Type Asymptomatic Clinical presentation Approximately 50% of infected individuals remain asymptomatic Undifferentiated Relatively benign febrile illness fevers Typically in young children experiencing their first infection Many go undiagnosed because of similarities with other febrile illnesses Dengue fever Fever and develop two or more of the following: without warning • Nausea or vomiting signs • Myalgias and/or arthralgias • Diffuse erythematous maculopapular rash • Leukopenia • Positive tourniquet test (inflation of a blood pressure cuff for results in >10–20 petechiae per square inch; a measure of capillary fragility) Dengue with Symptoms of dengue without warning signs with any of warning signs the following additional symptoms: • Abdominal pain or tenderness • Persistent emesis • Fluid overload (ascites, pleural effusion) • Mucosal bleeding • Lethargy • Hepatomegaly (liver edge appreciable cm below costal margin) • Increased hemoglobin (from hemoconcentration) and thrombocytopenia Severe dengue Symptoms of dengue with warning signs with any of the fever or dengue following: shock syndrome • Severe plasma leakage with resultant: • Shock • Fluid accumulation resulting in respiratory distress or failure • Severe bleeding