|
.gif) |
Dengue Fever (Dengue Hemorrhagic Fever) (Dengue Shock Syndrome)
1990 Case Definition
Clinical description
An acute febrile illness characterized by frontal
headache, retro-ocular pain, muscle and joint pain, and rash.
The disease is transmitted by the Aedes aegypti mosquito
and is confined to the tropics. Severe manifestations (dengue
hemorrhagic fever and dengue shock syndrome) are rare, but may
be fatal.
Laboratory criteria for diagnosis
-
Isolation of dengue virus from serum and/or
autopsy tissue samples, or
-
Demonstration of a fourfold or greater rise
or fall in reciprocal IgG or IgM antibody titers in paired
serum samples to one or more dengue virus antigens, or
-
Demonstration of dengue virus antigen in autopsy
tissue samples by immunofluorescence or by hybridization
probe
Case classification
Probable: a clinically
compatible illness with supportive serology (a reciprocal IgG
antibody titer of greater than or equal to 1280 or a positive
IgM antibody test on a single convalescent-phase serum specimen
to one or more dengue virus antigens)
Confirmed: a case that is laboratory confirmed
Comment
Dengue hemorrhagic fever is defined as acute onset
of fever with nonspecific symptoms. This is followed by hemorrhagic
manifestations that may include a positive tourniquet test* and/or
minor or major bleeding phenomena, thrombocytopenia (less than
or equal to 100,000/mm3), and hemoconcentration (hematocrit
increased by greater than or equal to 20%), or other objective
evidence of increasing capillary permeability; or decreasing
hematocrit after severe frank hemorrhage, such as upper gastrointestinal
bleeding.
The definition for dengue shock syndrome follows
all of the above criteria for dengue hemorrhagic fever and also
includes hypotension or narrow pulse pressure ( less than 20
mm Hg).
*Standard method (Wintrobe, 1967) utilizes a blood-pressure
cuff to impede venous flow. A test is considered positive if there
are equal to or greater than 20 petechiae/sq. in.
See also:
Printable
Version |
|
