Dengue surge: Mild to dangerous, common symptoms of different dengue strains | Health - Hindustan Times

Dengue surge: Mild to dangerous, common signs and symptoms of different dengue strains

By, New Delhi
Aug 02, 2023 12:49 PM IST

Dengue symptoms can range from mild to severe depending on the strain and how the disease is being managed.

India has been witnessing a deluge of dengue cases in the past few weeks due to heavy rains and flooding in several parts of the country. While monsoon usually registers a spike in vector-borne diseases, this year the cases have grown manifold due to prolonged rainy weather. Dengue must be diagnosed on time to ensure the health threats due to the disease are controlled. There is no cure for dengue, and it is self-limiting. The symptoms can range from mild to severe depending on the strain and how the disease is being managed. Dengue is caused by a viral infection with dengue virus (DENV) and it has four serotypes of the disease namely DENV-1, DENV-2, DENV-3, and DENV-4. The virus is spread human to human through bite of Aedes mosquitoes. (Also read: Dengue alert: Early signs of the deadly disease you shouldn't ignore amid rise in cases)

Dengue is caused by a viral infection with dengue virus (DENV) and it has four serotypes of the disease namely DENV-1, DENV-2, DENV-3, and DENV-4. (Freepik)
Dengue is caused by a viral infection with dengue virus (DENV) and it has four serotypes of the disease namely DENV-1, DENV-2, DENV-3, and DENV-4. (Freepik)

Most people with dengue are asymptomatic and do not even realise they were infected with the virus. In case of symptoms, they start showing typically 4–10 days after infection and the disease can last for 2–7 days. Symptoms may include high fever, severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands and rash. People may experience severe abdominal pain, persistent vomiting, rapid breathing, bleeding from gums or nose, fatigue or restlessness even after they recover from fever.

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"Dengue fever is a mosquito-borne viral infection caused by four different strains of the dengue virus, known as DENV-1, DENV-2, DENV-3, and DENV-4. While the general symptoms of dengue remain similar for all strains, the severity of the disease can vary depending on the specific strain involved. It's important to note that dengue can progress from mild to severe, and severe cases can lead to dengue haemorrhagic fever (DHF) or dengue shock syndrome (DSS), which can be life-threatening," says Dr M. A. Muqsith Quadri, Consultant - Internal Medicine, CARE Hospitals Banjara Hills, Hyderabad.

DENV-1 to DENV-4: Strain-wise symptoms of dengue

Dr Quadri breaks down dengue fever symptoms from mild to severe depending on the strain.

Here are the common signs and symptoms of dengue fever, followed by specific strain-wise breakdown of the symptoms:


This is the most common strain of dengue, and it typically causes mild symptoms. These symptoms may include:

  • High fever (40°C/104°F)
  • Severe headache
  • Pain behind the eyes
  • Muscle and joint pains
  • Nausea and vomiting
  • Rash


This strain is also known to cause mild symptoms, but it is thought to be more severe than DENV-1. Symptoms may include:

All of the symptoms of DENV-1, plus:

  • Severe abdominal pain
  • Persistent vomiting
  • Bleeding gums or nose
  • Rapid breathing
  • Fatigue/restlessness


This strain is typically less severe than DENV-1 or DENV-2, but it can still cause serious illness. Symptoms may include:

All of the symptoms of DENV-1, plus:

  • Haemoconcentration (increased haematocrit)
  • Low platelet count
  • Fluid accumulation in the lungs


This strain is the least common, and it is thought to be the mildest. Symptoms may include:

All of the symptoms of DENV-1, plus:

  • Conjunctivitis (pink eye)
  • Lymphadenopathy (swollen lymph nodes)

It is important to note that the symptoms of dengue can vary from person to person, and even from strain to strain. Some people may experience no symptoms at all, while others may develop severe illness. If you think you may have dengue, it is important to see a doctor right away.

All you need to know about symptom progression of dengue by Dr Quadri

Here is some additional information about the symptoms of dengue fever:

  • The symptoms of dengue usually start 4-10 days after being bitten by an infected mosquito.
  • The symptoms of dengue can last for 2-7 days.
  • If you have dengue, you are at risk of developing severe dengue. Severe dengue is a life-threatening illness.
  • There is no specific treatment for dengue. Treatment is supportive, which means that it is aimed at relieving symptoms and preventing complications.
  • There is a vaccine for dengue, but it is not yet widely available.
  • If you are traveling to an area where dengue is common, it is important to take steps to protect yourself from mosquito bites. These steps include:

Common symptoms of dengue caused by different strains

Dr Shuchin Bajaj, Founder Director, Ujala Cygnus Group of Hospitals shares a list of common symptoms of dengue

  • High fever
  • Severe headache
  • Pain behind the eyes
  • Joint and muscle pain
  • Nausea and vomiting
  • Skin rash
  • Mild bleeding (e.g., nose or gum bleeding)

Severe dengue (also known as dengue haemorrhagic fever or dengue shock syndrome) may have additional symptoms, such as severe abdominal pain, persistent vomiting, bleeding gums, rapid breathing, fatigue, and restlessness.

