How to Tell If You Have Dengue Fever?

Symptoms of Dengue Fever: What to Look Out For - DoctorOnCall

Within our nation, dengue fever is a common illness. The disease spread by the Aedes mosquito can be fatal. However, people may not have heard much about dengue during COVID-19 pandemic, which has been talked about more in recent years. However, like the latter, dengue fever has also been linked to numerous fatalities. 

Do you know that dengue is hyperendemic in Malaysia1? Hyperendemicity is a situation where there are persistent, high levels of disease occurrence2. In Malaysia, the incidence of dengue is expected to soar every 4-5 years3. The highest number of dengue cases reported in the country was 131,101 cases in year 20194. More than 39,000 dengue cases were recorded in Malaysia between January 2022 and the mid of September 20225.

Therefore, as someone who lives in Malaysia where dengue fever has high incidence, it's important to know how to recognize the signs and symptoms of this disease.

How to Recognise Dengue Fever?

The most common symptom of dengue fever is a high fever. How do we differentiate dengue fever and fever by other causes?

Dengue fever is often confused with other types of fevers. There are a few key ways to tell dengue fever apart from these other diseases.

According to the WHO, dengue infection should be suspected in individuals who have symptoms of fever with a high temperature (40° C) and accompanied by at least two of the symptoms listed below6:

  • Severe headache.

  • Pain behind the eyes.

  • Muscle and joint pain.

  • Nausea.

  • Vomiting.

  • Swollen glands.

  • Rash.


Differences between dengue fever, covid-19, flu and other types of fever6,7,8,9,10,11 


Dengue

Malaria

Influenza

Covid-19

Zika

Chikungunya

Transmission

Mosquito bite (Aedes. aegypti, Aedes. albopictus)

Mosquito bite  (Anopheles

Respiratory Droplets

Respiratory Droplets

Mosquito bite (Aedes. aegypti and Aedes. albopictus)

Mosquito bite (Aedes. albopictus and Aedes. aegypti)

Incubation

4-10 days

10-15 days

Usually 2 days, can be around 1-4 days

5-6 days average, up to 14 days

3-14 days

4-8 days (can range from 2 -12 days)

Distinguishing symptoms

Pain behind eyes, swollen glands, rash

Headache, chills

Severe malaria may present with respiratory distress

Cough (usually dry), severe malaise (feeling unwell), sore throat and a runny nose

Cough, tiredness, loss of taste or smell


Rash, conjunctivitis

Frequently accompanied by severe joint pain


Phases of Dengue

Dengue fever symptoms usually begin 4-10 days after being bitten by a mosquito that carries the dengue virus6. The period from the bite until symptoms start is called the incubation period6.

After that, dengue symptoms will appear in 3 phases, namely the fever phase, the critical phase, and the recovery phase.

Febrile phase - As the name suggests, this phase is dominated by fever symptoms and accompanied by other symptoms as listed above. This phase can last between 2 to 7 days12,13.

Critical phase - This phase is an important phase to pay attention to. This is because the patient's condition can become severe during this phase. Although the fever temperature will probably decrease at this time, the warning signs of more severe dengue should be observed12,13.

Recovery phase - In this phase, the patient's condition will improve and stabilize. But the skin rash experienced will begin to peel and become itchy12,13.

Reference13,14

Be Aware of Dengue Warning Signs


As mentioned, severe dengue fever such as dengue hemorrhagic and dengue shock syndrome can occur in the critical phase.

Therefore, recognize the following warning signs6,15:

  • Severe stomach ache.

  • Frequent vomiting.

  • Bleeding gums.

  • Blood vomiting.

  • Rapid breathing.

  • Fatigue.

  • Restlessness.


If the above warning symptoms are identified in any individual, the patient should be immediately taken to the hospital for emergency treatment.

Severe Dengue Can be Fatal If Left Untreated

Severe dengue is a potentially fatal complication due to plasma leakage, fluid accumulation, respiratory distress, severe bleeding, or organ dysfunction6.

Therefore, recognizing the symptoms of dengue and the warning signs of severe dengue is very important to ensure that early treatmentcan be given.


References

1. Rathakrishnan A, Klekamp B, Wang SM, Komarasamy TV, Natkunam SK, Sathar J, et al. (2014) Clinical and Immunological Markers of Dengue Progression in a Study Cohortfrom a Hyperendemic Area in Malaysia. PLoS ONE 9(3): e92021 | https://tinyurl.com/yck86uwh| Accessed on September 23, 2022.

2. Centers for Disease Control and Prevention (CDC). Lesson 1: Introduction to Epidemiology | https://tinyurl.com/wtnp8djx | Accessed on September 23, 2022.

3. 'Malaysia catat Kes demam Denggi Terendah Sejak Sedekad Lalu'. (2022, January 31) Berita Harian | https://tinyurl.com/4wc5pzmk | Accessed September 15, 2022.

4. CodeBlue. (2020, January 6). Malaysia reports 130,000 dengue cases in 2019, highest since 2015 | https://tinyurl.com/26365jyk | Accessed on September 23, 2022.

5. iDengue_Versi 3.0 | https://tinyurl.com/n2jjfmru | Accessed on August 26, 2022.

6. World Health Organisation. Dengue and Severe Dengue | https://tinyurl.com/46vwdxu7 | Accessed on September 23, 2022.

7. World Health Organization. Malaria | https://tinyurl.com/bdzhsbej | Accessed on September 12, 2022.

8.World Health Organization. Influenza (seasonal) | https://tinyurl.com/ms6bscb7 | Accessed on September 12, 2022.

9. World Health Organization. Coronavirus | https://tinyurl.com/2p8w8zkz | Accessed on September 12, 2022.

10. World Health Organization. Zika virus | https://tinyurl.com/2p8fwsh8 | Accessed on September 12, 2022.

11. World Health Organization. Chikungunya | https://tinyurl.com/3kyw8834 | Accessed on September 12, 2022.

12. MSF Medical Guidelines. Dengue | https://tinyurl.com/hrdnu6ny | Accessed on August 26, 2022

13. Centers for Disease Control and Prevention. Dengue Clinical Presentation | https://tinyurl.com/ycxjs6x7 | Accessed on September 23, 2022.

14. GUIDELINES FOR CLINICAL CASE MANAGEMENT OF DENGUE FEVER/ DENGUE HEMORRHAGIC FEVER/ DENGUE SHOCK SYNDROME 2011 IN PAKISTAN CONTEXT - Scientific Figure on ResearchGate | https://tinyurl.com/4343pv3s | Accessed on September 12, 2022.

15.Tanda-tanda amaran bagi jangkitan denggi yang teruk. World Health Organisation - Western Pacific Region | https://tinyurl.com/5ayww5mr | Accessed on August 26, 2022.

C-ANPROM/MY/DENV/0084 OCT 2022

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Disclaimer: This information is available to public for information purposes only; it should not be used for diagnosing or treating a health problem or disease. It is not intended to substitute consultation with a healthcare provider. Please consult your healthcare provider for advice.