Hesperian Health Guides

Dengue Fever (Breakbone Fever)

In this chapter:

Dengue usually occurs during the hot, rainy season. It is common in cities and places where people live close together. The mosquitoes breed where people store water and anywhere water collects, commonly in containers and on the ground where there is poor drainage.

The first time a person gets dengue, she can usually recover with rest and by drinking lots of liquids. When a person gets dengue a second time or any time after that, it is more dangerous.

The illness usually begins with sudden high fever along with body aches. After 3 to 4 days, the person may start to feel better but a rash begins on the hands and feet. The rash spreads to the arms, legs, and body (but usually not the face). Dengue can have other patterns but most people have the high fever and 2 or more of the other signs.

Signs of dengue
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  • Sudden high fever, 39° (102°F) or higher
  • Severe body aches in both the muscles and joints (this is why dengue is sometimes called breakbone fever)
  • Headache, pain behind the eyes
  • Rash
  • Sore throat
  • Nausea or vomiting
  • Chills
  • Extreme tiredness

Treatment can help you feel better. But watch for danger signs of severe dengue. If not treated right away, it can lead to death.

Danger signs of severe dengue
  • Tiny spots of blood on the skin or from the nose, ears, or mouth
  • Swollen stomach, blood in vomit that can be red or brown, or black feces (from bleeding in stomach)
  • Unable to eat or drink
  • Acts confused, pulse gets fast, the skin goes cold, or other signs of shock. Where a blood test is available, a high hematocrit or low platelets are signs that something is wrong.

Severe dengue can only be treated by giving fluids by IV quickly and treating blood loss. Go to a hospital immediately if there are danger signs.


Avoid mosquito bites and prevent mosquitoes from breeding.

This page was updated:14 Sep 2020