Dengue haemorrhagic fever management

Severe dengue can affect blood vessels and the body's circulating fluid, while platelets and clotting may also be affected. This can lead to bleeding, fluid collecting outside blood vessels and strain on organs. Fever, headache, muscle aches, joint pain or chills can occur earlier, but the appearance of easy bruising, abdominal pain, persistent vomiting, restlessness or unusual sleepiness changes the level of concern. The term is sometimes used broadly, so a hospital team must assess what is happening rather than relying on the label.

Medical teams may repeatedly check blood pressure, pulse, breathing, alertness, urine output, hydration and blood results. Fluids are adjusted carefully because too little may worsen circulation while too much can cause harm. Tell staff about bleeding, vomiting, medicines, pregnancy or other health conditions. Do not take aspirin, ibuprofen or blood-thinning medicines unless the treating clinician instructs you. At home, do not attempt to manage suspected severe dengue; arrange urgent assessment and bring a list of medicines.

Go to emergency care for bleeding, black stools, blood in vomit, severe abdominal pain, repeated vomiting, fainting, confusion, breathing difficulty, cold clammy skin, marked weakness or very little urine. A person who is difficult to wake needs emergency services immediately. Warning signs may become clearer as fever falls, so a lower temperature does not by itself mean the danger has passed.

Ask what monitoring is needed, how fluid treatment will be guided, which medicines to stop or continue, and what discharge warning signs require a rapid return.