Dengue fever – predictors of disease severity and their influence on management

The annual global figures for dengue fever (DF) and dengue haemorrhagic fever (DHF) are about 100 million and half a million respectively, and 90% of the patients are children <15 years [1]. Case fatality in Asia is 0.5 3.5% [2]. The first major epidemic in Sri Lanka was in 1989. The dengue pandemic in 1998 led to a resurgence of interest in its prevention and management. Clearly, early diagnosis and prompt, appropriate treatment of dengue prevent morbidity and mortality [3]. The majority of adult patients with dengue recover completely without specific interventions. It is necessary to identify the minority of patients early in the disease for close monitoring and appropriately timed fluid therapy to prevent progression to dengue shock syndrome (DSS). Achieving this requires the ability to predict disease severity.