At a glance
The World Health Organization (WHO) classifies symptomatic dengue cases as dengue (with or without warning signs) or severe dengue to facilitate dengue clinical management.
WHO 2009 Dengue Classification
Dengue is defined by a combination of ≥2 clinical findings in a febrile person who lives in or traveled to (in the last 14 days) a dengue-endemic area. Clinical findings include nausea, vomiting, rash, aches and pains, a positive tourniquet test, leukopenia, or any warning sign.
Dengue warning signs include abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleeding, lethargy, restlessness, and liver enlargement. Patients with warning signs should be monitored closely as they can be more likely to progress to severe disease.
Severe dengue is defined by dengue with any of the following clinical manifestations: severe plasma leakage leading to shock or fluid accumulation with respiratory distress; severe bleeding; or severe organ impairment such as hepatitis (elevated transaminases ≥1,000 IU/L), impaired consciousness, or heart impairment.