Breakbone fever

Alternative names
O’nyong-nyong fever; Dengue-like disease; Dengue fever

Dengue fever is a mild viral illness transmitted by mosquitoes. It is characterized by fever, rash, and muscle and joint pains. See also Dengue hemorrhagic fever.

Causes, incidence, and risk factors

Dengue fever is caused by several related viruses (four different arboviruses). It is transmitted by the bite of mosquitoes, most commonly Aedes aegypti, found in tropic and subtropic regions. This includes portions of Southeast Asia, the Indonesian archipelago into northeastern Australia, parts of sub-Saharan Africa, and parts of South and Central America.

Dengue fever begins with sudden onset of a high fever, often to 104 to 105 degrees Fahrenheit, headache, and slightly later the appearance of severe joint and muscle pains.

A flat, red rash may appear over most of the body early during the fever. A second rash, measles-like in appearance, appears later in the disease. Infected people may have increased skin sensitivity and are very uncomfortable.

Dengue fever is being seen more in world travelers. It is generally self-limited and although uncomfortable is not fatal. Diagnosis may depend on a traveler telling his or her doctor of any visits to areas of the world where dengue fever is known to occur.

Dengue fever should not be confused with Dengue hemorrhagic fever, which is a separate disease and frequently fatal.


  • fever  
  • rashes  
  • muscle aches (myalgia)  
  • joint aches (arthralgia)  
  • headache  
  • nausea  
  • vomiting  
  • enlarged lymph nodes

Signs and tests

  • CBC (shows mildly increased white blood cells, decreased platelets, and increase in hematocrit)  
  • acute and convalescent serum (measures an increase in antibody titer for dengue virus types)  
  • serologic studies (demonstrates antibodies to dengue viruses, may be type-specific)


Rehydration is necessary if dehydration is evident. The high fever can be treated with acetaminophen (avoid aspirin).

Expectations (prognosis)

Full recovery is expected.


  • febrile convulsions  
  • severe dehydration

Calling your health care provider

Call your health care provider if you have been traveling in an area where dengue fever is known to occur and have developed symptoms suggested above.


There is no vaccine currently available for dengue fever. According to the CDC (Centers for Disease Control and Prevention), research is underway for the development of a vaccine. However, the prediction is that there will not be a vaccine available for 5 to 10 years.

Using personal protection (clothing, mosquito repellent, netting, etc.) and traveling during periods of minimal mosquito activity can be helpful. Mosquito abatement programs may reduce the risk of infection, but vaccination is the only sure method of prevention.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.