The hallmark symptom of dengue is a sudden onset of high fever, accompanied by severe headache, and joint and muscle pain. Dengue infection can range in severity from a mild acute febrile illness to a potentially fatal infection. Typically, symptoms of dengue fever emerge within 4 to 7 days following a bite from an infected mosquito.
Symptoms of uncomplicated (classic) dengue fever include:
- Abrupt onset of high fever, reaching up to 105ºF.
- Nausea and vomiting.
- Severe headache.
- Intense joint and muscle pain.
- Retro-orbital pain (pain behind the eyes), exacerbated by eye movements.
- Rash resembling measles, often starting on the torso and spreading to the limbs and face. This rash typically appears 3 to 4 days after the onset of fever and resolves within 1 to 2 days, but may reappear later.
For some individuals, muscle and joint pains (myalgias and arthralgias) can be excruciating, earning dengue the moniker “break-bone fever” or “bonecrusher disease.”
While dengue fever is usually a mild, self-limiting illness, it can progress to Dengue Hemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS).
Symptoms of DHF and DSS include:
- Fluid leakage from blood vessels due to vessel damage, leading to hemoconcentration or increased hematocrit.
- Bleeding from the nose, gums, mouth, or skin, resulting from decreased platelet count.
- Dengue Shock Syndrome (DSS) represents the most severe form of dengue illness, featuring all symptoms of DF and DHF, along with:
- Fluid leakage outside blood vessels.
- Severe bleeding.
- Shock characterized by very low blood pressure.
Additional symptoms of DHF and DSS encompass:
- Severe and continuous abdominal pain.
- Pale, cold, or clammy skin.
- Bleeding from the nose, gums, or other sites, with purplish bruises.
- Red spots or purplish patches on the skin.
- Frequent vomiting, blood in vomit, or black-colored stools.
- Sleepiness, lethargy, and restlessness.
- Difficulty breathing.
- Confusion or seizures.
DHF and DSS can be fatal, particularly in children and young adults, and are more commonly observed during a second dengue infection.