Symptoms and Treatment of Dengue Hemorrhagic Fever

Written by Medicover Team and Medically Reviewed by Dr Sateesh Pydi , General Medicine

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Dengue Hemorrhagic Fever (DHF) is a severe and potentially life-threatening form of dengue infection caused by the dengue virus transmitted through Aedes mosquito bites. It is characterized by high fever, bleeding tendencies, plasma leakage, and a risk of shock if not treated promptly.

What are the Symptoms of Dengue Hemorrhagic Fever?

DHF's symptoms can be more severe and life-threatening than those of regular dengue fever. They typically appear after an incubation period of 4-10 days following the bite of an infected mosquito. The progression of symptoms can be divided into three phases: febrile, critical, and recovery.

Febrile Phase

High Fever: Sudden onset of high fever, often reaching 104°F (40°C).
Severe Headache: Intense pain usually centered around the forehead.
Retro-orbital Pain: Pain behind the eyes.
Myalgia and Arthralgia: Severe muscle and joint pains.
Rash: A maculopapular rash that may appear on the face, thorax, and limbs.
Mild Bleeding: Such as nosebleeds, gum bleeding, or easy bruising.

Critical Phase

Plasma Leakage: Leading to fluid accumulation in the chest and abdominal cavities.
Severe Abdominal Pain: Often indicative of plasma leakage.
Persistent Vomiting: Inability to retain fluids.
Rapid Breathing: Indicative of fluid accumulation and respiratory distress.
Bleeding: More severe bleeding from gums, nose, gastrointestinal tract, or other sites.
Shock: Characterized by a rapid, weak pulse, hypotension, and cold, clammy skin.

Recovery Phase

Reabsorption of Leaked Fluid: The body starts to reabsorb the leaked plasma.
Stabilization of Vital Signs: Blood pressure and pulse rate return to normal.
Gradual Improvement: Symptoms begin to subside, and the patient starts to recover.

What are the causes of Dengue Hemorrhagic Fever?

DHF is caused by the dengue virus, which has four serotypes: DENV-1, DENV-2, DENV-3, and DENV-4. The primary vector for dengue transmission is the Aedes aegypti mosquito, although Aedes albopictus can also transmit the virus. Secondary infection with a different serotype increases the risk of developing DHF due to a phenomenon known as antibody-dependent enhancement (ADE).

The disease spreads through the bite of an infected mosquito, which becomes a carrier after feeding on a person already infected with the virus. Factors such as living in tropical and subtropical regions, poor sanitation, stagnant water, and increased mosquito breeding sites significantly contribute to the spread of infection and the risk of severe disease.

When Should You See a Doctor for Dengue Hemorrhagic Fever?

Immediate consultation with a physician or emergency care doctor is necessary if warning signs or severe symptoms develop.

High fever lasting several days
Severe abdominal pain or persistent vomiting
Bleeding from the gums, nose, or stool
Extreme weakness or restlessness
Difficulty breathing or rapid breathing
Signs of shock such as low blood pressure or fainting

Find Doctors for Dengue Hemorrhagic Fever Treatment Near You

What are the Risk Factors for Dengue Hemorrhagic Fever?

Several risk factors increase the likelihood of developing DHF:

Previous Dengue Infection: Individuals who have had dengue fever before are at higher risk.
Age: Children are more susceptible to severe forms of dengue.
Genetic Factors: Certain genetic predispositions can increase susceptibility.
Geographical Location: Living in or traveling to endemic areas with high mosquito populations.
Immunocompromised State: Individuals with weakened immune systems are more vulnerable.

How is the diagnosis of Dengue Hemorrhagic Fever?

Accurate and timely diagnosis is essential for the effective management of DHF. The diagnostic process typically involves:

Clinical Evaluation

History and Symptoms: Assessment of clinical symptoms and patient history.
Physical Examination: Checking for signs of bleeding, fluid accumulation, and shock.

Laboratory Tests

Complete Blood Count (CBC): To identify thrombocytopenia (low platelet count) and hemoconcentration.
Serological Tests: Detection of IgM and IgG antibodies against the dengue virus.
RT-PCR: Reverse transcription-polymerase chain reaction to detect viral RNA.
NS1 Antigen Test: Detection of the non-structural protein one antigen of the virus.

What are the Prevention of Dengue Hemorrhagic Fever?

Preventing DHF involves controlling the mosquito population and minimizing exposure to mosquito bites. Key prevention strategies include:

Mosquito Control

Eliminating Breeding Sites: Removing standing water where mosquitoes can breed.
Insecticides: Using larvicides and adulticides to control mosquito populations.
Biological Controls: Introducing natural predators of mosquitoes.

Personal Protection

Protective Clothing: Wear long sleeves and pants to minimize skin exposure.
Repellents: Using insect repellents containing DEET, picaridin, or oil of lemon eucalyptus.
Mosquito Nets: Sleeping under insecticide-treated mosquito nets.

Community Engagement

Public Awareness: Educating communities about dengue prevention.
Government Initiatives: Supporting government-led mosquito control programs.

What is the Treatment for Dengue Hemorrhagic Fever?

There is no specific antiviral treatment for DHF. Management primarily focuses on supportive care to alleviate symptoms and prevent complications.

Hospitalization

Patients with DHF often require hospitalization for close monitoring and supportive treatment.

Fluid Replacement

Intravenous Fluids: Administering IV fluids to manage dehydration and maintain fluid balance.
Oral Rehydration: Encouraging oral intake of fluids if the patient can tolerate it.

Pain Management

Analgesics: Administering acetaminophen for pain relief. Avoid aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) due to the risk of bleeding.

Monitoring

Vital Signs: Regular monitoring of blood pressure, pulse, and respiratory rate.
Laboratory Tests: Frequent blood tests to monitor platelet count and hematocrit levels.