dengue fever
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.
Research draft, second pass
A second pass drafted this model: the structure a model of this thing needs, and what is known about it in the world. The line under this one says how the second half was obtained - researched against sources, or recalled without web access, in which case nothing here was read anywhere and every claim is a lead to verify. Unreviewed either way.
Researched by: Codex + Grok
Purpose and description
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.
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.
It can be 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..
Distinguishing features
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)
Scope
+ 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
- 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
Characteristics
- Diagnostic confidence
- suspected | presumptive | confirmed | excluded | unresolved; named criteria and assessment time Separates working clinical assessment from laboratory confirmation and surveillance classification.
- Illness timing
- Days since symptom onset; hours since defervescence; uncertainty interval Makes test interpretation and changing clinical risk interpretable in time.
- Clinical phase
- febrile | critical | recovery | indeterminate Prevents fever resolution from automatically closing the episode.
- Severity classification
- without warning signs | with warning signs | severe dengue | not yet classifiable; framework and timestamp Supports explicit reassessment and an auditable escalation rationale.
- Warning-sign assessment
- For each sign: present | absent | not assessed | uncertain Prevents missing observations from being interpreted as reassuring findings.
- Haematocrit trajectory
- Percent or L/L; baseline, collection times and fluid-treatment context Allows changes to be interpreted alongside leakage, bleeding and treatment.
- Platelet trajectory
- 10^9/L with collection times Preserves the trend without treating a single count as the complete severity assessment.
- 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 Supports assessment of perfusion and response to clinician-directed fluid management.
- Dengue test evidence
- Linked specimen, assay, result, collection time, laboratory and interpretation Keeps diagnostic conclusions traceable to the actual test and illness day.
- Exposure and immune-history context
- Dated location history, prior dengue evidence, relevant flavivirus infection or vaccination history; unknown permitted Supports exposure assessment, serology interpretation and clinician review of risk.
- Care disposition
- outpatient follow-up | observation | inpatient care | emergency escalation | discharged | unresolved Connects the current assessment to the responsible care team and next reassessment.
Also called
Where this came from
wikidata · CC0 1.0
Drafted structure
Bundle to layer to finding to question, as the second pass will find it: 7 bundles · 13 layers · 20 findings · 32 questions.
Dengue recognition and exposure Establish why this febrile episode is being considered dengue and what competing explanations remain.
Dengue recognition requires connecting a nonspecific illness to plausible exposure without turning that connection into proof.
Febrile presentation
Record the observed illness pattern and its attribution.
Compatible dengue syndrome
Preserve reported and observed fever, pain, rash and other manifestations with onset times and observer provenance.
- Which manifestations support considering dengue, when did they begin, and which were reported rather than directly observed? measurement
- Which findings require assessment for malaria, chikungunya, Zika, bacterial infection or a concurrent illness? boundary
Exposure and prior immunity
Connect the episode to dated exposure and relevant infection or vaccination history.
Exposure and history evidence
Separate documented travel, residence and prior infection from assumptions about exposure or immunity.
- Where was the person before symptom onset, on which dates, and what dated evidence supports dengue transmission there? provenance
- What evidence exists for prior dengue, a known previous serotype, or flavivirus vaccination, and what remains unknown? provenance
Dengue diagnostic evidence Represent test selection, results and interpretation in relation to illness timing.
A dengue result has different meaning depending on assay, collection day and immune history.
Specimen and assay timing
Anchor laboratory evidence to the episode timeline.
Time-qualified test result
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)
- Which assay and specimen produced each result, and how long after symptom onset was the specimen collected? measurement
- Does the applicable testing guidance call for an additional or convalescent specimen given the timing and existing results? action
Diagnostic adjudication
Separate evidence from the conclusion drawn from it.
Confirmation and residual ambiguity
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)
- Which named criteria support the recorded diagnostic category, and who made that interpretation? definition
- Could prior infection, vaccination, another flavivirus or discordant testing explain the result, and what would resolve the ambiguity? boundary
Dengue phase and trajectory Track the episode through fever, possible critical deterioration and recovery.
Dengue state depends on trajectory and timing, not merely the latest temperature.
Onset and defervescence
Maintain a timeline with uncertainty and reassessable phase assignments.
Phase assignment
Record the evidence for febrile, critical or recovery phase, including uncertainty when onset or fever resolution is unclear.
- What are the best-supported symptom-onset and defervescence times, and how uncertain are they? measurement
- What observations justify the current phase, and when must that assignment be reassessed? definition
Serial physiology
Interpret linked clinical and laboratory changes over time.
Trajectory in treatment context
Align haematocrit, platelets, perfusion, urine output and fluid administration so isolated measurements do not dominate interpretation.
