DENGUE

VADS CORNER — Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF) · Malaysia and the region
Online since 15 October 2005 · Comprehensively revised 28 August 2026

This page was set up in 2005 as a result of the resurgence of dengue worldwide. Twenty years on, dengue is no longer a resurgence — it is Malaysia's persistent epidemic, and by a considerable margin our largest current outbreak burden. In 2026 the country passed a full year's typical caseload before August was out. This revision brings the page up to date: a working clinical reference, the vaccine question that did not exist in 2005, and a resource list rebuilt link by link.

About this revision. The 2005 page accumulated some two hundred links over its life, and the great majority have since moved, been superseded, or died outright — GeoCities closed, a Yahoo guestbook service retired, CDC and WHO both rebuilt their sites more than once, and one specialist agency, the Walter Reed Biosystematics Unit, closed altogether in March 2025. Working links have been corrected or replaced with current equivalents; a few older academic sites turned out to have survived completely unchanged since the 1990s, which was a pleasant surprise. Nothing has been silently dropped — dead links of no continuing value are removed and noted here; the page as it stood before this revision is preserved at olddenguepage.html.

NEW added in this revision FIXED URL corrected or source replaced ARCHIVE historical, kept for the record VERIFY could not be independently confirmed; test before relying on it

What dengue is

Dengue is a mosquito-borne viral infection, caused by any of four related but distinct virus types (DENV-1 to DENV-4), transmitted by the bite of an infected Aedes aegypti or Aedes albopictus mosquito. Infection with one type gives long-term immunity to that type only, and short-term protection against the others — which is why a second infection with a different type can be more dangerous than the first.

Most infections are mild or produce no symptoms at all. A minority progress to severe dengue, characterised by plasma leakage, bleeding, and organ involvement, which can be fatal without prompt treatment but has a case-fatality rate below 1% with good clinical management.

Malaysian clinical guidelines

These are the primary references for how dengue is actually managed in Malaysia, and the source for the practical advice on Don't Wait for the Fever to Break.

Clinical Practice Guidelines: Management of Dengue Infection in Adults NEW — Academy of Medicine of Malaysia / Ministry of Health. Warning signs, fluid management, the paracetamol dose ceiling (4g/day) and the reasoning behind it, and NSAID avoidance.
Clinical Practice Guidelines: Management of Dengue Fever in Children, Second Edition NEW — the paediatric equivalent, with weight-based paracetamol dosing and its own explicit statement of the liver-injury rationale.

Other countries' clinical guidelines

For comparison, since the same disease is managed slightly differently in different health systems.

Singapore National Dengue Clinical Guideline NEW — published 31 March 2026, the most recent guideline referenced on this page by several months. Developed by the National Centre for Infectious Disease and methodologically validated by the Agency for Care Effectiveness. Covers the same febrile, critical and recovery phases as the Malaysian CPGs, with an explicit section on special populations: the elderly, pregnant women, infants and children.
CDC — Dengue for Health Care Providers NEW — the US clinical hub, including a downloadable pocket guide for case management organised by patient group and phase. Worth knowing before treating it as directly comparable: the vaccine ACIP recommends for the US is Dengvaxia, not Qdenga — a different vaccine from the one discussed in The Vaccine We Have — and the manufacturer is discontinuing Dengvaxia, with existing stock due to expire in August 2026.

The vaccine question

A dengue vaccine did not exist when this page was first built. One now does, is registered in Malaysia, and is not straightforward. The full argument is in The Vaccine We Have … For Some; the primary sources behind it are listed here for anyone who wants to go further.

WHO SAGE recommendation on TAK-003 (Qdenga) NEW — September 2023, Journal of Travel Medicine
TAK-003 immunogenicity, safety and efficacy meta-analysis NEW
Dengue vaccine deployment into routine immunisation NEW
MSIDC adult immunisation guideline — dengue NEW — the Malaysian serotype surveillance record and the efficacy figures actually used here
DPAM position paper on dengue vaccination NEW — Dengue Prevention Advocacy Malaysia, July 2026 edition; the registration conditions, the Act2Care registry, and its removal
Value-based pricing assessment, Malaysian dengue vaccination (2017) NEW
Azzeri model: national programme could save RM4 billion over 30 years NEW
Singapore HSA's published vaccine assessment NEW — shown in full, for comparison with how Malaysia's equivalent process is not

Wolbachia and vector control

Wolbachia Malaysia project — Institute for Medical Research FIXED — domain corrected; releases now run in the Klang Valley and Penang
First economic review of Wolbachia programmes NEW — June 2026; the Malaysian effectiveness estimate here is 40.3%, not the higher figures usually quoted
Auditor-General: no evidence fogging works NEW
iDengue — hotspot mapping FIXED — domain moved from the old Remote Sensing Agency address; daily case and hotspot data by locality
American Mosquito Control Association
Society for Vector Ecology VERIFY
MaHTAS — Integrated Vector Management for Aedes Control FIXED — MOH/P/PAK/425.19(RR)-e, 2019. The original moh.gov.my link no longer resolves; MaHTAS appears to have moved its web presence to a separate subdomain, mymahtas.moh.gov.my, and the report was not found there directly. This ResearchGate copy carries the same title and reference details. Six years old, so treat the specific figures as historical rather than current — dengue illness cost estimated at RM116 million by May 2019 and RM348 million by December that year — but the WHO five-element integrated vector management framework it sets out has not materially changed, and it comes from the same Ministry body that assesses the vaccine's cost-effectiveness question elsewhere on this page.

