Dengue virus infection constitutes major health problem in Nakorn Phanom, Northeast Thailand. Its epidemic season in Nakorn Phanom tends to start earlier than en- tire Thailand, or even Northeast Thailand as a whole. This discrepancy could be due to its geographical and climatic condition in Mae Kong Valley. Recent hospital data indicate health transition as shown by the emergence of traffic accidents and adult diseases to be counted among top 10 causes of death or hospitalizations.

Clinical manifestations and treatment on dengue hemorrhagic fever (DHF) were summarized based on 13 years experience of the first author at the Pediatric Department, Nakorn Phanom Provincial Hospital, Thailand. DHF is an acute febrile disease, characterized by hemoconcentration, thrombocytopenia, and coagulopathy. The underlying mechanism of increased vascular permeability, leads to hemoconcentration, hypovolemic shock, metabolic abnormalities, then disseminated intravascular coagulation (DIC), if not properly treated. Direct cause of death in DHF is either circulatory failure or massive hemorrhage. Therefore, DHF case management should be directed to correct determination of the stage and grade of the disease, and prescribe proper recipes, such as intravenous infu- sion and blood transfusion.

Dengue virus infection constitutes major health problem in Nakorn Phanom, Northeast Thailand. Its epidemic season in Nakorn Phanom tends to start earlier than en- tire Thailand, or even Northeast Thailand as a whole. This discrepancy could be due to its geographical and climatic condition in Mae Kong Valley. Recent hospital data indicate health transition as shown by the emergence of traffic accidents and adult diseases to be counted among top 10 causes of death or hospitalizations.