Dengue fever

**Dengue fever** (pronounced "DEN-gi") is a  infectious disease caused by the dengue virus. People get the dengue virus from mosquitoes. Dengue fever is also called **break-bone fever**, because it can cause so much pain that people feel like their bones are breaking.

Most people with dengue fever can get better just by drinking enough water. However, a small number of people get **dengue hemorrhagic fever** or **dengue shock syndrome**. These are medical emergencies and can kill a person if they do not get medical treatment.

There is no vaccine that can keep people from getting the dengue virus. There is also no treatment to cure dengue fever. Doctors can only provide "supportive care," which means they can only treat dengue's symptoms.

Since the 1960s, more people have been getting dengue fever. Since World War II, dengue has become a problem around the world. It is common in more than 110 countries. Every year, between 50 million and 100 million people get dengue fever. Climate change means that there are more mosquitoes. In Brazil it is expected that there will be at least twice as many cases in 2024 than in 2023.

## Signs and symptoms
80% of people who get the dengue virus have no symptoms, or have only mild symptoms (like a basic fever). About 5% of infected people get much sicker. A small number of those infected have symptoms that could kill them.

Often, when children have dengue fever, their symptoms are the same as gastroenteritis (stomach flu), like vomiting and diarrhea, or the common cold. Children are more likely to have bad complications from dengue fever.

### The febrile stage 
In the *febrile stage*, people with dengue usually have a high fever. ("Febrile" means that a person has a fever.) The fever is often over 40 degrees Celsius (104 degrees Fahrenheit). Sometimes the fever gets better, and then comes back.
* Pain all over their bodies
* A headache
* A  (this happens in 50% to 80% of people who get sick from dengue)
* Petechiae (small red spots on the skin). These are caused by capillaries (which carry blood) breaking. This makes the blood leak out and show up under the skin.
* Small amounts of bleeding from the mucous membranes in the mouth and nose
The febrile stage usually lasts 2 to 7 days.
* Neurological disorders: These are problems with the brain and the nerves, like Guillain–Barré syndrome 
* Infection of the heart, or sudden liver failure (these are very uncommon). *Aides aegypti* is the most likely type of mosquito to spread dengue, because it likes to live close to humans and feed off of people instead of animals. A person can get the dengue virus from just one mosquito bite.

Sometimes, mosquitoes can also get dengue from humans. If a female mosquito bites someone with dengue, the mosquito may get the dengue virus from the person's blood. After about 8 to 10 days, the virus spreads to the mosquito's salivary glands, which make saliva (or "spit"). Now the mosquito will make saliva that is infected with the dengue virus. When the mosquito bites a human, its infected saliva goes into the human and can give that person dengue.

A person can also get the dengue virus if they get a blood transfusion or organ donation from someone who has the virus. In some countries where dengue is common, like Singapore, between 1.6 and 6 blood transfusions out of every 10,000 spread dengue.

The dengue virus can also be spread from a mother to her fetus during pregnancy, or when the child is born. This is called vertical transmission.

Dengue is usually not spread in any other ways.

### Risk factors
Babies and young children with dengue are more likely than adults to become very sick. Women are more likely than men to get very sick.

There are four different types of the dengue virus. Once a person has had one type of the virus, they are usually protected from that type for the rest of their life. However, they will only be protected against the other three types of the virus for a short time. If they later get one of those three types of the virus, they will be more likely to have serious problems, like dengue shock syndrome or dengue hemorrhagic fever.

## Diagnosis
Usually, doctors diagnose dengue by examining the infected person and realizing that their symptoms match dengue. However, these special tests are expensive.

#### The new system 
In 2009, the WHO created a simpler system which divided dengue fever into two types: 
# *Uncomplicated*: People who just have the febrile stage of dengue fever, and never go into the critical phase. They get better on their own or just need basic medical help.
# *Severe*: People who have symptoms that could kill them, or have serious complications from dengue.

## Prevention
There are no vaccines that can keep people from getting the dengue virus.

Doctors can give medicines like acetaminophen (paracetamol) for fever and pain. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin should not be used because they make bleeding more likely.

When people reach the recovery stage of dengue, doctors usually stop giving intravenous fluids to prevent fluid overload (having too much fluid in the body). If a person gets fluid overload, doctors can give a type of medication called a diuretic, which will make the patient urinate out the extra fluid. The World Health Organization says that dengue fever is not taken as seriously as it should be. It calls dengue one of 16 "neglected tropical diseases" - diseases which do not get enough attention. In every million people, dengue causes about 1600 years of life to be lost. This is about the same as other tropical and deadly diseases, like tuberculosis. Scientists think dengue may be getting more common because:
* More people are living in cities
* There are more people in the world. The world's population is growing
* More people are travelling internationally (between countries)
* Global warming is thought to play a part in the increase in dengue.

Written records from the 17th century talk about what may have been epidemics of dengue (where the disease spread very quickly in a short time). The most likely early reports of dengue epidemics are from 1779 and 1780. These reports talk about an epidemic that spread across Asia, Africa, and North America. John Burton Cleland and Joseph Franklin Siler kept studying the dengue virus, and figured out the basics of how the virus spreads. However, it is also possible that the Spanish word came from the Swahili word, and not the other way around.

Other people think that the name "dengue" comes from the West Indies. In the West Indies, slaves that had dengue were said to stand and walk like "a dandy." Because of this, the disease was also called "dandy fever."

The name "breakbone fever" was first used by Benjamin Rush, a doctor and United States "Founding Father." In 1789, Rush used the name "breakbone fever" in a report about the 1780 dengue outbreak in Philadelphia. In his official report, Rush mostly used the more formal name "bilious remitting fever".

The term "dengue fever" was not commonly used until after 1828. creating a vaccine, and creating drugs to fight the virus. They are also working on figuring out how the virus's proteins are structured. This may help them create medications that work well for dengue.

## Related pages 
* Wolbachia
* World mosquito program

## Notes
## References
* 
*