Dengue Symptoms

Introduction 

Finding out the symptoms of Dengue earlier is significant as it helps in the faster treatment and prevents any further complications. The dengue fever early symptoms are commonly seen 4 to 10 days after an infected mosquito bite. The symptoms of Dengue in babies include a sudden high fever (up to 104°F), Irritability, rash, Vomiting or diarrhoea, along with other symptoms such as sleepiness, lack of energy, and reduced appetite. 

To identify the symptoms of Dengue, a medical professional can go through blood tests, like NS1 antigen detection, IgM and IgG antibody tests, and molecular tests (like PCR) to determine the presence of a virus or its components. But, finding out the Dengue symptoms in adults at home is also possible. 

A serum sample is used for dengue testing or to identify the dengue symptoms. Dengue fever is seen in above 100 countries, especially in tropical and subtropical regions, and they have the highest incidence in Southeast Asia, the Western Pacific, Latin America, and Africa. Dengue fever have caused an estimated 20,000 to 36,000 deaths yearly. Thus, it is better to find out the symptoms of Dengue. 

What is Dengue?

Dengue fever is a viral infection transmitted to humans through the bite of an infected mosquito. It is prevalent in tropical and subtropical regions around the world. The disease is caused by the dengue virus and is primarily spread by the Aedes aegypti mosquito, which bites most frequently during the daytime. In some cases, the infection can progress to severe dengue (formerly known as dengue hemorrhagic fever). This is a medical emergency characterised by warning signs like severe abdominal pain, persistent vomiting, bleeding gums, and difficulty breathing. Hospital care is crucial, as severe dengue can be life-threatening.

Symptoms of Dengue 

Recognising the symptoms of dengue fever is critical for early diagnosis and management. Typically manifesting 4 to 10 days after an infected mosquito bite, the illness often begins abruptly with a high fever, severe headache, and pain behind the eyes. Patients frequently experience intense muscle and joint pain, which is the origin of the disease's "breakbone fever" nickname, and may develop a characteristic skin rash. It is essential to seek prompt medical attention if the condition escalates to severe warning signs such as persistent vomiting, severe abdominal pain, or bleeding from the nose or gums.

There are many Dengue symptoms that help determine if a person is affected by Dengue.

What are the symptoms of Dengue?

The following are the common symptoms of Dengue fever.   

• A high fever - 104 F (40*C)
• Severe headache, particularly behind the eyes
• Intense muscle, joint, or bone pain (the source of its "breakbone fever" nickname)
• Nausea and Vomiting
• Swollen glands(Lymphadenopathy)
• Pain behind the eyes
• A distinctive skin rash that may appear a few days into the illness

Let's deep dive into each symptom individually

1. A High Fever - 104 F (40°C): This is the first symptom of dengue. The fever comes on very suddenly and is often described as "saddleback" because it may disappear after 1-2 days only to return for another day or two. The high temperature is a direct result of your body's immune system launching a massive attack against the dengue virus. The immune cells release chemicals called pyrogens, which signal the brain to raise the body's thermostat, creating an environment less hospitable for the virus to replicate.
2. Severe Headache, Particularly Behind the Eyes: This is not a typical tension headache. It is often a deep, throbbing, and intense pain that feels like it is centred directly behind the eyes. The pain can be severe enough to make it difficult to concentrate or move the eyes. This happens because the dengue virus can cause inflammation of the blood vessels and tissues in the brain and around the eyes. The pain behind the eyes is also frequently worsened by eye movement or pressure.
3. Intense Muscle, Joint, or Bone Pain (breakbone fever): This is the symptom that gives Dengue its terrifying nickname. The pain is not just a mild ache; it's often described as a deep, crushing, or intense soreness in the muscles (myalgia), joints (arthralgia), and even the bones. It can affect the lower back, legs, and large joints, making even small movements excruciating. This pain is caused by the virus directly invading muscle and bone marrow cells, and by the body's inflammatory response to the infection, which releases chemicals that stimulate pain nerves.
4. Nausea and Vomiting: Many patients experience a loss of appetite, persistent nausea, and episodes of vomiting. This is partly due to the body's general systemic response to a severe infection, which can disrupt normal digestive processes. Additionally, the high fever and intense pain can contribute to feelings of nausea. In severe cases, persistent vomiting can lead to dehydration, which is a serious complication to watch for.
5. Swollen Glands (Lymphadenopathy): You may notice tender, swollen lumps, particularly in the neck (cervical lymph nodes) and groin area. Lymph nodes are small, bean-shaped glands that are part of the immune system. They act as filters, trapping viruses and bacteria. When you have a dengue infection, these nodes become active sites where immune cells multiply and fight the virus, causing them to swell and become tender to the touch.
6. Pain Behind the Eyes (Retro-orbital Pain): While mentioned as part of the severe headache, this symptom is significant enough to be listed separately. It is a very characteristic feature of Dengue. The pain is a constant, pressing ache that feels like it's coming from deep within the eye sockets. It is caused by inflammation of the muscles and nerves that control the eye, as well as inflammation of the blood vessels in the retro-orbital space. This symptom is often a key clue for doctors in differentiating Dengue from other febrile illnesses.
7. A Distinctive Skin Rash That May Appear a Few Days into the Illness

