considered to be DSS. The presence of thrombocytopenia with concurrent
haemoconcentration differentiates grades I and II DHF from DF.
Grade I: Fever accompanied by non-speciﬁc constitutional symptoms; the only haemorrhagic manifestation is a positive tourniquet test and/or easy bruising.
Grade II:Spontaneous bleeding in addition to the manifestations of Grade I patients, usually in the forms of skin or other haemorrhages.
Grade III: Circulatory failure manifested by a rapid, weak pulse and narrowing of pulse pressure or hypotension, with the presence of cold, clammy skin and restlessness.
Grade IV: Profound shock with undetectable blood pressure or pulse