Dengue Virus
Dengue is an arthropod-borne viral disease (arboviral disease) caused by one of any four related viruses: DENV 1, DENV 2, DENV 3, and DENV 4. Dengue viruses are commonly transmitted to people by the bite of an infected Aedes species mosquito which can be found worldwide in tropical and subtropical regions. Dengue viruses are not found in Indiana mosquitoes. Indiana reports cases of dengue every year in travelers returning from areas with risk of dengue.
CDC- World map highlighting areas of dengue risk
Dengue risk is increasing globally and in the Americas region. Puerto Rico's Department of Health declared a public health emergency on March 25, 2024 due to a surge in dengue fever cases in the territory. Centers for Disease Control and Prevention (CDC) anticipates an increase in dengue cases in returning travelers from these areas and potentially limited local transmission in the United States.
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- Transmission
Mosquitoes become infected with dengue virus when they bite a person infected with the virus. Infected mosquitoes can then bite other people, spreading the virus to them.
The two species of Aedes mosquitoes known to transmit dengue virus are Aedes aegypti and Aedes albopictus. The most important vector in the United States is Aedes aegypti which is not established in Indiana.
While less common, other modes of transmission exist. A person who is infected with dengue virus during pregnancy can pass the virus to their fetus during pregnancy or around the time of birth. Rarely, dengue is spread through other routes such as laboratory or healthcare setting exposures through blood transfusions, organ transplants, or needlestick injuries.
- Signs and Symptoms
Symptoms of dengue range from mild to severe.
Approximately 1 in 4 people infected with a dengue virus will develop symptoms which usually appear within 2 weeks after being bitten by an infected mosquito. Symptoms typically last 2–7 days with most people recovering after about a week.
The most common dengue symptom is fever with one or more of the following:
- Aches and pains (eye pain, typically behind the eyes, muscle, joint, or bone pain)
- Nausea, vomiting
- Rash
- Any warning sign
When to Seek Emergency Help
About 1 in 20 people who get sick with dengue will develop severe dengue which can be life-threatening. Severe dengue is a medical emergency. Warning signs for severe dengue typically appear within 24–48 hours after fever has gone away.
Immediately go to the nearest clinic or emergency department if any of the following warning signs appear:
- Belly pain or tenderness
- Vomiting (at least 3 times in 24 hours)
- Bleeding from the nose or gums
- Vomiting blood, or blood in the stool
- Feeling extremely tired or restless
- Diagnosis
People should see a healthcare provider if they have symptoms of dengue and live in or have recently traveled to an area with risk of dengue.
A blood test is the only way to confirm the diagnosis, however laboratory confirmation is not required to manage illness from dengue. Healthcare providers should provide care based on compatible signs and symptoms and educate their patients on warning signs to watch for while awaiting test results.
In addition to ordering blood tests to look for dengue, providers should consider other non-endemic arboviruses like Zika or chikungunya that may cause similar signs and symptoms.
- Treatment
There is no specific medicine to treat dengue. If you think you might have dengue, it is important to:
- See a healthcare provider if you develop a fever or have symptoms of dengue. Tell them about any recent travel.
- Rest as much as possible.
- Take acetaminophen (also known as paracetamol outside of the US) to control fever and relieve pain.
- Do not take aspirin or ibuprofen! These medications can increase the risk of bleeding complications.
- Drink plenty of fluids to stay hydrated. Drink water or drinks with added electrolytes.
- For mild symptoms, care for a sick infant, child, or family member at home.
If you have dengue, prevent mosquito bites. During the first week of illness, dengue can be found in the blood. The virus can be passed from an infected person to a mosquito through mosquito bites posing a risk for local transmission.
- Prevention
Currently, there is no widely available dengue vaccine to prevent dengue infection. The best way to prevent dengue is to protect yourself from mosquito bites by taking the following actions:
- Use an Environmental Protection Agency (EPA)-registered insect repellent while outdoors. Aedes mosquitoes bite during the day and night.
- Wear loose-fitting, long-sleeved shirts and pants to reduce areas of exposed skin.
- Take steps to control mosquitoes in and around your home.
Visit our mosquito prevention page for more helpful tips.
- Resources
For the public
Dengue Fact Sheet English | Spanish
Caring for a Child or Family Member Sick with Dengue English | Spanish
For Healthcare Providers
2024 CDC HAN- Increased Risk of Dengue Virus in the United States
Dengue Information for Healthcare Providers Clinical Features | Testing | Clinical Care
Dengue Clinical Management Course (web-based education)