infectious diseases
Dengue
Introduction
Dengue is a Overview of Arbovirus, Arenavirus, and Filovirus Infections caused by a flavivirus. Dengue fever usually results in abrupt onset of high fever, headache, myalgias, arthralgias, and generalized lymphadenopathy, followed by a rash that appears with a recurrent fever after an afebrile period. Respiratory symptoms, such as cough, sore throat, and rhinorrhea, can occur. Dengue can also cause potentially fatal hemorrhagic fever with a bleeding tendency and shock. Diagnosis involves serologic testing and polymerase chain reaction (PCR). Treatment is symptomatic and, for dengue hemorrhagic fever, includes meticulously adjusted intravascular volume replacement. Dengue is endemic to the tropical regions of the world in latitudes from about 35°north to 35°south. Outbreaks are most prevalent in Southeast Asia but also occur in the Caribbean, including Puerto Rico and the US Virgin Islands, Oceania, and the Indian subcontinent; more recently, dengue incidence has increased in Central and South America. Each year, only about 100 to 200 cases are imported to the United States by returning tourists, but an estimated 50 to 100 million cases occur worldwide, with about 20,000 deaths. Limited local transmission has occurred most recently in Hawaii (2015), Florida (2013, 2020, 2022), and Texas (2013). The causative agents, enveloped single-strand RNA viruses from the genusFlaviviruswith 4 serotypes, are transmitted by the bite ofAedesmosquitoes. Individual mosquitoes may bite repeatedly, potentially exposing multiple people to infection. The virus circulates in the blood of infected humans for 2 to 7 days;Aedesmosquitoes may acquire the virus when they feed on humans during this period. ). There has been one report of potential dengue transmission through breast milk ( Reference ). 