What’s dengue hemorrhagic fever?

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Dengue hemorrhagic fever is a complication of dengue fever, which is a dangerous virus spread through mosquito bites. People most at risk for this difficult condition usually have already had a case of dengue fever, or there is a high risk for children and for women, particularly of Caucasian ancestry. Most people with dengue fever don’t progress to dengue hemorrhagic fever, but when they do, it’s a condition that requires treatment. Without it, half of the people who get this disease die.

People who have dengue fever have been bitten by mosquitoes which are known to occupy certain parts of the world. Areas where people are exposed include Southeast Asia, South America, Northern Australia, Central America and parts of Africa. The mosquitoes that transmit these viruses are the Aedes aegypti.

The initial symptoms of dengue hemorrhagic fever are usually identical to those of dengue fever, so it can be difficult to tell at first what kind of disease a person has. Early symptoms of dengue fever include very high fever—temperatures of 104 degrees F (40 degrees C) or slightly higher are not uncommon. People may experience muscle and joint pain, nausea and/or vomiting, lymph nodes are often enlarged, and the victim may experience headaches and fatigue.

If the disease is indeed dengue hemorrhagic fever, things change within days of the first symptoms appearing. People become extremely restless and sweat profusely. Petechiae or small red dots may appear on the body, indicating bleeding from capillaries in the skin. People may also get large red spots that suggest more significant bleeding under the skin. What can occur next is shock, where major organs in the body can stop working properly. People can develop swelling in the brain, inflammation of the liver, and fluid in the lungs.

While some people go through dengue hemorrhagic fever and never develop shock or are able to recover, many go through a crisis period that lasts about 24 hours, in which it’s not clear whether recovery will occur. It is very important to get treatment first when possible, as this can greatly improve the chances of survival. Unfortunately, the handling isn’t perfect.

One of the problems with dengue fever of all types is that it’s viral. Doctors can provide supportive care and work to combat organ damage, but they cannot treat the virus directly. Treatment for dengue hemorrhagic fever might address internal bleeding with blood transfusions, might help calm a fever or inflammation, and can treat things like dehydration or low oxygen levels. These supportive treatments usually help people overcome the disease.

For most people, the best treatment is prevention, which means using strong mosquito repellents in areas frequented by this mosquito. Repellents with DEET are the most recommended. It is also advisable to avoid being outdoors during the hours of the day when mosquitoes are most active. Given the additional risk of this disease for white children and women, particular caution might be advised for these groups.

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