Most people recover from dengue at home. A small number become seriously ill — and it usually happens just as the fever starts coming down. These are the signs that mean go to hospital now.
Most people who get dengue recover at home in one to two weeks with rest and fluids. But a small number become seriously ill, and when that happens it usually happens quickly.
The dangerous part catches many families by surprise, because it does not happen when the fever is at its worst. It happens when the fever starts coming down.
The danger period is day three to seven
Dengue usually runs in three stages.
For the first two or three days there is high fever, severe headache, pain behind the eyes, and strong muscle and joint pain. This feels terrible, but it is not usually the risky part.
Then, somewhere around day three to seven, the fever comes down. Many families relax at this point and stop watching closely. This is exactly the wrong moment to relax. In the small number of people who develop severe dengue, this is when fluid starts leaking out of the blood vessels, and it can happen within hours.
After that comes the recovery stage, when the person slowly starts feeling better and appetite returns.
So the rule is simple: the fever coming down is not proof that the illness is over. Keep watching closely for another two to three days.
The warning signs
Go to a hospital immediately if the person with dengue shows any of these:
- Severe stomach pain or pain when you press the tummy
- Vomiting again and again — three or more times in a day
- Bleeding from the gums or nose, or blood in vomit or in stool
- Fast or difficult breathing
- Restlessness, or unusual sleepiness and weakness — a change in how alert the person is
- Cold, clammy or pale skin
- Passing very little urine — much less than usual, or none for many hours
These are not “wait and see” symptoms. Any one of them means go now. Severe dengue is treatable, and treated early the results are usually good. The danger comes from waiting.
Watch children and older people more closely
Small children cannot tell you that their stomach hurts or that they feel strange. Watch instead for a child who has become unusually quiet or floppy, who is refusing to drink, who is not passing urine as often, or whose hands and feet feel cold.
Older people, and anyone with diabetes, heart disease or kidney problems, also need closer watching.
What to do at home while you watch
- Fluids matter more than anything else. Water, ORS, coconut water, soups, dal water, fresh juice — little and often through the day.
- Paracetamol is normally the medicine used for the fever and pain. Follow the dose on your pack or your doctor’s instruction.
- Aspirin and ibuprofen-type painkillers are usually avoided in dengue because they can increase the risk of bleeding. Ask your doctor before taking any painkiller.
- Rest. The tiredness is real and can last for weeks after the fever goes.
- Keep track of urine. Passing urine a normal number of times is one of the simplest signs that a person is drinking enough.
About the platelet count
Falling platelets frighten people more than almost anything else in dengue, and the number is often watched obsessively.
Doctors do not look at the platelet count alone. They read it alongside the person’s symptoms, their haematocrit, and how they look and feel. Many people with a low count recover perfectly well without any transfusion, which is only needed in specific situations.
A person who is alert, drinking, and passing urine normally is generally in a better position than one number on a report might suggest. And a person with warning signs needs hospital care regardless of what their platelet count says.
Papaya leaf juice, kiwi and other home remedies are widely shared during dengue season. There is no reliable evidence that any of them prevent severe dengue. They are not a substitute for fluids, monitoring and getting to a hospital if warning signs appear.
When to see a doctor in the first place
See a doctor for any high fever during the dengue season, especially with severe headache or body pain. A blood test can confirm dengue, and knowing early means you know when to start watching carefully.
You can read more about the symptoms, tests and treatment on our dengue page, and about fever in general on our fever page.
Common questions
Which day of dengue is most dangerous?
Usually day three to seven, around the time the fever comes down. Do not stop watching just because the temperature has settled.
Can dengue spread from person to person?
No. It spreads only through the bite of an infected mosquito. You cannot catch it by sitting with someone who has it.
Is a low platelet count always dangerous?
Not on its own. It is one part of the picture, read together with symptoms and other results.
How long does the tiredness last?
Often several weeks after the fever has gone. That is normal and does not mean something is wrong.