An acute febrile illness characterized by frontal headache, retro-ocular
pain, muscle and joint pain, and rash. The principal vector is the Aedes aegypti
mosquito and transmission usually occurs in tropical or subtropical areas. Severe
manifestations (e.g., dengue hemorrhagic fever and dengue shock syndrome) are
rare but may be fatal.
Laboratory criteria for diagnosis
Isolation of dengue virus from serum and/or autopsy tissue
samples, or
Demonstration of a fourfold or greater rise or fall in reciprocal
immunoglobulin G (IgG) or immunoglobulin M (IgM) antibody titers to one or
more dengue virus antigens in paired serum samples, or
Demonstration of dengue virus antigen in autopsy tissue or
serum samples by immunohistochemistry or by viral nucleic acid detection
Case classification
Probable: a clinically compatible
case with supportive serologic findings (a reciprocal IgG antibody titer of greater
than or equal to 1280 or a positive IgM antibody test on a single acute (late)-
or convalescent-phase serum specimen to one or more dengue virus antigens)
Confirmed: a clinically compatible case that is laboratory
confirmed
Comment
Dengue hemorrhagic fever is defined as an acute febrile illness
with minor or major bleeding phenomena, thrombocytopenia (less than or equal to
100,000/mm3), and evidence of plasma leakage documented by hemoconcentration
(hematocrit increased by greater than or equal to 20%) or other objective evidence
of increased capillary permeability. The definition of dengue shock syndrome follows
all of the above criteria for dengue hemorrhagic fever and also includes hypotension
or narrow pulse pressure (less than or equal to 20 mm Hg).