Clinical Description For Case Definitions

Dengue as defined above with any of the following:

Abdominal pain or tenderness

Persistent vomiting

Clinical fluid accumulation (ascites, pleural effusion)

Mucosal bleeding

Lethargy, restlessness

Liver enlargement >2 cm

Laboratory: increase in HCT concurrent with rapid decrease in platelet count

**requires strict observation and medical intervention

Dengue with at least one of the following criteria:
Severe Plasma Leakage leading to:

– Shock (DSS)
– Fluid accumulation with respiratory distress

Severe Bleeding as evaluated by clinician

Severe organ involvement

– Liver: AST or ALT ≥ 1000

– CNS: impaired consciousness

– Failure of heart and other organs

Fever lasting from 2-7 days

Evidence of hemorrhagic manifestation or a positive tourniquet test

Thrombocytopenia (≤100,000 cells per mm3)

Evidence of plasma leakage shown by hemoconcentration (an increase in hematocrit ≥20% above average for age or a decrease in hematocrit ≥20% of baseline following fluid replacement therapy), or pleural effusion, or ascites or hypoproteinemia.

Rapid and weak pulse and narrow pulse pressure (<20mm Hg), or

Age-specific hypotension and cold, clammy skin and restlessness.