Ask the experts
I'm thinking of taking a trip to India, and I'm reading about all the potential tropical diseases. The dengue fever virus seems the sacriest to me -- especially since I read about rash of outbreaks. Is dengue fever dangerous? Can dengue kill you?
Doctor's response
Dengue can be deadly, but with proper supportive care, most people beat the virus. The prognosis for dengue is usually good. The worst symptoms of the illness typically last one to two weeks, and most patients will fully recover within several additional weeks.
Typical dengue is fatal in less than 1% of cases; however, dengue hemorrhagic fever is fatal in 2.5% of cases. If dengue hemorrhagic fever is not treated, mortality (death) rates can be as high as 20%-50%.
Luckily, if you're planning on traveling, a vaccine is available. In April 2016, the WHO approved Sanofi Pasteur's Dengvaxia (CYD-TDV), a live recombinant tetravalent vaccine for dengue fever. Dengvaxia can be administered as a three-dose series in people 9-45 years of age who live in areas where dengue is endemic.
In clinical trials in Latin America and Asia involving more than 40,000 children and adolescents, Dengvaxia protected 66% of people aged 9 and older against dengue. Dengvaxia was very effective at protecting against severe dengue, which can be fatal, preventing 93% of severe cases, and reducing hospitalizations due to dengue by 80%.
Dengvaxia was initially approved in 2015 for use only in Mexico, the Philippines, Brazil, and El Salvador.
Several other vaccines for dengue are undergoing clinical trials, but none have yet been approved for use.
Prevention, however, is the best medicine for dengue. The transmission of the virus to mosquitoes must be interrupted to prevent the illness. To this end, patients are kept under mosquito netting until the second bout of fever is over and they are no longer able to transmit the virus to a biting mosquito.
The prevention of dengue fever requires control or eradication of the mosquitoes carrying the virus that causes dengue. In nations plagued by dengue fever, people are urged to empty stagnant water from old tires, trash cans, and flower pots. Governmental initiatives to decrease mosquitoes also help to keep the disease in check but have been poorly effective.
To prevent mosquito bites, wear long pants and long sleeves. For personal protection, use mosquito-repellant sprays that contain DEET when visiting places where dengue is endemic. There are no specific risk factors for contracting dengue fever except living in or traveling to an area where the mosquitoes and virus are endemic. Limiting exposure to mosquitoes by avoiding standing water and staying indoors for two hours after sunrise and before sunset will help, as the Aedes aegypti mosquito is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas.
For more information, read our full medical article about dengue fever.
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