Dengue Disease

Dengue disease

Currently, dengue disease is considered an epidemiological emergency, since an increase in endemic areas has been appreciated and alterations in the pattern of the disease are observed, thus increasing the risk of morbidity and mortality.

The World Health Organization (WHO), in 1997, published a form of dengue classification that was valid for more than thirty years, based on three categories: dengue fever (FD), hemorrhagic dengue fever (FHD) and syndromeDengue shock (SCD).

However, being a worldwide disease, it was found that the “FD/FHD/SCD” classification could not be applied globally for the clinical use of patients, especially in cases of greater serious.

This caused some countries to have their own classifications adapted, making epidemiological comparisons more difficult. This, together with the alterations in the pattern of the infection, led to WHO to sponsor a study called Denco (Dengue Control).

As a result of this study in November 2009, WHO issued a guide that classifies the disease as dengue or severe dengue

New Dengue classification

The serious dengue criteria are:

• Severe plasma extravasation, manifested by hypovolemic shock and/or respiratory distress caused by liquid abundance at lung level.
• Gravity hemorrhages.
• Organ injury: encephalitis, severe dengue.

It should be noted that ambiguous dengue cases must be examined in order to determine the presence or not of alarm signs, so this will determine a first classification: dengue with alarm signs or without alarm signs.

Dengue without alarm signs can be manifested as a nonspecific febrile syndrome and it is very important.

On the other hand, dengue with alarm signs is characterized in that the patient can present the following clinic: liquid storage, mucous bleeding, intense pain in the abdominal zone, insistent vomiting, altered consciousness, hepatomegaly and gradual growth of hematocrit.

It is very important to keep in mind that even dengue patients lacking alarm can develop gravity cases.