prevent dengue infection, travelers to dengue-endemic areas should
protect themselves against mosquito
bites by using EPA-registered
insect repellent, wearing long-sleeved shirts and long
pants, and taking other protective measures while traveling.
is usually a mild illness. However, in about 5% of cases, it can
progress to severe disease with associated shock, severe bleeding, or
for dengue can be as high as 13% in untreated patients. Common causes
of death include unrecognized or prolonged shock, unrecognized
hemorrhage, and secondary infections.
dengue symptoms include fever,
aches and pains (headache, retroorbital pain, myalgias, and
arthralgias), nausea and vomiting, and rash or petechiae. Symptoms
begin abruptly after an incubation period of 5 to 7 days. Fever can
last between 2 to 7 days.
(the abatement of fever to body temperature below 38.0°C
or 100.4°F) marks the beginning of
the critical phase, which is when progression to severe dengue can
occur and lasts 1 to 2 days.
should monitor closely for warning signs that can indicate
progression to severe dengue. These patients should be evaluated for
observation or inpatient management.
signs include persistent vomiting, severe abdominal pain,
extravascular fluid accumulation (e.g., pleural effusion, ascites),
mucosal bleeding, lethargy/restlessness, postural hypotension, liver
enlargement, and a progressive increase in hematocrit (i.e.,
with symptoms consistent with dengue can be tested with nucleic acid amplification
tests (NAAT) AND IgM antibody tests within 7 days of symptom onset.
After 7 days from symptom onset, test only with IgM antibody
- Dengue is a nationally
notifiable disease in the United States. All suspected cases should
be reported to the local health department.
- Intravenous (IV) fluid
therapy and management of complications are the mainstay of treatment. Management of
hospitalized dengue patients requires frequent monitoring of vital
signs and hematocrit levels to determine disease progression and
appropriate response to fluid replacement therapy.
- There are currently no
specific antivirals recommended for dengue treatment or vaccines
available to protect people who are traveling. The FDA-approved dengue vaccine is only recommended
for children living in areas where dengue is endemic, and not
approved for travelers.