Dengue

Reportable by Laboratories and Providers

About this Reportable Disease

Infectious agent:  Dengue Virus

Description of illness: Dengue is a tropical disease caused by a mosquito-borne virus. The dengue virus is spread by the bite of infected Aedes mosquitoes. It does not spread person to person, except in rare cases of transmission via organ transplants or blood transfusions from infected donors. Dengue is characterized by the rapid development of a fever, with intense headache joint and muscle pain, and rash. The rash develops several days after the onset of fever. The severe form of dengue is associated with loss of appetite, vomiting, high fever, headache and abdominal pain. Shock and circulatory failure may occur. Symptoms of infection usually begin 4 to 7 days after a bite from an infected mosquito and typically last 3 to 10 days. There are 4 distinct types of dengue virus. After infection a person becomes immune to that type of dengue virus but can still become infected with a different type. Sequential infections increase the risk for severe dengue.

Interactive Disease Data


Laboratory Reporting for this Disease

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

 

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

  • Dengue is a mosquito-borne viral illness (dengue virus, typically spread by infected Aedes mosquitoes). It is not spread person-to-person, except in rare situations such as transfusion, transplant, or other blood exposure.
  • Typical illness begins after an incubation period of 4–10 days and often includes fever plus headache, eye pain, muscle/joint pain, nausea/vomiting, rash, and sometimes mild bleeding (e.g., nose or gum bleeding). Warning signs for severe dengue often appear as the fever is going away and can include persistent vomiting, severe abdominal pain, fluid buildup, mucosal bleeding, lethargy/restlessness, postural hypotension, liver enlargement, and rising hematocrit (hemoconcentration).
  • Diagnosis is based on clinical suspicion plus timing-appropriate blood testing; CDC emphasizes that suspected patients should be managed appropriately without waiting for test results. Testing may include NAAT (PCR) and/or NS1 antigen early in illness and IgM serology later, depending on days since symptom onset.
  • Treatment is supportive (careful hydration, close monitoring for plasma leakage/shock and bleeding, and appropriate level-of-care decisions). CDC provides dengue case-management guidance (including outpatient vs inpatient criteria and shock management) focused on early recognition and preventing complications. In Tennessee, dengue is a reportable disease, supporting surveillance and public health response.

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting. 

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link. 

Information about this Reportable Disease for the Public

What It Is

Dengue is an acute viral illness caused by one of four dengue viruses (DENV-1, 2, 3, or 4). It leads to fever and can range from mild to life-threatening disease.

Types / Classifications

  • Dengue (Classic) – fever with typical symptoms like rash and body pain
  • Dengue-like Illness – fever only, less specific
  • Severe Dengue – serious complications such as plasma leakage, bleeding, or organ damage

Signs and Symptoms

  • Sudden fever
  • Headache, pain behind eyes
  • Muscle and joint pains (“breakbone fever”)
  • Nausea, vomiting
  • Rash
  • Warning signs for severe dengue:
    • Abdominal pain, persistent vomiting
    • Bleeding (nose, gums, mucosa)
    • Fluid accumulation (swelling, breathing difficulty)
    • Low platelets, shock

How It Spreads

  • Spread by bites of infected Aedes mosquitoes (Aedes aegypti / albopictus)
  • Not spread person-to-person directly

Treatment

  • No specific antiviral treatment
  • Fluids and hydration
  • Fever and pain management (avoid aspirin/NSAIDs)
  • Close monitoring for complications
  • Supportive care only:
    • Hospital care for severe cases

This Page Last Updated: March 25, 2026 at 8:53 PM