Chinese experts release new consensus to combat severe dengue

As dengue fever expands its geographic range due to climate change and global travel, China faces an increasing public health burden. While most dengue cases are mild, severe dengue (SD)—characterized by shock, severe bleeding, and organ impairment—progresses rapidly and carries a high mortality rate.

Historically, China has relied on WHO guidelines, but the clinical profile of SD in China differs significantly from highly endemic regions like Southeast Asia. In China, SD predominantly affects older adults and those with underlying comorbidities. To address this gap, the Society of Infectious Diseases, Chinese Medical Association, has published a new expert consensus in Infectious Diseases & Immunity, offering 16 tailored recommendations for the diagnosis and treatment of severe dengue.

The consensus clarifies high-risk populations, including those aged ≥65, pregnant women, and patients with secondary infections or chronic diseases. It pinpoints core warning signs—such as severe abdominal pain, persistent vomiting, mucosal bleeding, and rapid platelet decline—that emerge 24 hours before severe progression. Crucially, the experts detail diagnostic criteria for specific organ complications, including severe cardiac injury, neurological complications, and severe liver and kidney injury, which are often overlooked or lack unified global definitions.

For treatment, the consensus emphasizes a conservative fluid resuscitation strategy guided by point-of-care ultrasound and lactate levels to avoid fluid overload. It also provides clear recommendations on the rational use of blood products, restricting prophylactic platelet transfusions while outlining targeted interventions for severe organ-specific damage.

By standardizing early recognition and optimizing clinical management tailored to China's specific epidemiological context, this consensus aims to significantly reduce SD mortality and improve patient outcomes globally.