{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.dengue-fever","code":"thing-q30953","url":"https://ver.cy/models/thing/q30953/","name":"dengue fever","alternateNames":["asymptomatic dengue","dengue hemorrhagic fever"],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Activities and processes","entryKind":"thing","plane":"ACT","domain":["ACT.ACT"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"Dengue fever is an acute mosquito-borne viral disease caused by any of four closely related dengue virus serotypes (DENV-1-4), typically presenting as a self-limited febrile illness that can progress to plasma-leakage dengue or severe dengue.","purpose":"Enable an AI agent to recognise a possible dengue fever episode, track diagnostic confidence and clinical progression, and support timely clinician-directed monitoring, escalation and recovery assessment.","scope":{"in":["Episode recognition, exposure plausibility and diagnostic uncertainty","Symptom chronology, defervescence and clinical phase","Warning signs, plasma leakage, bleeding and organ involvement","Dengue-relevant host factors and serial clinical measurements","Care escalation, supportive-care constraints and response","Episode outcome and links to transmission prevention and reporting"],"out":["Dengue virus taxonomy, genome and laboratory strain management","Aedes mosquito biology and vector-control programme operations","Population outbreak forecasting and surveillance-system administration","The patient's complete longitudinal health record","Vaccine product specifications and population immunisation policy","Independent models of malaria, chikungunya, Zika and other differential diagnoses"],"boundaries":[]},"distinguishingFeatures":["Require dengue-specific evidence to distinguish confirmed infection from a compatible febrile syndrome: a positive NAAT or NS1 antigen result supports acute infection, whereas isolated IgM supports presumptive recent infection. [CDC testing guidance](https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html)","Interpret negative tests against specimen timing and assay type; a negative NAAT or NS1 result alone does not exclude dengue. [CDC testing guidance](https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html)","Treat fever, retro-orbital pain, aches and rash as compatible but insufficiently specific; require an explicit differential assessment rather than distinguishing dengue from other febrile illnesses by symptoms alone. [CDC clinical features](https://www.cdc.gov/dengue/hcp/clinical-signs/index.html)","Distinguish falling temperature from established recovery: dengue's critical phase can begin around defervescence, so the episode needs concurrent circulation and leakage assessment. [CDC clinical features](https://www.cdc.gov/dengue/hcp/clinical-signs/index.html)","Distinguish severe dengue from uncomplicated dengue or an isolated low platelet count by assessing severe plasma leakage, severe bleeding or severe organ impairment. [WHO outbreak toolbox](https://www.who.int/emergencies/outbreak-toolkit/disease-outbreak-toolboxes/dengue-outbreak-toolbox)"],"structure":{"bundles":[{"id":"dengue-recognition-and-exposure","name":"Dengue recognition and exposure","description":"Establish why this febrile episode is being considered dengue and what competing explanations remain.","layers":[{"id":"febrile-presentation","name":"Febrile presentation","description":"Record the observed illness pattern and its attribution.","findings":[{"id":"compatible-dengue-syndrome","name":"Compatible dengue syndrome","description":"Preserve reported and observed fever, pain, rash and other manifestations with onset times and observer provenance.","questions":[{"text":"Which manifestations support considering dengue, when did they begin, and which were reported rather than directly observed?","id":"compatible-dengue-syndrome-q01","kind":"measurement"},{"text":"Which findings require assessment for malaria, chikungunya, Zika, bacterial infection or a concurrent illness?","id":"compatible-dengue-syndrome-q02","kind":"boundary"}]}]},{"id":"exposure-and-prior-immunity","name":"Exposure and prior immunity","description":"Connect the episode to dated exposure and relevant infection or vaccination history.","findings":[{"id":"exposure-and-history-evidence","name":"Exposure and history evidence","description":"Separate documented travel, residence and prior infection from assumptions about exposure or immunity.","questions":[{"text":"Where was the person before symptom onset, on which dates, and what dated evidence supports dengue transmission there?","id":"exposure-and-history-evidence-q01","kind":"provenance"},{"text":"What evidence exists for prior dengue, a known previous serotype, or flavivirus vaccination, and what remains unknown?","id":"exposure-and-history-evidence-q02","kind":"provenance"}]}]}]},{"id":"dengue-diagnostic-evidence","name":"Dengue diagnostic evidence","description":"Represent test selection, results and interpretation in relation to illness timing.","layers":[{"id":"specimen-and-assay-timing","name":"Specimen and assay timing","description":"Anchor laboratory evidence to the episode timeline.","findings":[{"id":"time-qualified-test-result","name":"Time-qualified test result","description":"Record NAAT, NS1 and antibody results with specimen details; acute-phase testing and later serology have different roles. [CDC testing guidance](https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html)","questions":[{"text":"Which