Figure 2. Schematic diagram illustrating the common clinical manifestations of dengue infection (101).
Table 1. WHO case definitions for DF (101).
Probable DF |
An acute febrile illness |
AND two or more of the following:- Headache Retro-orbital pain Myalgia Arthralgia Rash Haemorrhagic manifestations Leucopenia |
|
AND Supportive serology OR Occurrence at the same location and time as other DF cases |
|
Confirmed DF |
An acute febrile illness |
AND two or more of the following:- Headache Retro-orbital pain Myalgia Arthralgia Rash Haemorrhagic manifestations Leucopenia |
|
AND Diagnostic serology/virology |
Table 2. WHO case definitions for DHF and DSS (adapted from reference 101)
Criteria |
DHF Strict Diagnosis |
Fever or history of fever · 2-7 days |
Present |
Haemorrhagic tendency* · A positive tourniquet test · Spontaneous petechiae or other skin bleeding · Mucosal / gastrointestinal tract bleeding |
Present |
Thrombocytopenia · Platelet count < 100,000 / mm3 |
Present |
Evidence of plasma leakage* · Elevation of the haematocrit to > 20% above the expected mean for age, sex and population · Reduction of the haematocrit by > 20% of the baseline value after volume replacement · Clinical signs of plasma leakage such as pleural effusion or ascites, and/or hypoproteinaemia |
Present |
Circulatory compromise* · Narrow pulse pressure < 20 mm Hg, with tachycardia · Hypotension for age, with cold, clammy skin and restlessness |
DSS – all four features must be present plus circulatory compromise |
* One or more of the following findings