What is a sign that indicates the need for urgent referral in cases of Dengue Hemorrhagic Fever?

Persistent vomiting is a significant sign that indicates the need for urgent referral in cases of Dengue Hemorrhagic Fever. Vomiting can be a warning sign of complications associated with the disease, such as the progression to Dengue Shock Syndrome or severe dehydration. In Dengue, particularly the hemorrhagic type, patients may experience severe gastrointestinal symptoms, and persistent vomiting can lead to further fluid loss and worsening of the patient's condition.

This symptom suggests that the body is struggling to maintain hydration and may precede critical complications. Ensuring that patients who present with persistent vomiting receive prompt medical attention is essential for managing their condition and decreasing the risk of severe outcomes.

In contrast, other options, while concerning, do not signify an immediate need for referral as strongly as persistent vomiting does. Persistent fever can be common in many viral infections and is not specific to the severe forms of Dengue. Mild abdominal pain may be a common symptom without indicating an immediate emergency, and a skin rash can occur in various conditions, not exclusively signaling a critical situation in Dengue.