Background
Microbiology
- Single-stranded positive-sense RNA virus
- Member of the Flaviviridae
Epidemiology
- Endemic in tropics worldwide, with almost half of the world's population at risk of infection
- Transmitted by Aedes aegypti and Aedes albopictus
Clinical Manifestations
- Incubation period of 4 to 7 days
- Classic presentation includes fever, headache (especially retroorbital), diffuse arthralgias ("breakbone fever"), and rash
- Often has thrombocytopenia
- With repeated infections, can progress to hemorrhagic fever and shock
Differential Diagnosis
| Feature | Dengue | Zika | Chikungunya |
|---|---|---|---|
| Asymptomatic | 40-80% | 35-85% | 3-28% |
| Fever | +++ | ++ | +++ |
| Rash | + | +++ | ++ |
| Conjunctivitis | – | ++ | + |
| Arthralgia | + | ++ | +++ |
| Myalgia | ++ | + | + |
| Headache | ++ | + | ++ |
| Hemorrhage | ++ | – | – |
| Shock | + | – | – |
| Thrombocytopenia | +++ | + | – |
| Leukopenia | ++ | – | ++ |
Management
- Supportive
