Consider Dengue in Patients Who Travel to Areas With Transmission Risk

The TMA Committee on Infectious Diseases encourages you to consider dengue in patients who have traveled to areas with known dengue transmission risk and who present with symptoms consistent with this mosquito-borne disease.

Dengue is endemic throughout the tropics and subtropics, including parts of Mexico, Central and South America, Puerto Rico, the U.S. Virgin Islands, the Caribbean, Southeast Asia, Africa, and Australia. In 2013, 23 cases of dengue were locally acquired in three South Texas counties. 

Early recognition and anticipatory supportive treatment of severe symptoms can significantly lower the risk of death or serious complications. Dengue symptoms begin after an incubation period of three to 14 days and can range in severity. 

Dengue fever usually lasts two to seven days and can include severe headache, retro-orbital pain, muscle and joint pain, rash, and minor hemorrhagic manifestations. The severe illness presentations of dengue hemorrhagic fever and dengue shock syndrome may additionally include hepatomegaly and, after defervescence, the development of hemorrhage, plasma leak, or shock. Severe forms of illness usually manifest after a two- to seven-day febrile phase. 

Dengue is a notifiable condition. For more information on reporting dengue, contact DSHS or your local health department or call DSHS at (800) 252-8239.

The CDC website has clinical guidance.

Action, June 2, 2014