Dengue Case Classification

1. Dengue case classification
• Due to the wide different clinical presentations and unpredictable
clinical evolution and outcome, a new model for classifying dengue
has been developed by WHO expert consensus group. It is practical to
use and aids the clinician in deciding as to where and how intensively
the patient should be observed and treated.
• Due to the wide different
clinical presentations and
unpredictable clinical
evolution and outcome, a
new model for classifying
dengue has been
developed by WHO expert
consensus group. It is
practical to use and aids
the clinician in deciding as
to where and how
intensively the patient
should be observed and
treated.

3. Phases of illness
1. Febrile Phase lasts 2 to 7 days-high grade fever, facial flushing, skin
erythema, generalized body ache, myalgia, arthralgia and headache.
Some may have sore throat, infected pharynx and conjunctival
infection. Anorexia, nausea and vomiting are common.
A (+) tourniquet test result increases the probability of dengue.
Therefore, monitoring for warning signs and other parameters is
needed to recognize progress to critical phase.

4. • Mild hemorrhagic manifestations like dengue. petechiae and redness
on mucosal membrane (nose and gums) may be seen. A progressive
decrease in total white cell count in the blood would alert the nurse
to a high probability of dengue.

5. 2. Critical Phase
• Lasts 24 to 48 hours-when the temperature drops and remains below
37.5 38'C or less usually on day 3-7 of illness, an increase in capillary
permeability with increasing hematocrit levels may occur.
• Rapid decrease in platelet count usually precedes plasma leakage.
Pleural effusion and ascites may be detectable. Shock may occur
when a large amount of plasma is lost through leakage that is
preceded by warning signs. Prolonged shock results to organ
impairment (severe hepatitis, encephalitis, myocarditis), metabolic
acidosis, and disseminated intravascular coagulation.

6. 3. Recovery Phase
• usually takes place in the following 48-72 hours. The general well-
being improves, appetite returns, gastrointestinal symptoms subsides,
hemodynamic status become stable.