You can get through dengue fever without treatment
- Dengue is a viral infection that can be transmitted by aedes mosquito
- The infection often manifests itself as an acute febrile illness, but it can also develop into an illness with potentially fatal complications.
- The global spread of dengue fever has increased dramatically in the last few decades.
- Dengue fever occurs worldwide in tropical and subtropical climates, often in urban areas.
- Severe dengue syndrome is a leading cause of serious illness and death in children in several Asian and Latin American countries.
- A vaccination is currently only available for residents of endemic areas under certain conditions.
- Early detection and access to medical care reduce the death rate below 1%.
- People in endangered regions should protect themselves from mosquito bites accordingly.
Table of Contents
Definition - What is dengue fever?
Occurrence - How many dengue infections are there worldwide? In which countries is it most common?
Infection - How is dengue infection transmitted to humans? How does the cycle work?
Course - In which clinical forms can dengue fever occur?
Incubation- How much time elapses between the mosquito bite and the appearance of the first symptoms?
Diagnosis- When and with which methods can dengue be detected?
Therapy - How can you treat dengue fever? What are the limits?
Prevention / vaccination- Are there any vaccinations against dengue? How can you protect yourself?
Differential diagnostics- Which clinical pictures with similar symptoms have to be differentiated from dengue fever?
Video: Dengue transmission- How is a dengue infection transmitted?
Left- More information about "Dengue"
Dengue is a viral disease that can be transmitted by the aedes mosquito with regionally different serotypes (types 1-4). Dengue is considered the most common mosquito-borne viral disease worldwide.
A dengue infection often manifests itself as an acute febrile illness with a greatly increased temperature and severe headache, muscle, bone and limb pain - hence the name "breakbone fever". Most of the time, those affected recover within a few days. Dengue fever can also lead to serious complications or even death.
Dengue fever is considered to be the most common and fastest spreading mosquito-borne viral disease in the world. According to expert estimates, between 284 and 528 million people are infected with the pathogen causing dengue fever. Global distribution and burden of dengue. 3.9 billion people from 128 countries, i.e. almost half of the world's population, are fundamentally exposed to the risk of dengue infection Refining the global spatial limits of dengue virus.
Dengue is especially widespread in Southeast Asia, parts of Asia such as Pakistan, Afghanistan and India, South and Central America, parts of the Pacific such as New Caledonia and Hawaii, Africa and Australia.
The global warming is expected to increase the incidence of dengue in areas that have not been affected so far. The Asian tiger mosquito is now widespread in southern Europe and is expanding its settlement area. In recent years there have been isolated local dengue infections in Europe, such as in Madeira, Croatia, France or Spain. It is feared that the mosquito may also increasingly spread to continental Europe.
Dengue mosquitoes are found mainly in urban areas. The female mosquitoes lay their eggs near small pools of water such as in buckets, old tires, flower pots or rain barrels. Infected female mosquitoes can transmit the dengue virus directly to their brood.
>> Your travel destination
>> Dengue world map with risk areas and current news
>> Current WHO reports on the dengue situation
Infected female mosquitoes transmit dengue to humans through a bite. An infected mosquito can transmit the virus for the rest of its life. The infected people serve as a reservoir for the previously uninfected mosquitoes to pass the virus on. However, people from one another cannot become infected with dengue. The dengue mosquitoes are mainly diurnal and often bite early in the morning and in the evening before dark. Monkeys can also carry the virus in Southeast Asia and Africa.
The cycle, from the mosquito bite to the dengue virus entry into a host cell to the spread in the breeding cycle, is illustrated in the following video:
Dengue fever infection
Dengue fever occurs in three main clinical forms:
I) dengue fever as acute febrile illness with sudden outbreaks of feverfollowed by generalized symptoms and sometimes a blotchy rash. Because of the severe muscle pain, the disease is also known as "breakbone fever". The fever can be biphasic - for example, in two separate fever attacks or waves. Most patients recover in a few days.
II) Dengue hemorrhagic fever begins with an acute fever, followed by other symptoms due to thrombocytopenia, increased vascular permeability, and bleeding.
III) Dengue shock syndrome develops only in a small number of cases. A severe drop in blood pressure due to fluid loss requires immediate medical treatment. Without adequate treatment, 40 to 50 percent of cases are fatal. If treatment is started on time, the death rate is one percent and below.
IncubationThe time between the bite of the Aedes mosquito and the appearance of the first symptoms (incubation period) is 3-14 days, usually 7-10 days.
The clinical diagnosis is difficult due to the unspecific initial symptoms. Sporadic courses can only be recognized by the virological detection of the dengue virus and differentiated from other viral diseases such as Chikungunya fever, yellow fever, West Nile virus infection or malaria.
The pathogen can only be detected during the viremic phase in the first 4 to 5 days of the disease using the reverse transcriptase polymerase chain reaction (PCR). Dengue NS1 protein has proven to be a marker for confirming a dengue virus infection in both first and second infections from the 1st to the 9th of October. Proven day after the onset of symptoms. IgM antibodies are detectable in serum / plasma from about the 5th day of illness, IgG antibodies from the 10th to 14th day. EuroImmunBlog.de.
If you have two of the following symptoms when you have a high fever (40 ° C), it may be dengue fever:
- strong headache
- Eye pain
- Muscle and joint pain
- swollen glands
- skin rash
Symptoms usually last 2-7 days after an incubation period of 3-14 days after being bitten by an infected mosquito.
Critical dengue disease is a potentially fatal complication due to plasma leakage, fluid retention, shortness of breath, severe bleeding, or organ damage.
Warning signs occur 3–7 days after the first symptoms associated with a drop in temperature (below 38 ° C / 100 ° F) and include:
- severe abdominal pain
- persistent vomiting
- rapid breathing
- Bleeding gums
- Vomiting blood
The next 24 to 48 hours of the critical stage can be fatal. Adequate medical care is required to avoid complications and the risk of death.
Treatment for dengue fever differs in the fever phase without complications not significantly different from treating "normal" flu:
Pain-relieving and fever-lowering medication can be administered against the high fever and pain, and sufficient fluid intake must be ensured. The virus itself cannot be combated - the doctor can only alleviate the associated symptoms (symptomatic therapy).
At a severe course of the disease (Shock, severe drop in blood pressure, bleeding) immediate inpatient treatment (hospitalization) must be carried out. In order to prevent a state of shock, infusions (fluids) are then often given through the vein. Depending on the patient's condition, it may also be necessary to give blood reserves and intensive medical care.
Prevention / vaccination
There is currently no vaccination against dengue in Germany. The Dengvaxia vaccine is approved in the EU, but is not used in travel medicine, as vaccination is only possible for residents of endemic areas. Travelers should take precautions to avoid mosquito bites in vulnerable areas both during the day and at night:
Use highly effective repellants on uncovered areas of skin and wear stab-proof or impregnated clothing as much as possible. Even if the dengue-transmitting mosquitoes are predominantly diurnal - in contrast to the malaria mosquito, which is predominantly crepuscular and nocturnal - the use of an impregnated mosquito net is also recommended in these countries.
>> Protection against insect bites
Dengue fever infographic
Most important differential diagnosis
Influenza, malaria, yellow fever, other hemorrhagic viral fever, typhoid, measles, rubella.
Video: transmission of dengue fever
Dengue fever - a small sting with a high risk (ARD Mittagsmagazin - 4/2014)
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