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Dengue is a mosquito-borne viral infection. The virus responsible for causing dengue, is called dengue virus (DENV). The virus is transmitted to humans through the bites of infected female mosquitoes, primarily the Aedes aegypti mosquito. There are four DENV stereotypes, meaning that it is possible to be infected four times. While many DENV infections produce only mild illness, DENV can cause an acute flu-like illness. Occasionally this develops into a potentially lethal complication, called severe dengue.

Severe dengue is a leading cause of serious illness and death in some Asian Countries, especially Tropical Rainforest area.  Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms during the febrile phase:

  • severe headache
  • pain behind the eyes
  • muscle and joint pains
  • nausea
  • vomiting
  • swollen glands
  • rash

Warning Severe Signs that doctors should look for include:

  • severe abdominal pain
  • persistent vomiting
  • rapid breathing
  • bleeding gums
  • fatigue
  • restlessness
  • blood in vomit


After several days, usually 3-7 days after the onset of symptoms, the patient may display the warning signs of severe dengue. These warning signs typically accompany a decrease in temperature (below 38 C) and includes Severe abdominal pain, Rapid breathing, Persistent vomiting, Blood in vomit, Fluid accumulation in the body, Mucous (gums and nose) bleeding, Rapid decrease in platelet count, Lethargy, restlessness and Loss of appetite.

If patients manifest these symptoms during the critical phase, close observation for the next 24–48 hours is essential so that proper medical care can be provided, to avoid complications and risk of death.