbean.

The dengue virus is transmitted by mosquitoes. A more severe version of the infection called dengue hemorrhagic fever can involve significant bleeding and a drop in blood pressure that can cause shock and death. This condition is sometimes known as dengue shock syndrome.

What Causes Dengue Hemorrhagic Fever?

Dengue hemorrhagic fever can occur when a person is bitten by a mosquito and exposed to blood infected with the dengue virus. Those who are repeatedly exposed to the dengue virus often experience more acute symptoms and are at risk for dengue hemorrhagic fever.

Who Is at High Risk for Dengue Hemorrhagic Fever?

Living in or traveling to Southeast Asia, South and Central America, Sub-Saharan Africa, and parts of the Caribbean can increase your risk of contracting the dengue virus. These patients are also at higher risk:

  • infants and small children
  • the elderly
  • those with compromised immune systems

What Are The Symptoms of Dengue Hemorrhagic Fever?

Symptoms of the dengue virus generally include:

  • mild, moderate, or high fever
  • headaches
  • nausea
  • vomiting
  • pain in the muscles, bones, or joints
  • rashes on the skin

In the case of dengue hemorrhagic fever, other disturbing symptoms can develop. These may include:

  • restlessness
  • acute fever
  • bleeding or bruising under the skin
  • cold or clammy skin

How Is Dengue Hemorrhagic Fever Diagnosed?

Doctors will usually diagnose the type of dengue virus and then begin to look for signs of dengue hemorrhagic fever. Your doctor may do the following:

  • check your blood pressure
  • examine your skin, eyes, and glands
  • perform blood tests and coagulation studies
  • take a chest X-ray

In addition to performing these tests, your doctor may ask you questions about your personal and family medical history. Your doctor may ask about your lifestyle and recent travels. Your doctors may also try to rule out other conditions like malaria that are common in tropical regions.

Treatment for Dengue Hemorrhagic Fever

If you have dengue hemorrhagic fever, your doctor will treat the symptoms in order to prevent the condition from becoming more severe. Emergency treatment methods may include:

  • hydration with intravenous (IV) fluids
  • over-the-counter or prescription drugs to manage pain
  • electrolyte therapy
  • blood transfusions
  • careful monitoring of blood pressure
  • oxygen therapy
  • skilled nursing observation

All these methods are aimed at controlling and alleviating the symptoms while helping your body heal naturally. Doctors will continue to monitor your body’s response.

What Is The Long-Term Outlook?

The prognosis for dengue hemorrhagic fever depends on how early the condition is detected. Patients who receive care in the early stages of dengue infection will often recover. As the patient moves toward a stage of shock, recovery becomes progressively more unlikely. Complications from severe or acute dengue hemorrhagic fever may include seizures, brain damage, and damage to other major organs.

How Can I Prevent Dengue Hemorrhagic Fever?

Researchers are working on a vaccine to prevent dengue fever. But it is currently unavailable. To protect yourself from mosquito bites, wear clothing that covers your arms and legs. Use mosquito netting and mosquito repellent when traveling in the tropics.

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