assay and specimen produced each result, and how long after symptom onset was the specimen collected?","id":"time-qualified-test-result-q01","kind":"measurement"},{"text":"Does the applicable testing guidance call for an additional or convalescent specimen given the timing and existing results?","id":"time-qualified-test-result-q02","kind":"action"}]}]},{"id":"diagnostic-adjudication","name":"Diagnostic adjudication","description":"Separate evidence from the conclusion drawn from it.","findings":[{"id":"confirmation-and-residual-ambiguity","name":"Confirmation and residual ambiguity","description":"Retain conflicting evidence and serological cross-reactivity; a single IgG result is not recommended for diagnosing acute dengue. [CDC testing guidance](https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html)","questions":[{"text":"Which named criteria support the recorded diagnostic category, and who made that interpretation?","id":"confirmation-and-residual-ambiguity-q01","kind":"definition"},{"text":"Could prior infection, vaccination, another flavivirus or discordant testing explain the result, and what would resolve the ambiguity?","id":"confirmation-and-residual-ambiguity-q02","kind":"boundary"}]}]}]},{"id":"dengue-phase-and-trajectory","name":"Dengue phase and trajectory","description":"Track the episode through fever, possible critical deterioration and recovery.","layers":[{"id":"onset-and-defervescence","name":"Onset and defervescence","description":"Maintain a timeline with uncertainty and reassessable phase assignments.","findings":[{"id":"phase-assignment","name":"Phase assignment","description":"Record the evidence for febrile, critical or recovery phase, including uncertainty when onset or fever resolution is unclear.","questions":[{"text":"What are the best-supported symptom-onset and defervescence times, and how uncertain are they?","id":"phase-assignment-q01","kind":"measurement"},{"text":"What observations justify the current phase, and when must that assignment be reassessed?","id":"phase-assignment-q02","kind":"definition"}]}]},{"id":"serial-physiology","name":"Serial physiology","description":"Interpret linked clinical and laboratory changes over time.","findings":[{"id":"trajectory-in-treatment-context","name":"Trajectory in treatment context","description":"Align haematocrit, platelets, perfusion, urine output and fluid administration so isolated measurements do not dominate interpretation.","questions":[{"text":"How have haematocrit, platelets, circulation and urine output changed across comparable observation times?","id":"trajectory-in-treatment-context-q01","kind":"measurement"},{"text":"Could fluid administration, bleeding, baseline variation or measurement quality account for the apparent change?","id":"trajectory-in-treatment-context-q02","kind":"boundary"}]}]}]},{"id":"dengue-warning-signs-and-severity","name":"Dengue warning signs and severity","description":"Separate warning signs from established severe manifestations and incomplete assessment.","layers":[{"id":"warning-sign-surveillance","name":"Warning-sign surveillance","description":"Record each warning sign explicitly and repeatedly.","findings":[{"id":"warning-sign-presence","name":"Warning-sign presence","description":"Assess abdominal pain or tenderness, persistent vomiting, fluid accumulation, mucosal bleeding, lethargy or restlessness, liver enlargement and rising haematocrit with rapidly falling platelets. [WHO outbreak toolbox](https://www.who.int/emergencies/outbreak-toolkit/disease-outbreak-toolboxes/dengue-outbreak-toolbox)","questions":[{"text":"Which warning signs are present, absent, uncertain or unassessed, and when was each last checked?","id":"warning-sign-presence-q01","kind":"measurement"},{"text":"What urgent clinical review or escalation does the current warning-sign pattern require under the applicable protocol?","id":"warning-sign-presence-q02","kind":"action"}]}]},{"id":"severe-manifestations","name":"Severe manifestations","description":"Identify the specific evidence supporting severe dengue.","findings":[{"id":"severity-mechanism-and-attribution","name":"Severity mechanism and attribution","description":"Record leakage-related shock or respiratory distress, severe bleeding and severe organ impairment separately, including alternative explanations.","questions":[{"text":"What evidence establishes each severe manifestation, and which severity definition is being applied?","id":"severity-mechanism-and-attribution-q01","kind":"definition"},{"text":"Which findings demand emergency escalation, and which may also reflect sepsis, another disease or a treatment complication?","id":"severity-mechanism-and-attribution-q02","kind":"action"}]}]}]},{"id":"dengue-care-and-response","name":"Dengue care and response","description":"Connect clinical assessment to care setting, supportive treatment and reassessment.","layers":[{"id":"care-setting-and-vulnerability","name":"Care setting and vulnerability","description":"Record patient-specific factors and practical access to reassessment.","findings":[{"id":"disposition-rationale","name":"Disposition rationale","description":"Capture the clinician's disposition decision with pregnancy, age, comorbidities, oral intake, available support and access to care as applicable.","questions":[{"text":"Which host factors and follow-up barriers change the monitoring or admission decision for