Dengue Hemorrhagic Fever Definition, Reason, Symptoms, Treatment & Prevention

Dengue Hemorrhagic Fever Definition, Reason, Symptoms, Treatment & Prevention

Dengue hemorrhagic fever (DHF) is a disease caused by dengue virus infection. Here are the symptoms, causes, and treatment.

Dengue Hemorrhagic Fever

Medical specialist Internal medicine specialist
Symptom Sudden high fever; muscle, bone, eye pain, reddish skin rash
risk factor Live or travel to the tropics
How to diagnose Physical examination and blood laboratory
Treatment Hydration and bedrest
Drug Paracetamol
Complications Dengue shock syndrome
When to see a doctor? Fever for 3 days and activity disturbance


Dengue hemorrhagic fever (DHF) is a disease transmitted by the bite of a mosquito called Aedes aegypti.

This disease is still a public health issue.

In fact, the infection rate of this disease is still one of the highest among Southeast Asian countries.


The cause of DHF is the dengue virus which is transmitted to humans by the Aedes aegypti mosquito.

When the dengue virus infects mosquitoes and mosquitoes bite humans, the virus enters the body.

The Aedes aegypti mosquito is generally smaller in size, its body is solid black with two white vertical stripes on its back and horizontal white stripes on its legs.

This mosquito usually “works” from morning to evening, although sometimes it also bites at night.

These insects like dark and cool places so they are more commonly found indoors than hot outside.

Risk Factors

Risk factors for someone experiencing dengue hemorrhagic fever include:

  • living or traveling in tropical areas
  • Being in tropical and subtropical areas increases the risk of contracting the dengue virus. Areas at risk include Southeast Asia, the western Pacific islands, Latin America and Africa.
  • been infected with the dengue virus
  • Having a history of being infected with the dengue virus increases the risk of severe symptoms when you get dengue again.
  • under 15 years of age
  • In Asia, dengue fever and dengue hemorrhagic fever mainly affect children under 15 years of age.


The main symptom of DHF is a sudden high fever of up to 39 degrees.

This fever will last continuously for 2-7 days, then drop quickly.

Usually, the characteristics of dengue fever above are also followed by:

  • headache
  • shivering and limp
  • pain behind the eyes, muscles, and bones
  • skin rash to redness
  • difficulty swallowing food and drink
  • nausea and vomiting
  • bleeding gums
  • nosebleed
  • red spots appear on the skin
  • vomiting blood
  • black defecation

In the febrile phase, the symptoms of DHF are usually followed by a critical phase for 2-3 days.

It is in this critical phase that the body temperature decreases, so that parts of the body such as hands and feet are cold, and usually feel as if they have recovered.

In fact, in this phase you have to be vigilant because dengue shock syndrome can occur which can be life-threatening.

If it’s not clear, ask the doctor for other DHF symptoms on the LiveChat feature.


There are several stages to diagnosing DHF. Anything?

Physical examination

Clinical signs are very important for the initial DHF examination, including high fever and the appearance of the other symptoms mentioned above.

Also seen is there any sign of plasma leakage.

This plasma leakage will be easy to see from worsening conditions such as excessive weakness in the early stages to a state of shock.

This state of shock can be characterized by a very weak body, shortness of breath, spontaneous bleeding, decreased urine, increased pulse rate, decreased blood pressure, and decreased consciousness.

Tourniquet Test

This test is done to see if there are petechiae on the inside of the arm (antecubital fossa).

The test is considered positive if there are 10 or more petechiae per 1 square inch.

Blood Check

In laboratory tests at the beginning of the febrile phase, a normal white blood cell count will be found.

Then, this number will decrease during the fever phase. The number of red blood cells at the beginning of a fever will generally also remain normal.

However, a decrease in the number is usually found between the third to the seventh day. Therefore, this red blood cell examination needs to be repeated.

It should be noted that an increase in red blood cells is always found in dengue hemorrhagic fever.

This is an indicator of plasma leakage, where blood cells should be stored.


Examination of the NS 1 antigen can be detected from the first day of fever so that dengue fever and DHF can be detected earlier.

Examination of the NS1 antigen using the ELISA method is also said to have high sensitivity and specificity (88.7 percent and 100 percent).

Antibody serology

If it has entered the 3-5th day, serological examination of Ig G and Ig M antibodies can be carried out because they have begun to form.


Handling and treatment of DHF include:

Consume Lots of Fluids

Initial handling of dengue hemorrhagic fever can be done at home.

The principle is that the patient must consume lots of fluids to prevent dehydration, which leads to decreased platelets and shock.

It is recommended, patients drink 2-3 liters of water per day.

Intravenous (Infusion) Fluids

If oral fluids cannot be given, the patient should be admitted for intravenous fluids.

Bedrest Total

The patient is expected to rest completely while still having a fever or shock phase.

It is also important to always monitor the level of platelets and levels of red blood cells in the blood until they reach normal levels again.

Compress the whole body

To deal with fever, compresses can be done all over the body, especially in the armpits and groin.

Symptomatic drug administration

Administration of drugs is symptomatic only or only relieves symptoms, not treating the cause.

If you have a high fever, you can give fever reducers; if nausea can drink anti-nausea.

Consult a doctor

Handling dengue hemorrhagic fever can indeed be done alone at home, but of course it must be under the supervision and advice of a doctor.

The doctor who treats dengue hemorrhagic fever is a specialist in internal medicine or in the case of children, a pediatrician.


Until now the treatment of dengue hemorrhagic fever is only symptomatic. For example, administering the febrifuge paracetamol for symptoms of high fever.


Here are some ways to prevent dengue:

  • drain the water reservoir
  • Close the water storage containers
  • bury waste
  • avoid piles of items at home such as used clothes, books, and others
  • ensure that light enters the house
  • use mosquito repellant
  • spraying mosquitoes or fogging
  • use mosquito nets while sleeping
  • use mosquito nets on every house’s ventilation
  • wear light-colored clothes
  • wear closed clothes
  • killing mosquito larvae in water reservoirs with abate
  • Dengue vaccination in children aged 9-16 years
  • avoid areas that have the potential for a lot of dengue hemorrhagic fever infection


The following are complications of dengue hemorrhagic fever that you need to be aware of:

  • nosebleed
  • bleeding gums
  • bleeding under the skin
  • black vomit
  • coughing up blood
  • black faeces
  • decreased blood pressure
  • weak pulse
  • body feels cold
  • decreased frequency of urination
  • a small amount of urine
  • out of breath
  • loss of consciousness

The worst condition can lead to DSS or dengue shock syndrome which can cause death.

When to See a Doctor?

If you experience symptoms as mentioned above, such as fever for 3 days and activity disturbances, you should see a doctor and have a blood test.


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