Dengue Fever: Symptoms, Prevention, Treatment, Shock Syndrome

Dr. Himmat Singh

Medically reviewed by

Dr. Himmat Singh

Family Medicine

9 min read

Key Takeaways

  • With proper medical care, dengue fever resolves within days to weeks, though it can be life-threatening
  • Dengue fever symptoms include high fever, rash, headaches, muscle pain, joint pain and in severe cases, bleeding
  • If you think you have dengue fever symptoms make no delay in contacting a doctor

Dengue fever is a mosquito-borne disease spread by the female Aedes mosquito and caused by the dengue virus, or rather, one of four closely-related viruses (DENV1-4). The Aedes species aegypti and albopictus spread the virus when they bite a person having the dengue virus, subsequently, get infected themselves and then, bite a healthy person. The symptoms of dengue show up within 3 to 14 days of a person getting infected. Dengue fever symptoms include high fever, rash, headaches, muscle pain, joint pain and in severe cases, bleeding and shock. With proper medical care, dengue fever resolves within days to weeks, though it can be life-threatening.

Dengue outbreaks are common to areas having tropical or subtropical climates and affect about over 1 lakh Indians every year. In India, the spread of dengue fever occurs year-round in the southern states and from April to November in Northern areas. If you find yourself having dengue fever symptoms you should visit the doctor and, if necessary, get a dengue test done to rule out the disease. Thankfully, dengue is not spread from person to person. This means that if you take measures like throwing out stagnant water you can significantly reduce the risk of infection.

To understand dengue fever, its symptoms, diagnosis, and treatment in greater depth, read on.

Who Does Dengue Fever Affect?

Dengue fever is most frequent in Central and South America, Africa, Asia, and the Pacific Islands. Dengue fever is also seen in several locations in the United States. Moreover, half of the world's population lives in or travels to these places, putting them in danger. Children and the elderly are more vulnerable to severe sickness.

Early Symptoms of Dengue Fever

Many people have no symptoms or signs of dengue fever.

When symptoms appear, they might be confused with other illnesses, such as the flu, and usually appear four to ten days after being bitten by an infected mosquito.

Any of the following signs and symptoms, as well as a high temperature of 104 degrees Fahrenheit (40 degrees Celsius), are brought on by dengue fever:

  • Headache
  • Muscle, bone, or joint discomfort
  • Nausea
  • Vomiting
  • Back of the eye pain
  • Glandular swelling
  • Rash

Most people recover in about a week. In certain instances, symptoms might worsen to the point of being life-threatening. Severe dengue, dengue hemorrhagic fever, or dengue shock syndrome are all used to describe this illness.

Severe dengue symptoms include ruptured and leaking blood vessels. Additionally, your blood's platelet count declines. Platelets are the cells that create clots. Shock, internal bleeding, organ failure, and even death can result from this.

Severe dengue fever, which is a life-threatening condition, can manifest swiftly. Following the first day or two after your fever has dropped, you can experience the following symptoms:

  • Severe stomach ache
  • Constant vomiting
  • Bleeding from the nose or gums
  • You have blood in your pee, faeces, or vomit
  • Bleeding beneath the skin, which may seem like bruises
  • Breathing that is difficult or quick
  • Fatigue
  • Irritability or agitation

Symptoms of Dengue Fever

Dengue fever symptoms vary according to the severity of the sickness. Around 75% of those with dengue fever will not show any signs.

Symptoms of Dengue Fever

Mild Signs of Dengue Fever

If symptoms appear, a sudden temperature of approximately 104°F (40°C) is possible. It contains the symptoms with one or more of the following:

  • Muscle and joint pain
  • A rash behind the eyes
  • Nausea and vomiting 
  • Flushed face 
  • Painful throat 
  • Headache 
  • Red eyes

The symptoms usually linger between 2 and 7 days, and most patients feel better within a week. The temperature may soar, then subside for 24 hours, only to flare again.

Severe Signs and Symptoms of Dengue Fever

According to Trusted Source, it may be fatal when the infections turn severe, between 0.5% and 5% of dengue fever.