Dengue often causes two types of rashes:

• Initial Rash: Early in the illness (first 1-2 days), a widespread, red, flushed rash (resembling sunburn) may appear, often accompanied by high fever.
• Characteristic Later Rash: A second, more distinctive rash typically appears 3-5 days after the fever starts. As the initial high fever subsides, a measles-like rash with small red bumps (maculopapular) emerges. It often starts on the torso (chest, back, and stomach) and can spread to the arms, legs, and face. A key characteristic is that there may be small, isolated areas of unaffected, normal-looking skin within the rash, creating a "islands of white in a sea of red" pattern. In some cases, the rash can be intensely itchy, particularly on the soles of the feet.

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Signs of Dengue Fever

Severe Dengue occurs when your blood vessels become damaged and leaky. The warning signs of severe dengue fever generally start on the first day or two after your fever goes away. These warning signs are life-threatening emergencies which can develop quickly. The warning signs of severe dengue fever might include: 

• Severe Stomach Pain
• Persistent Vomiting
• Blood in your Urine, Stools or Vomit
• Bleeding from your Gums or Nose
• Bleeding below the skin, which may appear like bruising.
• Difficulty in breathing or rapid breathing
• Irritability or restlessness

The Mild Dengue Signs include:

• Sudden High Fever: (104°F or 40°C)
• Severe Headache: Often behind the eyes.
• Pain: Severe muscle, joint, and bone pain
• Eye Pain: Particularly when moving the eyes.
• Nausea and Vomiting
• Skin Rash: A rash may appear a few days after the fever starts. A second rash can appear later in the illness.
• Swollen Glands
• Fatigue
   

Types of Dengue 

There are four types of Dengue virus types: dengue-1, dengue-2, dengue-3, and dengue-4.

• Dengue virus type 1 (DENV-1) is one of the serotypes of arthropod-borne viruses (arbovirus) that result in Dengue. 
• Dengue virus type 2 (DEN-2) have the ability to result in the dengue hemorrhagic fever, that have been shown belonging to the Southeast (SE) Asian genotype.
• Dengue virus type 3 were isolated from patients in Brazil from 2002 through 2004. These isolates were assigned genotype 1, as per phylogenetic analyses. 
• Dengue virus type 4 is one among the four dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) that causes dengue fever. It was first recognised in the Western Hemisphere in 1981.

Causes of Dengue

The primary cause of dengue is infection with the dengue virus (DENV), which has four distinct serotypes (DENV-1, DENV-2, DENV-3, and DENV-4). The fundamental cause of its spread to humans is the bite of an infected mosquito.

Here is a breakdown of the causes and contributing factors:

• Dengue virus is spread by a female Aedes mosquito, which generally bites an infected person in the morning to take a blood meal, and then it spreads the virus any time of the day. 
• Within 2-10 days, the mosquito becomes infected, and the virus spreads to other tissues and is released into saliva. 
• When the mosquito bites an uninfected person, the person becomes infected. The mosquito is generally infected for a lifetime.
• The dengue virus also spreads via blood or organ donation from an infected person.

