Best Dengue Doctor In Mumbai Dengue viruses ( DENV ) are members of the family Flaviviridae, genus Flavivirus. The DENV complex comprises at least four antidenically related but distinct viruses, designated DENV types 1 through 4. Susceptible humans become infected after an infected female Aedes mosquito takes a human blood meal. Aedes aegypti mosquitoes, the principal vector for the transmission of the DENVs, have many characteristics that make them ideal for dissemination of the virus. They breed typically breed in or close to houses, laying eggs in both man-made and natural water containers. They are preferentially daytime feeders, and their feeding episodes often go unnoticed. They are easily interrupted in their feeding and often move on to another host, frequently taking multiple blood meals in a single breeding cycle. Thus an infected Ae. aegypti mosquito may transmit a DENV to several individuals within the household. The three clinical phases of dengue are febrile phase, critical phase, and recovery phase. The critical phase is not seen in all infections. The febrile phase is characterized by fever. Other common symptoms include headache, body ache, muscle pain and a transient rash. Typical findings include low platelet, low white blood count and deranged liver function tests. At the end of fever, a small proportion of patients develop bleeding, shock, and organ failure which usually lasts 24 to 48 hours. Signs of impending critical illness include persistent vomiting, severe abdominal pain, bleeding, lethargy and restlessness. During the recovery phase, hemorrhage resolve and vital signs stabilize. A pruritic eruption may appear. Polymerase chain reaction ( PCR ) to detect viral genomes and antigen tests are typically positive during the first week of illness. Virus specific IgM positivity develops around the fourth day of illness and is widely used to make a presumptive diagnosis. Outpatient management, under supervision of a specialist, is appropriate for patients with presumptive diagnosis of dengue in the absence of warning signs or coexisting conditions like pregnancy, infancy, old age, diabetes, renal failure, obesity. Patients should be instructed to take plenty of fluids and watch for signs of dehydration. Inpatient management is warranted for patients with dengue and warning signs of severe infection. Mosquito repellants should be used for personal protection along with insecticide spraying. One vaccine, CYD-TDV ( Dengvaxia ) has been licensed in over 20 countries in Latin America and Southeast Asia. Vaccines in development include TAK-003 ( Takeda ) and a tetravalent, live-virus vaccine attenuated through directed mutagenesis. At present none of the vaccines are available in our country.