Prognosis

The mortality rate for severe dengue infection is 0.8% to 2.5%.[1] Children are at an increased risk of severe infection and death compared with adults; however, severe infection in adults is increasingly being reported.[1][14][15][39] The risk of a child ages 1 to 5 years dying from dengue infection is fourfold higher compared to children ages 11 to 15 years.[40] Even though dengue hemorrhagic fever (DHF) and dengue shock syndrome are uncommon in adults, a higher morbidity and mortality rate has been reported, especially in older people, which is related to an increased risk of organ impairment.[1][15][41][42][43]

According to one meta-analysis, a positive tourniquet test, ascites, and shock were identified as the best predictors of dengue infection, DHF, and mortality, respectively.[17]

Long-term sequelae

There are no long-term sequelae associated with dengue infection once the patient has recovered; however, some patients may experience post-viral fatigue syndrome after recovery. The patient's platelet count gradually increases during convalescence; however, some patients may develop temporary thrombocytosis during recovery. Complete normalization of liver function tests may take up to 3 or 4 weeks.

Recurrence

Recurrence is possible with a different dengue virus serotype, leading to secondary dengue infection. Third and fourth recurrences of clinical infection can also occur, but the clinical impact is not very clear. Once immunity has developed to all 4 serotypes, lifelong immunity to each serotype occurs.

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