Dengue virus

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

• Zika virus
• Chikungunya virus
• Rickettsiae

Feature	Dengue	Zika	Chikungunya
Asymptomatic	40-80%	35-85%	3-28%
Fever	+++	++	+++
Rash	+	+++	++
Conjunctivitis	–	++	+
Arthralgia	+	++	+++
Myalgia	++	+	+
Headache	++	+	++
Hemorrhage	++	–	–
Shock	+	–	–
Thrombocytopenia	+++	+	–
Leukopenia	++	–	++

Management

• Supportive