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Dengue in Puerto Rico: clinical manifestations and management from 1960's to 1987.

Dengue is a viral disease transmitted by the Aedes aegypti mosquito. It is endemic in Puerto Rico and the Caribbean with periodic epidemics occurring at varying intervals. There are three dengue serotypes present in Puerto Rico, at the present time. The clinical manifestations of dengue in Puerto Rico are presented from a historical perspective. Dengue in Puerto Rico has evolved from a clinically mild illness in the 1960's to a devastating disease with hemorrhagic manifestations in the 1980's and dengue shock syndrome in 1987. The approach to clinical diagnosis and management is presented with emphasis on early recognition, performance of tourniquet test, serial hematocrits and aggressive intravenous fluid replacement with crystalloids of colloids in DSS. The best way to treat dengue is eliminating the vector, therefore, prevention.