Question 1

Can a patient move between classification categories during the same illness?

Accepted Answer

Yes — the clinical course of dengue is dynamic. A patient without warning signs can develop warning signs within hours, especially around the time of defervescence. Reassess and reclassify at least every 4–6 hours during the critical phase (days 3–7 of illness).

Question 2

What is the management difference between dengue with and without warning signs?

Accepted Answer

The management is significantly different. Dengue without warning signs can be managed with oral rehydration and outpatient follow-up. Dengue with warning signs requires hospital admission, isotonic IV fluids at a controlled rate, and strict monitoring of vital signs, haematocrit, and urine output every 4–6 hours.

Question 3

Do I need a diagnostic test to use this classification?

Accepted Answer

The classification should be applied to suspected dengue cases based on clinical presentation (fever ≥2 days with at least two of: headache, retro-orbital pain, myalgia, arthralgia, rash, leukopenia, positive tourniquet test). Confirmatory serology (NS1, IgM/IgG) or PCR should be obtained but is not required to begin clinical management per WHO guidelines.