Figure 1.  CDC world distribution of dengue.

 

Figure 2. Schematic diagram illustrating the common clinical manifestations of dengue infection (101).

 

Table 1. WHO case definitions for DF (101).

Probable DF

An acute febrile illness

AND two or more of the following:-

Headache

Retro-orbital pain

Myalgia

Arthralgia

Rash

Haemorrhagic manifestations

Leucopenia

AND

Supportive serology       OR

Occurrence at the same location and time as other DF cases

Confirmed DF

An acute febrile illness

AND two or more of the following:-

Headache

Retro-orbital pain

Myalgia

Arthralgia

Rash

Haemorrhagic manifestations

Leucopenia

AND

Diagnostic serology/virology

 

Table 2. WHO case definitions for DHF and DSS (adapted from reference 101)

Criteria

DHF

Strict Diagnosis

Fever or history of fever

·        2-7 days

Present

Haemorrhagic tendency*

·        A positive tourniquet test

·        Spontaneous petechiae or other skin bleeding

·        Mucosal / gastrointestinal tract bleeding

Present

Thrombocytopenia

·        Platelet count < 100,000 / mm3

Present

Evidence of plasma leakage*

·        Elevation of the haematocrit to > 20% above the expected mean for age, sex and population

·        Reduction of the haematocrit by > 20% of the baseline value after volume replacement

·        Clinical signs of plasma leakage such as pleural effusion or ascites, and/or hypoproteinaemia

Present

Circulatory compromise*

·        Narrow pulse pressure < 20 mm Hg, with tachycardia

·        Hypotension for age, with cold, clammy skin and restlessness

  DSS  –  all four features must be present plus circulatory compromise

                         * One or more of the following findings