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Dengue fever
Other Resources UpToDate PubMed

Dengue fever

Contributors: Vivian Wong MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed


Dengue fever, also known as breakbone fever, is caused by a flavivirus transmitted to humans by day-biting mosquitoes in tropical areas of the Caribbean, Central America, South America, Southeast Asia, and Africa. There are estimated to be 50 million cases of dengue fever each year worldwide, and 2.5 billion people are now at risk. Travelers can present once home due to a 2-day to 7-day incubation period. Clinical manifestations vary, and include asymptomatic infection (75% of cases), mild dengue, classic dengue, and dengue hemorrhagic fever.

In classic dengue fever, there is a biphasic pattern to symptoms. During the first phase, there is an abrupt onset of fever for 2-5 days, malaise, chills, severe headache, myalgias, and retro-orbital and lumbosacral pain. The fever may climb as high as 41°C (105.8°F), but is not associated with an increased pulse. There can be a faint, transient diffuse morbilliform macular rash during the first few days.

During the next several days, there is defervescence despite the onset of nausea, vomiting, possible cough, rhinitis, and sore throat. Leukopenia, thrombocytopenia, and hemorrhagic manifestations are possible.

Incidence is associated with increased urbanization in endemic areas. There is increased severity and 10%-30% mortality in children.

In October 2013, discovery of a new dengue virus serotype, dengue 5, was announced; it is thought to be phylogenetically distinct from the other 4 types.

Transmission of dengue virus via allogeneic blood cell transplantation has been documented.

The hemorrhagic form is believed to be more likely to occur during secondary infections with the dengue virus, especially if the secondary infection involves a different serotype.


A90 – Dengue fever

38362002 – Dengue fever

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Last Updated:08/16/2019
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