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Dengue Virus Infections
1996 Case Definition

Clinical Description

An acute febrile illness characterized by frontal headache, retro-ocular pain, muscle and joint pain, and rash. The principal vector is the Aedes aegypti mosquito and transmission usually occurs in tropical or subtropical areas. Severe manifestations (e.g., dengue hemorrhagic fever and dengue shock syndrome) are rare but may be fatal.

Laboratory Criteria for Diagnosis

  • Isolation of dengue virus from serum and/or autopsy tissue samples, OR
  • Demonstration of a fourfold or greater rise or fall in reciprocal immunoglobulin G (IgG) or immunoglobulin M (IgM) antibody titers to one or more dengue virus antigens in paired serum samples, OR
  • Demonstration of dengue virus antigen in autopsy tissue or serum samples by immunohistochemistry or by viral nucleic acid detection

Case Classification


A clinically compatible case with supportive serologic findings (a reciprocal IgG antibody titer of greater than or equal to 1280 or a positive IgM antibody test on a single acute (late)- or convalescent-phase serum specimen to one or more dengue virus antigens)


A clinically compatible case that is laboratory confirmed


Dengue hemorrhagic fever is defined as an acute febrile illness with minor or major bleeding phenomena, thrombocytopenia (less than or equal to 100,000/mm3), and evidence of plasma leakage documented by hemoconcentration (hematocrit increased by greater than or equal to 20%) or other objective evidence of increased capillary permeability. The definition of dengue shock syndrome follows all of the above criteria for dengue hemorrhagic fever and also includes hypotension or narrow pulse pressure (less than or equal to 20 mm Hg).