The Dangers of Severe Dengue
Dengue is a disease that is transmitted by mosquitoes infected with dengue virus.[1] Dengue is spread by the Aedes mosquito specifically Aedes aegypti and Aedes albopictus.[1] There are 4 known serotypes of dengue viruses (DENV-1, DENV-2, DENV-3, and DENV-4) suggesting that it is possible to experience dengue up to 4 times in one’s life.[2]
According to the World Health Organisation (WHO) statistics, Malaysia has one of the highest numbers of dengue cases globally with more than 100,000 cases a year.[3] As of 30th December 2024, Malaysia has experienced 121,050 reported cases.[4]
Dengue may present with or without symptoms and may lead to severe conditions that require hospitalisation.[3] In this article, we will discuss severe dengue.
How has the classification of dengue changed?
Since 2009, WHO has done away with the classification of ‘dengue fever’ and ‘dengue haemorrhagic fever’. Today, dengue has been classified according to its severity, simply named as ‘dengue’ and ‘severe dengue’.[1]
Severe dengue is often accompanied by complications such as organ damage, severe bleeding, or severe plasma leakage.[1] This classification holds some resemblance to the old definition of Dengue Hemorrhagic Fever (DHF) which had been described by the following criteria and symptoms:
Criteria | Symptoms or Manifestation |
|---|---|
Fever or a recent fever lasting 2-7 days |
|
Any manifestation of abnormal bleeding A low platelet count is often discovered through blood tests (thrombocytopenia) |
|
Warning signs related to veins, arteries, and other vessels |
|
About 1 in 20 patients with dengue will develop into severe dengue disease.[5] While not all dengue patients develop symptoms of severe dengue,[3] severe dengue may develop quickly over a short time which is why it is important to recognise its symptoms.
Since there is no treatment for dengue, severe dengue must be monitored and managed closely by healthcare professionals to increase the chances of health outcomes.[3]
Are You At Risk of Severe Dengue?
Severe dengue fever occurs more often in children less than 15 years old in hyperendemic areas, however, cases of severe dengue in adults are on the rise.[6]
A second infection caused by a different virus serotype may increase your risk of severe dengue.[3]
The following categories of people are at higher risk of severe dengue:[6]
- Babies and the elderly
- Obese individuals
- Pregnant ladies
- Patients with peptic ulcer disease
- Women who experience abnormal menstruation or vaginal bleeding
- Patients with hemolytic diseases such as glucose-6-phosphatase dehydrogenase (G6PD) deficiency, thalassemia, and other haemoglobinopathies
- Patients with congenital heart disease
- Individuals with chronic diseases such as diabetes mellitus, hypertension, asthma, ischemic heart disease, chronic kidney failure, liver cirrhosis
- Patients receiving steroid or NSAID treatment, etc.
Prevention is the best strategy.
Some initiatives you could consider include:[7]
- Disposing of containers that can hold water
- Ensuring water tanks and rain catchment containers are sealed
- Ensuring flower pots and containers are emptied of water to prevent standing water
- Ensuring the roof drains are always flowing
- Rearing fish in any water feature at your home such as ponds
- Using insect spray to kill mosquitoes
- Applying mosquito repellent on limbs exposed to mosquito bites
- Wearing bright-colored shirts with long sleeves and long pants when leaving the house
- Installing mosquito nets and electric mosquito repellents in closed areas
- Ensuring windows and doors are closed
Recently, vaccination has been added to the list of dengue prevention methods in Malaysia. Consult your doctor about preventive measures including vaccination for you and your loved ones. WHO recommends vaccination for children between the ages of 6 to 16 years old in settings with high dengue burden.[8]
Manage your risk of severe dengue by taking precautionary measures against dengue and learning to seek medical help early by recognizing symptoms and risk factors of severe dengue.
References
- Kementerian Kesihatan Malaysia. CPG - Dengue 3rd edition | https://tinyurl.com/tazp2ca5 | Accessed on 22th September 2022.
- European Centre for Disease Prevention and Control (ECDC). Dengue Fever Facts. | https://www.ecdc.europa.eu/en/dengue-fever/facts | Accessed on 22th September 2022.
- World Health Organization (WHO). Fact Sheet: Dengue and Severe Dengue | https://tinyurl.com/3s9ryfhp | Accessed on 26th September 2022.
- Kementerian Kesihatan Malaysia. iDengue Untuk Komuniti | https://tinyurl.com/4d5pf3pj | Accessed on 26th September 2022.
- Centers for Disease Control and Prevention. Clinical Presentation - Dengue | https://www.cdc.gov/dengue/hcp/clinical-signs | Accessed on 22th September 2022.
- World Health Organization. Regional Office for South-East Asia. (2011). Comprehensive Guideline for Prevention and Control of Dengue and Dengue Haemorrhagic Fever. WHO Regional Office for South-East Asia. https://tinyurl.com/3jwst4ad | Accessed on 22nd September 2022.
- Bahagian Pendidikan Kesihatan Kementerian Kesihatan Malaysia. Info Sihat - Demam Denggi | https://infosihat.moh.gov.my/demam-denggi.html | Accessed on 23th September 2022.
- World Health Organization (WHO). (2024). WHO Prequalifies New Dengue Vaccine. WHO | https://www.who.int/news/item/15-05-2024-who-prequalifies-new-dengue-vaccine | Accessed on 9 December 2024.
This article is brought to you by Takeda Malaysia Sdn. Bhd.
Disclaimer: This information is available to the public for information purposes only; it should not be used for diagnosing or treating a health problem or disease. It is not intended to substitute consultation with a healthcare provider. Please consult your healthcare provider for advice.
C-ANPROM/MY/DENV/0390 March 2025
Written By Sean Koh, Bachelor of Medicine, Bachelor of Surgery, Bachelor of Obstetrics - MB, BCh, BAO (Hons) - National University of Ireland on
Reviewed By DoctorOnCall Panel Doctor
