DENGUE

also called Breakbone Fever, or Dandy Fever, acute, infectious, mosquito-borne hemorrhagic fever that temporarily is completely incapacitating but is rarely fatal. Besides fever, the disease is characterized by an extreme pain in and stiffness of the joints (hence the name breakbone fever). Dengue is caused by a virus and may occur in any country where the carrier mosquitoes breed. The carrier incriminated throughout most endemic areas is the yellow-fever mosquito, Aedes aegypti. The Asian tiger mosquito, A. albopictus, is another prominent carrier of the virus. A mosquito becomes infected only if it bites an infected individual (humans and perhaps also certain species of monkey) during the first three days of the victim's illness. It then requires 8 to 11 days to incubate the virus before the disease can be transmitted to another individual. Thereafter, the mosquito remains infected for life. The virus is injected into the skin of the victim in minute droplets of saliva. The spread of dengue is especially unpredictable because there are four serotypes of dengue virus. Infection with one typethough it confers lifetime immunity from reinfection with that type of denguedoes not prevent an individual from being infected by the other three types. Diagnosis is made on clinical findings, namely, sudden onset, moderately high fever, excruciating joint pains, intense pain behind the eyes, a second rise in temperature after brief remission, and particularly the type of rash and decided reduction in neutrophilic white blood cells. There is no specific therapy; therefore attention is focused on relieving the symptoms. Temporary preventive measures must be taken to segregate suspected as well as diagnosed cases during their first three days of illness and, by screens and repellents, to keep mosquitoes from biting more people. The potentially fatal fever is prevalent in parts of Asia, and in the late 20th century it spread to areas of South and Central America and to Cuba, Puerto Rico, and other nearby islands. Fundamental in the control of the disease is the destruction of mosquitoes and their breeding places.