How to Tell If You Have Dengue Fever?

Dengue is hyperendemic in Malaysia.^[1] Hyperendemic describes a state where a disease is persistent with high levels of occurrence.^[2] 

In Malaysia, the incidence of dengue is expected to soar every 4-5 years.^[3] The highest number of dengue cases reported in the country was 131,101 cases in 2019.^[4] In 2023, 123,133 cases of dengue were recorded alongside 100 related deaths.^[5]

It is important to know how to recognize the signs and symptoms of dengue in order to seek help early to avoid complications of severe dengue

How to Recognise Dengue Fever?

The most common symptom of dengue fever is a high fever. How do we differentiate dengue fever and fever by other causes?

According to the WHO, dengue infection should be suspected in individuals who have symptoms of fever with a high temperature (40° C) and are accompanied by at least two of the symptoms listed below^[6]:

• Severe headache

• Pain behind the eyes

• Muscle and joint pain

• Nausea

• Vomiting

• Swollen glands

• Rash

In order to differentiate dengue, doctors may ask for the duration of symptoms and other relevant information as part of a comprehensive history taking.  

Table of the differences between dengue fever, influenza, and covid-19^[6],[7],[8]:

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Phases of Dengue

Dengue fever symptoms usually begin 4-10 days after being bitten by a mosquito that carries the dengue virus.[6] The period from the bite, until symptoms start, is called the incubation period.^[6]

After incubation, dengue symptoms may appear in 3 phases:

Febrile phase –  characterised by the presence of fever and accompanied by other symptoms as listed above. This phase may last between 2 to 7 days.^[9],[10]

Critical phase - this phase, typically lasting 24 to 48 hours and occurring between days 3 to 7 of illness, is when warning signs of severe dengue may be observed.^[9],[10] It is crucial for patients to be under close medical observation during this period due to the risk of complications.

Recovery phase – characterised by easing of symptoms as patients’ condition improves and stabilizes. Patients experiencing dengue-related rash may notice their skin begin to peel and itch.^[9],[10]

Reference^[11]

​Be Aware of Dengue Warning Signs

Severe dengue fever such as dengue hemorrhagic and dengue shock syndrome may develop quickly in the critical phase. It is therefore important to recognize the following warning signs early^[6],[12]:

• Severe stomach ache

• Frequent vomiting

• Bleeding gums

• Blood vomiting

• Rapid breathing

• Fatigue

• Restlessness

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If the above warning symptoms are identified in any individual, the patient should be immediately taken to the hospital for emergency treatment.

Severe Dengue Can be Fatal If Left Untreated

Severe dengue is a potentially fatal complication due to plasma leakage, fluid accumulation, respiratory distress, severe bleeding, or organ dysfunction.^[9]

Recognizing the symptoms of dengue and the warning signs of severe dengue early is important to ensure that medical attention and treatment can be sought promptly.

While there is still no specific treatment for dengue,^[6] anyone can take preventive steps. Effective integrated dengue prevention strategy includes vector control, public education, personal protection, disease tracking, and vaccination. By eliminating mosquito breeding sites, using personal protective measures, and considering vaccination, individuals and communities can help keep dengue at bay. Speak to your doctor about dengue prevention methods today. 

References

1. Rathakrishnan A, Klekamp B, Wang SM, Komarasamy TV, Natkunam SK, Sathar J, et al. (2014) Clinical and Immunological Markers of Dengue Progression in a Study Cohort from a Hyperendemic Area in Malaysia. PLoS ONE 9(3): e92021 | https://tinyurl.com/yck86uwh | Accessed on September 23, 2022

2. Centers for Disease Control and Prevention (CDC). Lesson 1: Introduction to Epidemiology | https://tinyurl.com/wtnp8djx | Accessed on September 23, 2022

3. 'Malaysia catat Kes demam Denggi Terendah Sejak Sedekad Lalu'. (2022, January 31) Berita Harian | https://tinyurl.com/4wc5pzmk | Accessed September 15, 2022

4. CodeBlue. (2020, January 6). Malaysia reports 130,000 dengue cases in 2019, highest since 2015 | https://tinyurl.com/26365jyk | Accessed on September 23, 2022 

5. International Federation of Red Cross and Red Crescent Societies (IFRC). (2023) Malaysia: Dengue Prevention and Control DREF Operational Update. ReliefWeb | https://tinyurl.com/2x2cvfaz | Accessed on November 4, 2024

6. World Health Organisation. Dengue and Severe Dengue | https://tinyurl.com/46vwdxu7 | Accessed on September 23, 2022 

7. World Health Organization. Influenza (seasonal) | https://tinyurl.com/ms6bscb7 | Accessed on September 12, 2022

8. World Health Organization. Coronavirus | https://tinyurl.com/2p8w8zkz | Accessed on September 12, 2022 

9. Centers for Disease Control and Prevention. Dengue Clinical Presentation | https://tinyurl.com/ycxjs6x7 | Accessed on September 23, 2022

10. MSF Medical Guidelines. Dengue | https://tinyurl.com/hrdnu6ny | Accessed on August 26, 2022

11. GUIDELINES FOR CLINICAL CASE MANAGEMENT OF DENGUE FEVER/ DENGUE HEMORRHAGIC FEVER/ DENGUE SHOCK SYNDROME 2011 IN PAKISTAN CONTEXT - Scientific Figure on ResearchGate | https://tinyurl.com/4343pv3s | Accessed on September 12, 2022

12. Tanda-tanda amaran bagi jangkitan denggi yang teruk. World Health Organisation - Western Pacific Region | https://tinyurl.com/5ayww5mr | Accessed on August 26, 2022 

C-ANPROM/MY/DENV/0385 JAN 2025

This article is brought to you by Takeda Malaysia Sdn. Bhd.

Disclaimer: This information is available to 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

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