To begin, the fever usually drops to 99.5 to 100.4°F (37.5 to 38°C). Severe symptoms may emerge 24-48 hours later or 3-7 days after the individual begins to feel ill.

They are as follows:

  • Stomach discomfort or soreness
  • Bleeding from the nose or gums 
  • Vomiting blood at least three times in 24 hours
  • Blood in the stool 
  • Tiredness 
  • Feeling restless or angry 
  • Fever changes
  • From extremely hot to extremely cold 
  • Cold skin, clammy skin
  • A weak and fast pulse
  • A narrowing of the systolic-diastolic blood pressure differential

Anyone experiencing severe symptoms should seek medical assistance right once. Severe indications and symptoms might indicate DSS or DHF, which can be fatal.

Dengue fever symptoms can be divided into 3 categories. Those pertaining to mild dengue fever, and those pertaining to the complications dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS).

Mild Dengue Fever

Dengue fever symptoms for a mild case start after 4 to 7 days of the patient getting infected and generally last for 2 to 7 days. The symptoms are:

High Fever of 104-106°F

This is accompanied by symptoms like:

  • Rash
  • Nausea
  • Vomiting
  • Muscle, joint pain
  • Bone pain
  • Pain behind the eyes
  • Headache
  • Swollen glands

Some people, especially the young, do not experience dengue fever symptoms in case of mild dengue fever.

Dengue Shock Syndrome

In case DHF prolongs and the patient’s condition deteriorates, the patient can go into a state of shock. Like DHF, DSS can be fatal. DHF and DSS can occur after 3 to 5 days of fever. Symptoms of DSS include those of DHF as well as:

  • Weak and rapid pulse
  • The sudden drop in blood pressure (shock)
  • Low pulse pressure (<20mmHg)
  • Severe stomach pain
  • Blood vessels leaking fluid
  • Restlessness
  • Cold, clammy skin
  • Organ failure
  • Reduced fever

It is important to note that during DHF and DSS fever often drops. This may lead you to think that recovery is at hand. However, this is the most dangerous period and demands proper and immediate medical attention.

Diagnosis of Dengue Fever

Since the symptoms of dengue fever resemble those of malaria, typhoid, leptospirosis, and chikungunya, accurate diagnosis of dengue can be tricky. Your doctor will probably start out by asking about your travel history to know if you have visited areas that are at a high risk of dengue transmission. Part of the diagnosis could also involve the doctor checking your medical history and vaccinations to rule out diseases like yellow fever.

To confirm the diagnosis, the doctor will request that you undergo a blood test for dengue. The purpose of the blood test is either to detect the dengue virus or to detect antibodies produced in response to the dengue infection. The dengue test result may or may not be conclusive. For instance, in case of a molecular PCR test, a positive result is regarded as conclusive, but a negative one may simply mean that the level of virus is too low to detect. Yet, a blood test is the surest and only way to confirm dengue fever. Since the test requires no preparation, your physician may even consider doing a dengue test at home.

To rule out DHF and severe dengue fever, doctors will do the following tests:

  • Total white blood cell count (low WBC count)
  • Thrombocytopenia (low platelet level)
  • Haematocrit (ratio of volume of RBC to that of whole blood)

Doctors may even take a chest X-Ray and do coagulation studies.

Dengue Prevention

Avoiding mosquito bites is the most significant way to prevent the disease, primarily if you reside in or travel to a tropical region. To do this, you must safeguard yourself. A vaccine called Dengvaxia was given FDA approval in 2019 to aid in preventing the illness in teenagers between the ages of 9 and 16 who have already contracted dengue. There is currently no vaccine available to prevent the general population from contracting it.

To safeguard yourself:

  • Even indoors, use insect repellant
  • When heading outside, wear long sleeves, long pants, and socks
  • When indoors, use the air conditioning if it is available
  • Check that the screens on your windows and doors are secure and free of holes. Cover yourself with mosquito netting if your bedroom isn't air-conditioned or has a screen
  • If you are exhibiting signs of dengue, see your doctor

To reduce the mosquito population, remove mosquito breeding grounds. Examples include old tires, cans, and flower pots that collect rain. Regularly replace the water in outdoor pet bowls and birdbaths.

