Signs of dengue fever- which don’t ignore

Signs of dengue fever Posted On


Currently, Dengue fever is at a peak period because we are observing many dengue cases around us. So, Today I am going to address crucial warning signs of dengue fever.

Whenever you have a fever or someone in your home gets a fever, you get confused whether it is malaria fever, chikungunya, or dengue fever. 

Initially, dengue symptoms may confuse with other viral illnesses. But after a certain period, dengue fever clinically differentiates from other viral diseases. 

The clinical signs of dengue also determine the severity of infection. 

If you want to know the signs of dengue fever. Keep reading this article. In this post, I will take you through 7 warning signs of dengue fever.


What is Dengue fever?

Dengue fever is caused by Aedes aegypti mosquitoes. This mosquito belongs to the Flaviviridae family. 

It is a vector-borne viral disease. 

Once Aedes mosquitoes bite a dengue-infected person. Then this mosquito becomes a carrier of dengue fever. Now, this infected mosquito can spread the virus from human to human. 

Dengue fever is quite common because the incidence is very high in tropical and subtropical parts of the world like the Americas, Asia, Africa, and Australia.

Dengue infection is strongly influenced by the monsoon season. So, it becomes more prevalent after the rainy season.

According to the world mosquito program (WMP), more than 40% population are at risk now globally. Every year, around 390 million people get infected from dengue fever throughout the world. 

It causes 20 to 25,000 deaths, especially in children. 


What are the 7 warning signs of dengue fever?

The signs and symptoms of dengue can vary from asymptomatic to life-threatening conditions. Your dengue symptoms may be mild or severe. 

Initially, you may have mild symptoms of dengue. It usually occurs in the febrile phase.  Later on, the severity of dengue can increase in the critical phase. 

You may observe different clinical findings in both phases. 

In the Febrile Phase  – You will observe four crucial clinical signs during the febrile phase: high-grade fever, skin rash, intense body pain, and gastrointestinal disturbances. 

These criteria indicate mild dengue infection. 


1. Sudden high-grade fever 

The first warning sign of dengue infection is high-grade fever. This is an early sign of the febrile phase of dengue. 

You may have a sudden onset fever which can be up to 104 to 106 °F. During fever, you may feel severe shivering. It usually occurs last 2 to 7 days.  

Signs of dengue fever


2. Skin erythema 

Skin erythema is an essential characteristic clinical finding. It is also called maculopapular rash.

During this skin rash, you will observe flat red patches and small raised bumps. 

Signs of dengue fever


3. Intense body pain 

You may have experienced –

  • severe headache
  • retro-orbital pain (eye pain)
  • myalgia (muscle pain)
  • arthralgia (joint pain)
  • lymphadenopathy (swollen lymph nodes)


 Due to this intense pain, dengue fever is also called “break-bone fever.”

Signs of dengue fever


4. Gastrointestinal disturbance 

Your dengue fever symptoms may also associate with gastrointestinal disturbance. 

According to a study published in the journal of Gastroenterologia Hepatologia 2011 determined the frequency of abdominal and gastrointestinal symptoms –  

  • Nausea (52%)
  • Abdominal pain (36%)
  • Vomiting (29%)
  • Diarrhea (17%)
  • Anorexia 


These symptoms become more frequent if you are hospitalized or in a critical phase. 


In Critical Phase – You are more likely to have severe dengue infection in four primary conditions – 

  • Secondary infection – If you get dengue infection again within 18 months of prior dengue infection. 
  • Pregnancy 
  • Infants
  • Pre-existing medical conditions such as obesity, diabetes, hypertension, and asthma 


If dengue symptoms do not recover in the febrile phase. Then mild warning signs of dengue gradually progress to severe dengue (critical stage).  

The symptoms of severe dengue start to reflect after resolving fever (defervescence). It usually occurs last 24 to 48 hours. 


5. Dengue hemorrhagic fever (DHF)

If you develop severe dengue, you may have bleeding that indicates a low platelet count.

The primary function of platelets is the formation of clots and helps to prevent bleeding.

But when the dengue virus introduces into your body, it binds on platelets and destroys or reduces platelet count. As a result, it causes increased vascular leakage or bleeding.

Signs of dengue fever

So, you may have developed some important hemorrhagic manifestations –

  • Epistaxis (bleeding from the nose)
  • Gingival bleeding (gum bleed)
  • Hematochezia (blood cells in stool)
  • Melena (black stool due to gastrointestinal bleeding)
  • Hematuria (Blood in urine)
  • Hematemesis (vomiting of blood)
  • Menorrhagia (heavy menstrual period)


In these conditions, you will notice the platelet count less than 100,000 mm3 (thrombocytopenia) and the increased hematocrit level (greater than 20%) in your CBC laboratory report

These hemorrhagic conditions are associated with fever, called “dengue hemorrhagic fever (DHF).” It is a serious medical emergency


6. Dengue shock syndrome (DSS)

This symptom is associated with high mortality. The mortality rate in DSS can be more than 10%. 

The DHF symptoms may progress to massive bleeding and severely decreased blood pressure (hypotension). This condition may result in hypovolemic shock.

This severe form of dengue infection is also called “dengue shock syndrome (DSS).” 

If it is not treated, then it can rapidly progress to death. 


7. Organ dysfunction

The most lethal forms – dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) may lead to multi-organ dysfunction. 

Almost all organs may develop hemorrhage (leakage of blood from vessels) and edema (deposition of fluid in tissue) during severe dengue infection. 

In the critical stage, your organ starts to destroy or be damaged by increased vascular leakage, higher hematocrit level (PCV), and vasodilation like – 

  • Liver – Increased AST, Increased ALT, hepatomegaly, liver failure
  • Lungs – Pleural effusions (excess fluid in lungs)
  • Abdomen – Ascites (too much fluid in the abdomen)
  • Kidney – Acute tubular necrosis and kidney failure
  • Heart – Pericardial effusion (too much fluid builds up in the space around the heart). 
  • Spleen – Splenomegaly (enlargement of the spleen)
  • CNS – Encephalitis (inflammation of the brain), myelitis (inflammation of spinal cord), and meningitis (inflammation of meninges)


What is the recovery phase in dengue?

There is another phase in dengue infection, i.e., the recovery phase. In this phase, your symptoms start to resolve. You will observe – 

  • Rise in platelet counts around at 9th day of illness
  • Fall in hematocrit level
  • Improved appetite
  • A rise in blood pressure
  • Increase urine output



Dengue fever is a common viral illness, and it happens to anyone. Most people recover within a week. 

You don’t need to take any specific medicine to treat dengue infection. You can take medication for symptomatic relief like 

  • For fever- paracetamol
  • For itching – cetirizine 
  • For vomiting – antiemetic drug


If you think your signs of dengue are going towards severity. Do not try to treat dengue infection in severe conditions.

It is a medical emergency. You need to immediately require hospitalization. 

So, you always need to monitor your symptoms. 

If you found this post informative, please share it on social media. 

Read more posts…

Also, watch video on foods to increase platelet count


Related Post

2 thoughts on “Signs of dengue fever- which don’t ignore
  1. Yogesh kumar

    Very nice

leave a Comment