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disease, time and days

DENGUE FEVER.—A tropical disease, which runs an acute course and is very contagious. It is endemic in the Lesser Antilles, along the coast of the Red Sea, and on the West Coast of Africa. From time to time the disease invades other countries. It has occurred in the southern United States ; and an epidemic of dengue raged in Philadelphia in 1798. The disease begins, after three to five days of incubation, with sudden fever, general indisposition, pains in the head, joints, and limbs, catarrhal symptoms, and a transitory rash which extends over the entire body in the form of a diffuse redness or red patches, A favourite site of the pain is in the knee-joints. This pain becomes worse on walking, and gives rise to a peculiar strutting gait which is characteristic of the disease, and which has given it the popular name of " dandy fever." The fever, which may rise as high as 1o6° to 107° F., usually disappears in about three days, together with the other symptoms, this stage being marked by a profuse perspiration. A day or two later,

however, a second eruption may take place, which is uncertain in character, and may resemble measles, scarlatina, urticaria, or other rashes. This second eruption may last anywhere from a few hours to several days ; recovery follows its disappearance, although a complete return to health may be greatly retarded.

The course of the disease is, as a rule, favourable. Fatal cases are rare, and mostly in children or in persons afflicted with some other severe illness. Such persons should, therefore, be especially protected against infection during the prevalence of an epidemic ; and in order to avoid actual contact with the subjects of the disease they had best be removed from their homes for a time. The disease is extremely contagious, some times spreading even more rapidly than influenza. Epidemics have been rare within recent years.