Periodic epidemics have occurred in the Western Hemisphere for over 200 years. In the past 15 years, however, dengue transmission has increased greatly in most countries of the Caribbean Basin, and epidemics are occurring at more frequent intervals. In addition, many patients may notice a change in taste sensation. Symptoms tend to be milder in children than in adults, and the illness may be clinically indistinguishable from influenza, measles, or rubella. The acute phase may last up to one week, with a prolonged convalescence characterized by weakness, malaise, and anorexia.
Treatment based on symptoms is recommended.
Dengue hemorrhagic fever may resemble classical dengue or other viral syndromes in the first few days of illness. The most common of these manifestations are skin hemorrhages such as petechiae, and purpura or ecchymoses, but they may also include epistaxis, bleeding gums, hematemesis, and melena. Most patients develop thrombocytopenia and hemoconcentration, the latter as a result of plasma leakage from the vasculu compartment. Fatality rates in countries that are not prepared for this disease may be very high. Thus, it becomes very important that both the medical and lay communities learn to recognize this disease.