Dengue haemorrhagic fever
The dengue haemorrhagic fever is a complication caused by infection of a dengue virus. The dengue virus is a species of the genus flavivirus spread by a bite of an infected mosquito (especially Aedes spp., mainly A. aegypti). Infection with the dengue virus results in dengue fever, an acute febrile disease. The usual onset is three to 14 days after infective mosquito bite. The duration of the disease is typically between two to seven days. Typically, the first exposure to dengue virus results in relatively milder symptoms. The fundamental symptoms are fever (i.e. over 40 °C or 104 °F), headache (especially behind the eyes), an itchy, measle-like rash, and platelet count below the normal level. The condition may lead to severe, potentially lethal, complications. One of which is dengue hemorrhagic fever. This is the more severe type of the disease. It may occur in immunocompromised patients or in patients exposed to dengue virus of another strain. It is characterized by haemorrhages in the skin, gastrointestinal tract, and mucosa along with the symptoms described above. There is also plasma leakage resulting in fluid in the abdomen and lungs. The dengue haemorrhagic fever has four grades depending on severity: Grade I, II, III, and IV. Grade I is characterized by fever and constitutional symptoms. Grade II is similar to Grade I with spontaneous bleeding of skin, gums or gastrointestinal tract. Grade III is similar to Grade II but with agitation and circulatory failure. Grade IV is when there is a profound shock. Grades III and IV are associated with the so-called dengue shock syndrome.
The disease is prevalent in the tropics and subtropics. Places that are at the greatest risk are Southeast Asia, Southern China, Taiwan, The Indian subcontinent, Mexico, Africa, and certain places in the Carribbean, Central America, and South America.
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