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Chapter: Microbiology and Immunology: Virology, Virus: Arboviruses

Clinical syndromes - Mosquito-Borne Flaviviruses

The dengue virus causes classic dengue or break-bone fever characterized by fever, muscle and joint pain, lymphadenopathy, and rash.

Clinical syndromes

The dengue virus causes classic dengue or break-bone fever characterized by fever, muscle and joint pain, lymphadenopathy, and rash. In addition, it also causes dengue hemorrhagic fever, i.e., a much more severe disease than classic dengue fever with a high fatality rate.

Classic dengue fever: The incubation period varies from2 to 7 days. The onset of the disease is sudden, which begins as influenza-like illness manifesting as fever, malaise, cough, and headache. The fever, which may be as high as 41°C, typically begins on the third day and lasts for 5–7 days. The fever is typically biphasic, coinciding with the absence of virus in the blood. A maculopapular rash usually appears on third or fourth day of the illness. The rash lasts for 1–5 days, fading with desquamation. Severe pain in muscles and deep bone pain and joint pain (break-bone fever) are characteristic. Enlarged lymph nodes and leukopenia are also seen. Classic dengue fever is a self-limiting disease. It is rarely fatal and has few sequelae and complications. The convalescent phase may last for 2 weeks.

Dengue hemorrhagic fever: Dengue hemorrhagic fever is amost severe manifestation of the disease. The initial classic phase of dengue hemorrhagic fever is similar to that of dengue fever and other febrile viral illnesses. But, subsequently, the condition of the patient suddenly worsens with shock and hemorrhage, especially into the gastrointestinal tract and skin. The hemorrhagic manifestations include bleeding from nose or gums, melena, and hematemesis. This condition shows a high fatality rate as high as 10%. It occurs in children with passively acquired maternal antibodies. It may also occur in a person previously infected with a different serotype of the virus, showing non-neutralizing heterologous antibodies in the serum.

Dengue shock syndrome: It is the most severe form of thedisease caused by dengue virus. This is most commonly seen in untreated cases of dengue hemorrhagic fever. The common symptoms include abdominal pain, vomiting, and restlessness and finally, the patient may die of circulatory failure and shock. When treated, dengue hemorrhagic fever has a mortality rate of 5%; if left untreated, the condition has a mortality rate as high as 50%.

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Microbiology and Immunology: Virology, Virus: Arboviruses : Clinical syndromes - Mosquito-Borne Flaviviruses |


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