In short, the cause of a dengue infection is always the dengue virus. The overwhelmingly common cause of transmission is the bite of an infected Aedes mosquito. Environmental and human factors like urbanization, stagnant water, and climate create the perfect conditions for the disease to spread.

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Risk Factors of Dengue 

We have discussed the causes and symptoms of Dengue, so let's see the risk factors. There are some risk factors for Dengue fever, they include : 

1) Living or travelling in tropical areas 

Staying in tropical and subtropical regions increases your exposure to the virus that could cause dengue fever. The risk is high in places like Southeast Asia, Latin America,  the western Pacific islands, and Africa.

2) Previously affected by Dengue Fever

If you have had dengue fever in the past, then your risk of dengue fever is high.  This is because the dengue fever infection increases your risk of symptoms if you get dengue fever again.  

How is Dengue Fever Diagnosed?

Dengue fever is diagnosed through a combination of clinical evaluation and specific blood tests, with the choice of test depending on the timing since symptom onset. In the early stages (days 1-5), diagnosis focuses on detecting the virus itself using the NS1 antigen test, a rapid and common method, or the more precise RT-PCR test, which identifies the virus's genetic material. After the first few days (from day 4-5 onward), the body produces antibodies, and serological tests are used to detect IgM antibodies, indicating a current infection, and IgG antibodies, which can help distinguish between a primary and a secondary infection. Often, doctors will order both NS1 and antibody tests together for a comprehensive diagnosis, while supportive tests like a complete blood count are crucial for monitoring platelet levels and detecting potential complications.

Treatment for Dengue Fever

There is no particular medicine to treat Dengue. So, some methods to manage the dengue symptoms will work out. The methods to manage the symptoms of Dengue  include : 

• Have rest as much as possible. 
• Take acetaminophen to manage fever and relieve Pain.
• Drink enough fluids to become hydrated. 
• Consult a healthcare provider if you develop a fever or have symptoms of Dengue. 
• Without hesitation, tell your medical provider about your travel.  

Foods to Eat in Dengue Fever

Eating some foods helps with fast recovery from Dengue. Here are the foods to be included during Dengue.  

Foods to Avoid during Dengue Fever

There are some foods which have to be avoided to prevent further complications. Here are those foods that have to be avoided during Dengue. 

Dengue Medications

Some medications help in dengue treatment for managing the symptoms; let's see them.  

These tablets for Dengue are prescription-only and should only be used under the guidance of a healthcare professional.
 

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Recovery Time for Dengue

• Dengue fever recovery generally takes 1-2 weeks, with symptoms usually reducing within a week, though a few cases might need very long recovery periods.  
• Initial Symptoms of Dengue generally appear between 3 and 14 days after being bitten by an infected mosquito.  
• Fever Duration will be for about 6 days.  
• The recovery time for most people is within a week, but a few might take up to two weeks.  
• In the case of severe Dengue, the recovery time can take many weeks or even months.      
• After dengue recovery, a few individuals might experience fatigue for many weeks.   

How to Prevent Dengue Fever?

In general, one can prevent dengue fever by taking precautions like avoiding mosquito bites by using repellents, wearing protective clothing, and avoiding mosquito breeding grounds, particularly in standing water etc. Also, some things that have to be considered include : 

• Take extra precautions to prevent mosquito bites if you travel. 
• Get medical advice if you suspect you have dengue fever. 
• Though there is no vaccine to prevent initial dengue infection, a vaccine known as Dengvaxia could help prevent secondary infection in children aged 6 to 16 who have been diagnosed with the virus earlier and who have lived in regions where Dengue spread. 
• Be aware of dengue outbreaks in your area and medical advice provided by the medical staff.

Conclusion

There are many signs and symptoms of Dengue. The dengue fever first symptoms include a sudden high fever, heavy headache, pain behind the eyes, nausea, vomiting, muscle and joint pain, and a rash, that appears 4-10 days after an infected mosquito bite. The dengue fever first symptoms are typically diagnosed using blood tests that detect the virus or antibodies against it. 

The medicines and treatment methods to manage the symptoms help the dengue fever symptoms day by day. The mild dengue symptoms are usually manageable with rest, hydration, and acetaminophen to control fever and pain. 
As there is no direct dengue treatment, the medical professionals will provide medicines to manage the dengue fever symptoms.