International agencies

CDC — Dengue FIXED
CDC — About Dengue, fact sheet and Q&A FIXED
CDC — current case definition FIXED
CDC — clinical testing guidance FIXED
CDC — epidemiology and statistics FIXED
CDC — areas with risk / travel notices FIXED
CDC — isolation precautions guideline FIXED
CDC — Emerging Infectious Diseases journal FIXED
CDC — MMWR
WHO — Dengue and severe dengue FIXED
WHO — fact sheet FIXED
WHO — Dengue Case Management for Primary Health Care and Home-Based Care NEW — October 2025; supersedes the 2011–2012 SEARO handbook and guideline this page used to cite.
WHO SEARO — Dengue, South-East Asia Region FIXED
WHO global dengue surveillance dashboard FIXED — replaces the discontinued DengueNet tool
PAHO — Pan American Health Organization VERIFY

Regional and Malaysian sources

The Star — new risks from DENV-3 NEW — June 2026, with Professor Zamberi Sekawi and Professor Sharifa Ezat Wan Puteh
New Straits Times — chronic illness raises dengue risk NEW
Free Malaysia Today — Health Ministry warning, August 2026 NEW
Systematic review: drivers of rising dengue cases in Malaysia NEW — April 2026
ADVA — Dengue Dashboard FIXED — Asia Dengue Voice and Action's regional dashboard, archived back to 2023 and updated roughly monthly, currently through Week 27, 2026. Linked here as the live index rather than a single dated PDF, so it always points to the latest situation report.
Singapore MOH — published Dengvaxia decision reasoning NEW
Singapore NEA — dengue and Zika FIXED

My own writing on dengue

The Vaccine We Have … For Some NEW — Kerbside Consult 3/2026. A dengue vaccine is registered here and being sold privately. What the government's cost-benefit analysis actually assumes, why a registry that could have answered that question was quietly closed in February 2026, and why the population most likely to die of dengue is the one the trial evidence says least about.
Don't Wait for the Fever to Break NEW — Kerbside Consult 4/2026. The practical version, for anyone who is not a clinician: mosquito control that works, the warning signs, when to go to hospital, and what to avoid at home. One screen long, and printable.

General reference

The Big Picture Book of Viruses — Flaviviridae — still online, unchanged, more than two decades on.
Department of Medical Entomology, Sydney — Dengue fact sheet
EXTOXNET — Pesticide Information Profiles — for anyone looking into what is actually in a mosquito fogging product.
National Center for Biotechnology Information (NCBI) FIXED — search MEDLINE via NLM PubMed. Related articles for any result are shown alongside it automatically on the current site. Search PubMed for “dengue”.
Dengue fever — Wikipedia
Supercourse: Epidemiology, the Internet and Global Health FIXED — moved from a personal University of Pittsburgh directory to the university's current hosting platform
ProMED-mail FIXED — old direct search-tool link retired; homepage still active
Break Dengue
Dengue Vaccine Initiative FIXED — domain corrected to the plural form

Retained for context, unverified in this revision VERIFY

A handful of specialist and news-search links from the original page could not be individually re-confirmed without disproportionate effort: BBC and CNN dengue search results, ChannelNewsAsia, Health Canada travel health pages, the UK Clinical Virology Network, the Public Health Laboratory Service, Infectious Diseases in Children, microscopy-uk.org.uk, and a small number of others. None was load-bearing to any specific claim on this page. If you rely on any of these, check first.

Removed in this revision ARCHIVE

Confirmed dead and removed outright: the GeoCities-hosted mirror (GeoCities closed in 2009); the Yahoo webhosting guestbook, sign and view links (retired the same year); the ClustrMaps visitor counter; and two eMedicine links, since folded into Medscape. The old PubMed and NCBI Entrez search-string links have also been dropped — PubMed's URL structure has changed completely; searching pubmed.ncbi.nlm.nih.gov directly is now the right approach.

The Walter Reed Biosystematics Unit VERIFY

This page previously linked to WRBU's mosquito identification keys. The unit closed in March 2025 following US Army budget cuts. The Smithsonian retains an archived version of the site at the same address, but individual sub-pages may no longer exist. Kept, with this caveat, rather than removed outright, since the specimen collection and much of its documentation are understood to remain with the Smithsonian.

Content current as at 28 August 2026. Links last checked 28 August 2026.

Suggestions and corrections are welcome by email. Links marked VERIFY could not be confirmed in this revision and should be tested before you rely on them.