Dengue in Singapore: spotting the warning signs and protecting your home

The warning signs of severe dengue are high fever, severe abdominal pain, repeated vomiting, bleeding from the nose or gums, vomiting blood or passing black stools, drowsiness or restlessness, cold and clammy skin, and difficulty breathing. They often appear around days 3 to 7 of the illness, sometimes just as the fever starts to settle. If you notice any of them, seeking medical care immediately is important.

Key takeaways

• Dengue is a viral infection spread by the bite of an infected Aedes mosquito, and it is present in Singapore all year round.
• Typical early symptoms are a sudden high fever, headache with pain behind the eyes, joint and muscle aches, nausea and a rash.
• The riskiest period is often when the fever comes down, around days 3 to 7, so feeling “better” does not always mean you are out of the woods.
• Use paracetamol for fever and pain; avoid aspirin and anti-inflammatory painkillers such as ibuprofen unless a doctor tells you otherwise.
• NEA’s B-L-O-C-K steps help stop mosquitoes breeding in and around your home.

What are the early symptoms of dengue?

Dengue usually starts with a sudden fever that lasts 2 to 7 days, along with aches and tiredness. Symptoms typically begin 4 to 7 days after being bitten by an infected mosquito, though the range is wider.

Common early symptoms include:

• Sudden high fever
• Headache, often with pain behind the eyes
• Joint and muscle pain
• Nausea or vomiting
• A skin rash, which may appear a few days into the illness
• Mild bleeding, such as a nosebleed, bleeding gums or easy bruising

These symptoms overlap with those that are often seen with influenza (flu), COVID-19 and other viral fevers, so it is hard to tell them apart at home. A GP can examine you and arrange blood tests, including a platelet count, to help confirm dengue and see how your body is coping. Fever and infections are part of the everyday problems our GPs treat.

What are the warning signs of severe dengue?

Warning signs are symptoms that suggest dengue may be becoming severe, which can lead to leaking blood vessels, bleeding and a dangerous drop in blood pressure. They need immediate medical attention, and some need emergency care.

A point that catches many people out: warning signs often appear around the time the fever breaks. Keep watching closely for a day or two after your temperature returns to normal.

When should you see a doctor for suspected dengue?

See a GP early if you have a fever with any of the typical dengue symptoms, especially if you live or work near a dengue cluster. Early review means your doctor can confirm the diagnosis, check your blood counts and tell you what to watch for.

Book a GP consultation if you:

• Have a fever lasting more than two days, or a fever with aches and a rash
• Are pregnant, an older adult, or have diabetes, heart or kidney disease
• Have had dengue before (a second infection with a different type of the virus carries a higher risk of severe illness)
• Are struggling to drink enough fluids
• Are passing much less urine than usual

Go to the emergency department or call 995 if you notice any of the warning signs in the table above, feel faint when standing up, or have trouble staying awake.

Your doctor may ask you to return for repeat blood tests over several days, because platelet counts and other results can change quickly. Keep these follow-up appointments even if you feel better, and check the clinic’s opening hours so you can plan repeat visits.

A key note is that even when the fever has passed and you feel better dengue could still be active and your platelets (which help your blood to clot) may still decrease. Follow up blood tests for this are important to ensure that the risk of uncontrollable bleeding is minimised.

How can you look after yourself at home with dengue?

There is no specific medicine that kills the dengue virus, so care focuses on rest, fluids and watching for warning signs. Most people recover within one to two weeks, although tiredness can linger. If you still feel run down weeks later, a health screening or GP review can check that your blood counts have returned to normal.

1. Drink plenty of fluids, such as water, oral rehydration solutions, isotonic drinks, fruit juice or soup.
2. Rest and take time off work or school.
3. Use paracetamol for fever and aches, at the dose on the packet or as advised by your doctor.
4. Avoid aspirin and anti-inflammatory painkillers (such as ibuprofen, naproxen, diclofenac or mefenamic acid), as they can raise the risk of bleeding.
5. Keep a simple diary of your temperature, fluid intake and how often you pass urine, to share with your doctor.
6. Protect others by using mosquito repellent while you are sick, so mosquitoes cannot pick up the virus from you and pass it on.

How can you protect your home from dengue mosquitoes?

The Aedes mosquito breeds in small pools of clean, stagnant water, often inside homes. The National Environment Agency (NEA) asks households to do the B-L-O-C-K steps regularly:

• Break up hardened soil
• Lift and empty flowerpot plates
• Overturn pails and wipe their rims
• Change water in vases
• Keep roof gutters clear and place BTI insecticide

A few extra checks help too. Look at places that collect water after rain, such as dish racks, toilet bowls that are rarely used, pet water bowls and items on balconies. Once a week is a good habit, because the mosquito life cycle from egg to adult takes about a week.

For personal protection, NEA also promotes S-A-W: Spray insecticide in dark corners of your home, Apply mosquito repellent regularly, and Wear long-sleeved tops and long pants. Aedes mosquitoes bite mainly during the day, so repellent matters in the daytime as well as at night.

Frequently asked questions