Dengue Fever (DF) vs. Dengue Hemorrhagic Fever (DHF)

Medically Reviewed on 10/27/2022
Dengue Fever vs. Dengue Hemorrhagic Fever
People with severe dengue hemorrhagic fever (DHF) need immediate medical attention.

The major difference between dengue fever (DF) and dengue hemorrhagic fever (DHF) is that the latter is a severe form of dengue that occurs in a person with a dengue infection

DF and DHF are caused by an infected Aedes species mosquito. The Aedes species are commonly found in the tropical and subtropical regions of the world.

Four strains of the dengue virus may cause DF. After getting infected with one strain of the virus, your body may develop immunity against that strain. 

However, the antibodies attacking one strain don’t attack other strains of the dengue virus. If your body gets infected by a different version of the dengue virus, it may trick the antibody to attack it.

Other differences between DF and DHF are highlighted below.

Dengue fever vs. dengue hemorrhagic fever chart

Characteristics DF DHF
Onset It starts 3 to 14 days after the bite of an infected mosquito Starts three to seven days after symptom onset

Symptoms of DF include:

  • Fever
  • Frontal headache
  • Muscle pain
  • Joint pain
  • Rash
  • Low white blood cell count

Symptoms of DHF include:

  • Severe abdominal pain
  • Persistent vomiting
  • Marked change in temperature
  • Easy bruising
  • Bleeding from the nose or gums
  • Bleeding from the internal organs
  • Throwing up blood or blood in the stool
  • Frequent vomiting
  • Extreme tiredness
  • Irritability
  • Restlessness
Complications DHF and dengue shock syndrome
  • Brain damage
  • Encephalitis (inflammation and swelling of the brain due to a viral infection or other causes)
  • Liver failure
  • Seizure
  • Shock
Life-threatening No Yes
Prognosis Usually good because the person may recover within a week Typically fatal if not treated earlier
Fatal Can cause death in less than one percent of the population Can cause death in 2.5 percent population. Without proper treatment, the death rate may increase to 20 percent


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Different grades of dengue hemorrhagic fever chart

Different grades of dengue hemorrhagic fever based on the severity of the symptoms are categorized below:

Characteristics Grade I Grade II Grade III Grade IV
Signs High fever with no to minimal signs of bleeding such as scattered petechiae (tiny spots, brown to purple, due to bleeding under the skin)

The person may or may not be able to eat and drink as usual

Have more severe hemorrhagic manifestations than those in grade I

The person may have a weak pulse along with the following symptoms:

  • Cold hands and feet
  • Pale complexion
  • Severe discomfort

These symptoms could indicate a drop in blood pressure

Severe drop in blood pressure, making it difficult to take reading
Needs hospital admission Can be managed at home Yes, if the person cannot eat and drink as usual Needs hospital admission Yes
Treatment options

Drink plenty of water and frequently 

Apply a wet cloth over the forehead to relieve the fever

Symptomatic treatment

Fluid and electrolyte replacement

Monitor vitals

Examine vital signs to check for a drop in blood pressure

Symptomatic treatment

Fluid and electrolyte replacement

Symptomatic treatment

Fluid and electrolyte replacement

Monitor vitals

How is dengue hemorrhagic fever treated?

People with severe dengue hemorrhagic fever (DHF) need immediate medical attention. It is best to admit the person with DHF to the hospital for optimal care and to prevent mortality.

A dengue vaccine called Dengvaxia has been approved for use in children and adolescents aged 9 to16 years who have had previous dengue virus infection and are living in an area where dengue is endemic.

If a person presents with less severe symptoms, they might not require any hospital admission and can be managed at home. However, people who present with severe symptoms need hospital admission and immediate medical attention.

Some ways to prevent dengue fever include:

  • Protect yourself from a mosquito bite.
  • Find an insect repellent that is appropriate for you.
  • Wear a long-sleeved shirt and long trousers while visiting a dengue-endemic region.
  • Take steps to control mosquitoes indoors and outdoors.
  • Sleep under a mosquito net.
Medically Reviewed on 10/27/2022
Image Source: iStock image