This rash usually disappears in 1-5 days, often with skin scaling. About the time the rash appears the temperature may rise again before falling back to normal, when the infectious episode is effectively over. Bleeding from the gastrointestinal tract, and excessive vaginal bleeding if menstruating can also occur, but do not usually occur in the majority of cases. The presentation of dengue in the younger child is much less characteristic than in the older child and adult as above. There are no immediately useful tests for dengue fever which are unequivocally accurate.
Convalescence can take weeks, and bed rest and antipyretics and analgesics are required.
An attack produces immunity for a year or more, but only to the one of the four flavivirus strains responsible. This can sometimes be a serious illness. In children, the progression of disease is not always characteristic. A relatively mild first phase with an abrupt onset of fever, malaise, vomiting, headache anorexia and cough is succeeded 2-5 days later by weakness and, sometimes, physical collapse. Frequently, spots appear on the forehead, arms and legs, along with spontaneous bruises and bleeding from punctures where blood was taken.