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Dengue fever is a disease caused by a virus that is spread by mosquitos. In its mild form, dengue causes fever and rash and lasts approximately one week. 

Severe dengue can cause shock, internal bleeding, and death. Approximately 1 in 20 people with dengue will develop severe dengue within a few hours after symptoms start. 

The primary risk factor for severe dengue is previous dengue infection.

Dengue fever is caused by 1 of 4 viruses that are different but related. 

It is transmitted through a bite by a mosquito, primarily the Aedes aegypti mosquito, which is found in tropical and subtropical regions:

• The Indonesian archipelago in northeastern Australia
• Central and South America
• Southeast Asia
• Sub-Saharan Africa
• The Caribbean (including Puerto Rico and the US Virgin Islands)

It starts with a sudden high fever, often up to 105 °F (40.5 °C), that begins four to seven days after infection.

Two to five days after the fever starts, a flat, red rash may appear over most of the body. Later in the course of the disease, a second, measles-like rash appears.

Other symptoms include:

• Fatigue
• Headache (especially behind the eyes)
• Joint pain (often severe)
• Muscle pain (often severe)
• Nausea and vomiting
• Swelling of the lymph nodes
• Cough
• Sore throat
• Stuffy nose
  

Symptoms of severe dengue can develop 24 to 48 hours after the fever has gone away. Symptoms of severe dengue include:

• Intense stomach pain and sensitivity
• Frequent vomiting (at least three times in 24 hours)
• Bleeding from the nose or gums
• Blood in vomit, stool, or urine
• Bleeding under the skin (seen as bruises)
• Difficulty breathing, rapid breathing
• Feeling tired, restless, or irritable

Tests to diagnose this condition include:

• Antibody titer for the types of dengue virus
• Complete blood count (CBC)
• Polymerase chain reaction (PCR) test for the types of dengue virus
• Liver function tests

There is no specific treatment for dengue fever. Fluids are given if there are signs of dehydration. Paracetamol (acetaminophen, Tylenol) is used to treat high fever.

Avoid taking acetylsalicylic acid (aspirin), ibuprofen (Advil, Motrin), and naproxen (Aleve), as they can make bleeding problems worse.

Severe dengue is a medical emergency. Treatment for severe dengue is supportive care and may include:

• Fluids given through a vein (IV)
• Oxygen
• Blood pressure monitoring
• Blood transfusions

If untreated, dengue fever can cause the following conditions:

• Febrile seizures
• Severe dehydration
• Death

Using protective clothing, mosquito repellent, and mosquito nets can help reduce the risk of bites by the mosquitos that can spread dengue fever, along with other infections.