- How have haematocrit, platelets, circulation and urine output changed across comparable observation times? measurement
- Could fluid administration, bleeding, baseline variation or measurement quality account for the apparent change? boundary
Dengue warning signs and severity Separate warning signs from established severe manifestations and incomplete assessment.
An agent must recognise escalation needs even when diagnostic confirmation is pending or fever is resolving.
Warning-sign surveillance
Record each warning sign explicitly and repeatedly.
Warning-sign presence
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)
- Which warning signs are present, absent, uncertain or unassessed, and when was each last checked? measurement
- What urgent clinical review or escalation does the current warning-sign pattern require under the applicable protocol? action
Severe manifestations
Identify the specific evidence supporting severe dengue.
Severity mechanism and attribution
Record leakage-related shock or respiratory distress, severe bleeding and severe organ impairment separately, including alternative explanations.
- What evidence establishes each severe manifestation, and which severity definition is being applied? definition
- Which findings demand emergency escalation, and which may also reflect sepsis, another disease or a treatment complication? action
Dengue care and response Connect clinical assessment to care setting, supportive treatment and reassessment.
The model must expose what constrains action and whether the chosen care is achieving its intended effect.
Care setting and vulnerability
Record patient-specific factors and practical access to reassessment.
Disposition rationale
Capture the clinician's disposition decision with pregnancy, age, comorbidities, oral intake, available support and access to care as applicable.
- Which host factors and follow-up barriers change the monitoring or admission decision for this episode? measurement
- Who selected the care setting, which protocol supports it, and what changes trigger transfer or admission? action
Supportive-care safety
Track ordered care, response and treatment-related concerns.
Fluids, medications and reassessment
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)
- What fluids and medicines were ordered and administered, and what subsequent observations document benefit or harm? measurement
- Which medication exposures, persistent perfusion problems or signs of fluid overload require clinician review of the plan? action
Dengue outcome and transmission handoff Establish how the episode ends and what patient-level follow-up or public-health links remain.
Clinical improvement, episode closure and transmission precautions are related but require separate evidence.
Recovery and episode closure
Document recovery, persistent effects, transfer, death or loss to follow-up without treating discharge as proof of full recovery.
Supported episode outcome
Link the outcome to clinical assessment, remaining symptoms and responsibility for unresolved findings.
- What evidence and applicable discharge criteria support recovery or closure, and which symptoms or abnormalities persist? boundary
- Who owns follow-up of pending tests, persistent symptoms or organ injury, and when is reassessment due? action
Mosquito exposure and notification
Connect the individual episode to bite prevention and jurisdiction-specific case reporting.
Prevention and reporting handoff
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)
- What mosquito-bite prevention advice was provided, for what period, and can the person follow it? action
- Which jurisdictional case definition and notification requirements apply, and what reporting has been authorised and completed? provenance
Evidence and external alignment What the world already says about this thing, gathered so the model can be checked against it.
A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.
Reported evidence
Findings from the breadth pass, kept separate from the structural claims.
Kinds and varieties
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Dengue without warning signs
- Dengue with warning signs
- Severe dengue
- DENV-1
- DENV-2
- DENV-3
- DENV-4
- Secondary dengue infection
- Which of these kinds and varieties hold for the sense of dengue fever this model covers, and on what evidence? provenance
Identifiers and schemes
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Wikidata - Q30953 - Dengue fever
- Which of these identifiers and schemes hold for the sense of dengue fever this model covers, and on what evidence? provenance
Standards and regulation
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- WHO dengue case classification (2009) - World Health Organization
- Which of these standards and regulation hold for the sense of dengue fever this model covers, and on what evidence? provenance
Real-world use
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Clinical diagnosis and notifiable-disease reporting in endemic tropical and subtropical countries
- Which of these real-world use hold for the sense of dengue fever this model covers, and on what evidence? provenance
Typical measurements
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Incubation period - 4-10 - days
- Which of these typical measurements hold for the sense of dengue fever this model covers, and on what evidence? provenance
Failure modes and hazards
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Progression to severe dengue with plasma leakage, shock, or haemorrhage
- Which of these failure modes and hazards hold for the sense of dengue fever this model covers, and on what evidence? provenance
Regional variation
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- WHO 2009 classification is used internationally; some programmes still use DF/DHF/DSS
- Which of these regional variation hold for the sense of dengue fever this model covers, and on what evidence? provenance
Neighbouring kinds and how to tell them apart
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Chikungunya - Arthralgia is typically more severe and prolonged in chikungunya; dengue more often causes thrombocytopenia and plasma leakage
- 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? provenance
Sources
- Dengue and severe dengue - WHO clinical classification, transmission, and public-health definition
What the second pass must settle
- 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?