Modified dengue severity classification, PAHO/WHO
Dengue without warning signs - DNWS:
• Person who lives or has traveled to areas with dengue transmission in the last 14 days and presents fever, usually of 2 to 7 days duration, and at least 2 of the following criteria:
1 . Nausea/ vomiting
2. Exanthema
3. Headache/ retro-orbital pain
4. Myalgia and arthralgia
5. Petechiae or positive tourniquet test
6. Leukopenia
• Cases also include any child coming from or living in an area with dengue transmission, with acute febrile illness, usually of 2 to 7 days and no apparent focus.
Dengue with warning signs - DWWS:
• Every dengue case that, near and preferably at defervescence, presents one or more of the following signs:
1. Intense abdominal pain or tenderness
2. Persistent vomiting
3. Fluid accumulation (ascites, pleural effusion, pericardial effusion)
4. Mucosal bleed
5. Lethargy/ restlessness
6. Postural hypotension (lipothymia)
7. Liver enlargement >2 cm
8. Progressive increase in hematocrit
Severe dengue - SD:
• Every dengue case that has one or more of the following manifestations:
1. Shock or respiratory distress due to severe plasma leakage. Shock evidenced by: weak or undetectable pulse, tachycardia, cold extremities, and capillary perfusion >2 seconds, pulse pressure 20 mmHg: hypotension in late phase.
2. Severe bleeding: based on evaluation by the attending physician (e.g. hematemesis, melena, ample metrorrhagia, central nervous system [CNS] bleeding)
3. Severe organ involvement, such as liver impairment (AST or ALT > 1000 IU), CNS (impaired mental state), heart (myocarditis), or other organs
#dengue #fever #severity #classification #diagnosis
