Popularly known as dengue hemorrhagic fever, the worsening of dengue fever is characterized by a sharp drop in platelets – cellular fragments produced by the bone marrow that circulate in the bloodstream and help the blood to clot – and which generally leads to severe plasma leakage. The term hemorrhagic dengue fever, in fact, was no longer used by the World Health Organization (WHO) in 2009, since hemorrhage, in these cases, is not always present.
According to guidelines published by the WHO, health authorities currently distinguish infections between dengue and severe dengue. While non-severe dengue cases are subdivided into patients with or without warning signs, severe dengue is defined when there is plasma leakage or fluid accumulation, leading to shock or respiratory distress . There may also be severe bleeding and involvement of organs such as the liver and even the heart. .
The WHO says that, from 2009 onwards, the magnitude of the dengue problem in the world increased dramatically, in addition to extending, geographically, to many areas previously unaffected by the disease. The entity's assessment is that dengue was and remains, even today, the most important human viral disease transmitted by arthropods – a group of invertebrate animals that includes the Aedes aegypti mosquito, which transmits the disease.
Currently, the clinical severity classification for dengue defined by the WHO and followed by the Ministry of Health in Brazil is as follows:
Dengue without warning signs
In these cases, the patient generally presents with a fever for a period of 2 to 7 days accompanied by two or more of the following clinical manifestations: nausea or vomiting; exanthema (skin rash); headache or pain behind the eyes; pain in the body or joints; petechiae (small reddish spots); and low levels of white blood cells in the blood.
Dengue with warning signs
Any case of dengue that presents one or more of the following signs during or preferably after the fever has subsided: intense and sustained abdominal pain or tenderness in the abdomen; persistent vomiting; accumulation of liquids; mucous membrane bleeding; lethargy or restlessness; postural hypotension (low blood pressure when getting up from a sitting or lying position); enlarged liver; and progressive increase in hematocrit (percentage of red blood cells in the blood), with a drop in platelet count.
Severe dengue
Any case of dengue that presents one or more of the following clinical manifestations: shock or respiratory difficulty due to severe extravasation of plasma from blood vessels; heavy bleeding; and severe organ impairment (liver damage, myocarditis and others).
Source: CNN Brasil
I’m James Harper, a highly experienced and accomplished news writer for World Stock Market. I have been writing in the Politics section of the website for over five years, providing readers with up-to-date and insightful information about current events in politics. My work is widely read and respected by many industry professionals as well as laymen.
