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Every year over 400,000,000 people are infected with dengue fever, some experiencing severe symptoms such as hemorrhagic shock, which may be fatal. Finally a vaccine may be on its way.

Dengue fever has been one of the most notorious of all tropical diseases for 200 years. With the reality of climate change, it's no longer only tropical.

What Is Dengue Fever?

Dengue (pronounced den-gee with a hard g) fever is the most common mosquito-born illness in the world. More people get dengue fever than get malaria. More people get dengue fever than get yellow fever. Every year, over 400 million people are infected with the virus that causes dengue fever after mosquito bites, although most do not come down with symptoms.

How dengue infection expresses itself depends a lot on the age of the victim. In children under 15, the virus usually causes vague symptoms including a mild fever and maybe a mottled rash, or maybe not. In adults, symptoms show up two or three days after the mosquito bite and may include:

  • Headache.

  • Pain behind the eyes.

  • Severe muscle pain, especially in the lower back, arms, and legs.

  • Painful joints, usually in the knees and shoulders

  • Nausea and vomiting (diarrhea is rare).

  • Rash, consisting of a bumpy maculopapular or macular confluent rash over the face, torso, and the folds of the elbows and knees, with islands of skin unaffected.

  • Muscle weakness, sometimes severe.

  • Muscle pain, sometimes so severe that the illness used to be known as "breakbone fever."

  • Altered taste sensation

  • Loss of appetite.

  • Sore throat.

  • Swollen lymph glands.

  • Mild hemorrhagic (bleeding) manifestations (petechiae of the eyes, bleeding gums, nosebleed, blood in the urine, and, in women who have not reached menopause, unusually heavy periods).

As the disease progresses, it may cause bleeding symptoms that are more severe. About the same time as the initial fever breaks, it's as if the patient springs leaks. There can be oozing of blood plasma from the eyes, nose, mouth, anus, and genital organs, and there can also be serious internal bleeding in the digestive tract. Any cuts or scrapes will start to bleed. Loss of blood can lead to seizures and loss of consciousness. There can be destruction of heart tissue (cardiomyopathy), inflammation of testes (orchitis) or ovaries (oophoritis), depression, liver damage, and severe inflammation of the eyes. When dengue fever progresses to its second stage, 50 percent of people will die without treatment.

Dengue Fever is Spreading

Textbooks used to say that dengue fever was unknown in Europe. In recent years, there have been cases in France, Italy, and Croatia. In January of 2016, there were 240 cases of dengue on the Big Island of Hawaii. Dengue has appeared in Florida, and caused death in Texas. It is one of several threats to opening the Olympics in Brazil. Nearly three billion people in at least 112 countries are exposed to the disease, and the number is only increasing. Biologists predict that by the year 2100 there will be cases in Norway, Russia, Germany, the United Kingdom, most of the United States, and Canada.

Part of the problem has been the re-emergence of species of mosquito known as Aedes aegypti, the only insect that transmits it. This mosquito was wiped out 50 years ago with DDT in much of the tropical world, but new strains resistant to pesticides have emerged. Aedes aegypti was never wiped out the in the southern United States. Since it is now impossible to get rid of the mosquito, attention has turned to finding a vaccine.

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