this episode?","id":"disposition-rationale-q01","kind":"measurement"},{"text":"Who selected the care setting, which protocol supports it, and what changes trigger transfer or admission?","id":"disposition-rationale-q02","kind":"action"}]}]},{"id":"supportive-care-safety","name":"Supportive-care safety","description":"Track ordered care, response and treatment-related concerns.","findings":[{"id":"fluids-medications-and-reassessment","name":"Fluids, medications and reassessment","description":"Record clinician-directed hydration and symptom treatment; aspirin and ibuprofen can increase bleeding risk in dengue. [WHO dengue guidance](https://www.who.int/news-room/questions-and-answers/item/dengue-and-severe-dengue)","questions":[{"text":"What fluids and medicines were ordered and administered, and what subsequent observations document benefit or harm?","id":"fluids-medications-and-reassessment-q01","kind":"measurement"},{"text":"Which medication exposures, persistent perfusion problems or signs of fluid overload require clinician review of the plan?","id":"fluids-medications-and-reassessment-q02","kind":"action"}]}]}]},{"id":"dengue-outcome-and-transmission-handoff","name":"Dengue outcome and transmission handoff","description":"Establish how the episode ends and what patient-level follow-up or public-health links remain.","layers":[{"id":"recovery-and-episode-closure","name":"Recovery and episode closure","description":"Document recovery, persistent effects, transfer, death or loss to follow-up without treating discharge as proof of full recovery.","findings":[{"id":"supported-episode-outcome","name":"Supported episode outcome","description":"Link the outcome to clinical assessment, remaining symptoms and responsibility for unresolved findings.","questions":[{"text":"What evidence and applicable discharge criteria support recovery or closure, and which symptoms or abnormalities persist?","id":"supported-episode-outcome-q01","kind":"boundary"},{"text":"Who owns follow-up of pending tests, persistent symptoms or organ injury, and when is reassessment due?","id":"supported-episode-outcome-q02","kind":"action"}]}]},{"id":"mosquito-exposure-and-notification","name":"Mosquito exposure and notification","description":"Connect the individual episode to bite prevention and jurisdiction-specific case reporting.","findings":[{"id":"prevention-and-reporting-handoff","name":"Prevention and reporting handoff","description":"Record advice to reduce mosquito bites during illness and link authorised case notification to the relevant public-health process. People with dengue can infect mosquitoes that bite them. [WHO dengue guidance](https://www.who.int/news-room/questions-and-answers/item/dengue-and-severe-dengue)","questions":[{"text":"What mosquito-bite prevention advice was provided, for what period, and can the person follow it?","id":"prevention-and-reporting-handoff-q01","kind":"action"},{"text":"Which jurisdictional case definition and notification requirements apply, and what reporting has been authorised and completed?","id":"prevention-and-reporting-handoff-q02","kind":"provenance"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-kinds","name":"Kinds and varieties","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these kinds and varieties hold for the sense of dengue fever this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-identifiers","name":"Identifiers and schemes","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these identifiers and schemes hold for the sense of dengue fever this model covers, and on what evidence?","id":"evidence-identifiers-q01","kind":"provenance"}]},{"id":"evidence-standards-and-regulation","name":"Standards and regulation","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these standards and regulation hold for the sense of dengue fever this model covers, and on what evidence?","id":"evidence-standards-and-regulation-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these real-world use hold for the sense of dengue fever this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-measurements","name":"Typical measurements","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these typical measurements hold for the sense of dengue fever this model covers, and on what evidence?","id":"evidence-measurements-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of dengue fever this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-regional-variation","name":"Regional variation","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these regional variation hold for the sense of dengue fever this model covers, and on what evidence?","id":"evidence-regional-variation-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of dengue fever this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Share official public health guidance on dengue, its warning signs and mosquito control.","Report case numbers and outbreak alerts from health authorities."],"mustNot":["Diagnose dengue in a person or rule it out without clinical testing.","Recommend medicines or remedies for dengue that a clinician has not advised.","Disclose a person's infection status without consent or legal basis.","Understate an outbreak in public reports."],"requiresHuman":["Declaring or ending an outbreak alert.","Spraying insecticides in places where people live."]