In dengue, the WHO 2009 classification replaced the older DHF grading and introduced a new category. A dengue patient with severe plasma leakage causing respiratory distress and requiring mechanical ventilation is classified as:
- A Dengue Haemorrhagic Fever Grade IV
- B Dengue with warning signs — severe respiratory category
- C Severe dengue (dengue with severe plasma leakage) ✓
- D Expanded dengue syndrome
Explanation
WHO 2009 classification has three categories: (1) Dengue without warning signs; (2) Dengue with warning signs (abdominal pain, persistent vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement >2cm, rising haematocrit with rapid platelet decline); (3) Severe dengue — defined by severe plasma leakage leading to shock or respiratory distress, severe bleeding, or severe organ impairment (liver AST >1000, CNS impairment, cardiac, renal). Respiratory distress from severe plasma leakage requiring ventilation is classified as severe dengue. The old DHF Grade III/IV terminology is replaced in this classification.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.