If someone in your household contracts dengue fever, take extra measures to protect yourself and other family members from mosquitoes. Mosquitoes that bite an infected family member may transmit the virus to others in your home.

Dengue Prevention

Treatment of Dengue Fever

Dengue is caused by a virus and hence, there is no specific treatment for dengue fever. In the case of mild dengue, it is key to prevent dehydration, often caused by vomiting and high fever. Clean water is recommended and rehydration salts can also help replace lost minerals.

To ease pain and lessen the fever, your doctor may give painkillers such as paracetamol and Tylenol. It is important not to self-medicate with drugs like ibuprofen as they can put you at risk of internal bleeding.

In case of severe dengue, treatment may include:

  • Hospitalisation
  • Intravenous (IV) fluid and electrolyte replacement
  • Blood transfusion
  • Electrolyte therapy
  • Oxygen therapy

Dengue fever usually resolves within days to weeks.

Risk Factors of Dengue Fever

You have a higher chance of contracting dengue fever or a more severe form of the illness if you:

  • Reside or visit tropical locations. The risk of dengue fever rises in tropical and subtropical environments. Africa, Latin America, the western Pacific islands, and Southeast Asia are at risk.
  • You've got dengue fever before. If you have previously been infected with a dengue fever virus, you are more likely to have severe symptoms if you get dengue fever again.

Complications of Dengue Fever

Dengue fever can progress to a more deadly disease known as dengue hemorrhagic fever in a tiny percentage of people.

Hemorrhagic Dengue Fever

Antibiotics to the dengue virus from prior infection and a weakened immune system are risk factors for developing dengue hemorrhagic fever.

This uncommon variant of the illness gets distinguished by the following:

  • High temperature 
  • Causes lymphatic system damage
  • Causes blood vessel damage
  • The nose is bleeding
  • Internal bleeding
  • Internal hemorrhage bleeding from the gums
  • Liver enlargement 
  • Circulatory system failure

Dengue hemorrhagic fever symptoms can lead to dengue shock syndrome, marked by low blood pressure, a weak pulse, chilly, clammy skin, and restlessness. Dengue shock syndrome is a severe condition that can result in profuse bleeding and possibly death.

When mild dengue fever worsens, blood vessels can get damaged and the number of platelets in the blood can drop. This deterioration can cause dengue hemorrhagic fever. DHF symptoms may start after 10 days of getting infected. Here, the symptoms of dengue include:

  • Severe, persistent pain in the abdomen
  • Continuous vomiting
  • Bleeding from the gums, mouth, or nose
  • Internal bleeding leading to blood in the urine, stools, or vomit
  • Skin bruising, caused by bleeding under the skin
  • Difficulty in breathing
  • Excessive thirst
  • Clammy or pale, cold skin
  • Fatigue
  • Restlessness, sleepiness, and irritability

In case of moderate DHF, the symptoms subside once the fever recedes.

Now that you know about the symptoms of dengue, its diagnosis and treatment take steps to prevent its transmission altogether. You can do so by wearing long-sleeved clothes, using a mosquito repellent, and throwing out stagnant water present in containers.

If you think you have dengue fever symptoms make no delay in contacting a doctor.

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Published on 30 Oct 2020Last updated on 11 Nov 2022

Please note that this article is solely meant for informational purposes and Bajaj Finserv Health Limited (“BFHL”) does not shoulder any responsibility of the views/advice/information expressed/given by the writer/reviewer/originator. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. The above article has been reviewed by a qualified doctor and BFHL is not responsible for any damages for any information or services provided by any third party.

Dr. Himmat Singh

Medically reviewed by

Dr. Himmat Singh

, MBBS 1

Dr.Himmat singh is a general physician based in jaipur, with an experience of over 1 year.He has completed his mbbs and is registered under rajasthan medical council.


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