},"ethics":{"considerations":["Dengue falls hardest on crowded, poor areas with weak water and waste services.","Severe cases need prompt care; delay or false reassurance can cost lives."],"affectedParties":["People in affected areas","Children and older people","Health workers"]},"owners":{"steward":"Nobody owns a disease; public health authorities monitor and report it.","roles":[],"masterSystems":["National notifiable disease surveillance systems"]},"relations":[{"target":"Q131345497","type":"parent","note":"registry parent class"},{"target":"Q19001421","type":"parent","note":"registry parent class"},{"target":"Q6916469","type":"parent","note":"registry parent class"},{"target":"Q929451","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.dengue-fever","Wikidata: Q30953 (https://www.wikidata.org/wiki/Q30953)"]},"properties":{"applicability":"not-applicable","items":["Diagnostic confidence: suspected | presumptive | confirmed | excluded | unresolved; named criteria and assessment time","Illness timing: Days since symptom onset; hours since defervescence; uncertainty interval","Clinical phase: febrile | critical | recovery | indeterminate","Severity classification: without warning signs | with warning signs | severe dengue | not yet classifiable; framework and timestamp","Warning-sign assessment: For each sign: present | absent | not assessed | uncertain","Haematocrit trajectory: Percent or L/L; baseline, collection times and fluid-treatment context","Platelet trajectory: 10^9/L with collection times","Circulatory and fluid status: Blood pressure and pulse pressure in mmHg; heart rate in beats/min; urine output in mL/kg/hour; intake and output in mL over a stated interval","Dengue test evidence: Linked specimen, assay, result, collection time, laboratory and interpretation","Exposure and immune-history context: Dated location history, prior dengue evidence, relevant flavivirus infection or vaccination history; unknown permitted","Care disposition: outpatient follow-up | observation | inpatient care | emergency escalation | discharged | unresolved"]},"recognition":{"applicability":"not-applicable","items":[]},"capabilities":{"applicability":"required","items":["Assemble an evidence-linked suspected dengue episode without presenting suspicion as confirmation.","Identify missing or poorly timed diagnostic evidence for clinician review.","Compare serial observations and flag new warning signs or deterioration for urgent clinical assessment.","Present phase, severity, host factors and follow-up feasibility together to support care disposition.","Check proposed supportive care against an identified clinical protocol and recorded patient constraints.","Prepare recovery, mosquito-bite prevention and reporting handoffs for authorised review."]},"hazards":{"applicability":"required","items":["Severe dengue can cause plasma leakage, shock, major bleeding or organ impairment.","Apparent improvement as fever subsides can obscure progression to severe illness.","Confusing dengue with other febrile diseases can delay appropriate assessment and care."]},"interfaces":{"applicability":"required","items":["Dengue guidelines for diagnosis, treatment, prevention and control, World Health Organization."]},"context":{"applicability":"required","items":["Dengue fever is encountered in public health surveillance and clinical care, particularly in tropical and subtropical regions where its mosquito vectors occur.","Travel history and local transmission patterns provide context for assessing a suspected illness, but symptoms alone do not establish the diagnosis."]}},"sources":[{"title":"Dengue and severe dengue","url":"https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue","note":"WHO clinical classification, transmission, and public-health definition"},{"title":"Wikidata item Q30953: dengue fever","url":"https://www.wikidata.org/wiki/Q30953","note":"identity and sense of the item"},{"title":"Wikipedia: Dengue fever","url":"https://en.wikipedia.org/wiki/Dengue_fever","note":"general description of the item"}],"openQuestions":["Does the registry intend dengue fever to own the entire symptomatic dengue spectrum, including severe dengue, and is there an existing world model that must serve as its source of truth?","Which jurisdiction-specific clinical and surveillance definitions should govern classification, including mappings from older dengue haemorrhagic fever and dengue shock syndrome terminology?","Which assays are available in the intended deployment settings, and what locally validated interpretation rules address timing, previous flavivirus exposure and vaccination?","Which clinical protocols supply age-, pregnancy- and comorbidity-specific monitoring intervals, escalation thresholds, fluid-management constraints and discharge criteria?","What evidence should govern follow-up duration and attribution of persistent symptoms after the acute episode?"],"resources":{"spec":"/models/things/publications/thing-q30953/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q30953/spec.json"],"providers":["Codex","Grok"],"researchStatus":"unreviewed","generatedAt":"2026-09-07T10:14:27Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"not-applicable","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:29+00:00: completeness 1.00; sense: Wikidata description; 3 live sources; review by codex: pass","interaction.properties":"Plane ACT: no invented physical properties.","interaction.recognition":"Dengue fever has no distinctive visual appearance that reliably separates it from other illnesses."},"score":1.0}}