Dengue is a viral disease casued by mosquito bite of Aedes mosquitoes. Usually 4-10 days after mosquito bite, patient starts showing symptoms such as high-grade fever, severe headaches, body pain, and pain in eyelids while moving the eyes. Although some symptoms are common, in case of mild fever, symptoms subside after 2 weeks of illness. In case of severe dengue fever, patients can go into dengue shock syndrome, platelet counts can fall below 20,000 and symptoms like severe abdominal pain, persistent vomiting, bleeding from nose, gums or other mucous membranes, cold or clammy skin, fluid accumulation and even organ failure are there. 1 in 20 patients can go into the critical stage if not treated in time, says Dr Ashutosh Shukla, Senior Director – Internal Medicine & Medical Advisor – Max Hospital, Gurgaon.

Why you have high chances of getting dengue during the day

"Aedes mosquitoes are primarily active during daylight hours, with their peak biting periods occurring in the early morning and late afternoon. The Aedes mosquito is known to be an aggressive daytime biter and can fly up to a limited distance of 400 meter. To get one full blood meal the mosquito has to feed on several persons, infecting all of them. Aedes mosquitoes have a tendency to bite humans primarily on exposed skin areas. They typically target areas such as the ankles, feet, lower legs, and arms. These mosquitoes are known for their preference to bite below the knee level. Taking measures to protect exposed skin by wearing long sleeves, long pants, and using mosquito repellent can help prevent mosquito bites. Dengue viruses are spread to people through the bites of infected Aedes species mosquitoes. Rarely, dengue can be spread through blood transfusion, organ transplant, or through a needle stick injury," says Dr Ajay Aggarwal, Director - Internal Medicine, Fortis Hospital Noida.

Preventive measures to ward off dengue as per Dr Quadri

It is important to remember that while certain strains may have a reputation for causing more severe cases, any strain of the dengue virus can lead to severe symptoms and complications. Timely medical attention, proper fluid intake, and rest are crucial for managing dengue fever effectively and preventing its progression to severe forms. If you suspect you have dengue fever, seek medical attention promptly.

Stagnant water is a breeding ground for mosquitoes, particularly the Aedes mosquitoes that transmit the dengue virus. These mosquitoes lay their eggs in still water, and the larvae develop in these water sources. To prevent mosquito breeding and reduce the risk of dengue transmission, it is crucial to eliminate or manage stagnant water around homes and communities.

Here are some important details and preventive measures:

1. Identify and remove stagnant water sources

Regularly inspect your surroundings for potential breeding sites, such as flowerpots, vases, discarded containers, old tires, and other items that can hold water. Empty, remove, or cover any containers or objects that collect water, such as buckets, bird baths, and pet water bowls. Keep gutters clean and free of debris to ensure proper water drainage. Properly dispose of trash and waste materials to avoid water accumulation in containers or receptacles.

2. Maintain water storage containers

If you use water storage containers like tanks or barrels, ensure they have tightly fitted covers or lids to prevent mosquitoes from accessing the water. If possible, treat stored water with larvicides approved for mosquito control to prevent mosquito larvae from developing.

3. Clean and treat water features

If you have decorative water features, like fountains or ponds, consider adding mosquito larvae-eating fish or using biological larvicides to control mosquito breeding. If fish are present, make sure to clean the water feature regularly and keep it free from debris.

4. Practice proper yard maintenance

Trim bushes and shrubs regularly to minimize shaded areas where mosquitoes may rest during the daytime. Remove accumulated leaves and debris that can hold water in gardens and outdoor spaces.

5. Cover rainwater collection containers

If you collect rainwater for gardening or other purposes, make sure to cover the containers securely to prevent mosquito access.

6. Use mosquito screens

Install screens on windows and doors to prevent mosquitoes from entering your living spaces. Repair any damaged screens promptly to ensure they remain effective.

7. Wear protective clothing and use repellents

When going outdoors, wear long-sleeved shirts, long pants, and socks to reduce exposed skin. Apply mosquito repellents containing DEET, picaridin, or oil of lemon eucalyptus to exposed skin and clothing, following the product instructions carefully.

8. Promote community awareness

Educate your community about the importance of eliminating stagnant water and preventing mosquito breeding. Encourage collective efforts in cleaning up public spaces and reducing mosquito breeding sites.

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