Dengue: The Warning Signs That Come When the Fever Goes Down

Dengue is caused by a virus that spreads through mosquito bites. It is common in tropical countries such as Indonesia, especially in the rainy season. Most people who catch it have only mild symptoms, or none at all. A small number, however, become seriously ill and need hospital care.

The usual symptoms

According to WHO, symptoms usually begin 4 to 10 days after infection and last 2 to 7 days. They include:

• High fever, up to 40 degrees Celsius.
• A severe headache and pain behind the eyes.
• Muscle and joint pain.
• Nausea, vomiting, and a skin rash.

Most people recover within 1 to 2 weeks, although tiredness can last several weeks.

Watch closely when the fever goes down

This is the most important part. WHO notes that the warning signs of severe dengue often appear after the fever has gone. A fever that comes down does not always mean the illness is over. Go to hospital straight away if any of these appear:

• Severe pain in the belly.
• Vomiting that does not stop.
• Fast breathing.
• Bleeding gums or nose.
• Blood in vomit or stools.
• Restlessness, extreme thirst, pale and cold skin, or feeling very weak.

People who have had dengue before have a higher risk of the severe form.

Fever medicine that is safe

There is no medicine that kills the dengue virus itself. Care means rest, plenty of fluids, and easing fever and pain. WHO advises paracetamol for pain.

Avoid pain relievers of the NSAID group, such as ibuprofen and aspirin, because they can raise the risk of bleeding. If you are not sure which group a medicine at home belongs to, ask before taking it.

Preventing mosquito bites

Indonesia's Ministry of Health asks every household to do 3M Plus:

1. Drain and clean water containers such as tubs and buckets.
2. Close water containers such as drums and tanks tightly.
3. Reuse or recycle old items that can hold water.

The "plus" includes sprinkling larvicide powder in containers that are hard to clean, using mosquito repellent, sleeping under a net, keeping fish that eat larvae, letting light and air into the house, and not leaving clothes hanging indoors.

WHO also advises wearing clothes that cover the skin and fitting screens on windows.

In short

• A fever that comes down is not always the end. Watch for warning signs in the days that follow.
• Use paracetamol for fever and pain, and avoid ibuprofen and aspirin.
• Drink enough and rest.
• Do 3M Plus at home every week.

A Coapotek pharmacist can help check whether the fever medicine you have is safe when dengue is suspected.

Sources

1. World Health Organization. Dengue and severe dengue, fact sheet, 21 August 2025.
2. Ministry of Health of the Republic of Indonesia. Menkes: Dibanding Fogging, PSN 3M Plus Lebih Utama Cegah DBD (Minister of Health: 3M Plus matters more than fogging in preventing dengue), 12 February 2016.