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 |
---|---|---|---|
Fever | +++ | ++ | +++ |
Rash | + | +++ | ++ |
Conjunctivitis | – | ++ | + |
Arthralgia | + | ++ | +++ |
Myalgia | ++ | + | + |
Headache | ++ | + | ++ |
Hemorrhage | ++ | – | – |
Shock | + | – | – |
Thrombocytopenia | +++ | + | – |
Leukopenia | ++ | – | ++ |
Management
- Supportive