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Am. J. Trop. Med. Hyg., 25(6), 1976, pp. 866-874
Copyright © 1976 by The American Society of Tropical Medicine and Hygiene

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Shock Syndrome in Primary Dengue Infections*

Robert McNair Scott, Suchitra Nimmannitya, William H. Bancroft AND Pethai Mansuwan
Department of Virology, U. S. Army Medical Component, SEATO, Rajvithi Road, Bangkok, Thailand, and Children's Hospital of Bangkok, Rajvithi Road, Bangkok, Thailand

During 1974, 114 patients with dengue hemorrhagic fever were studied at the Bangkok Children's Hospital. Over 40% of the patients had dengue shock syndrome. Five fatal cases were included in the study. Primary dengue infections were identified by absent or low titered antibodies in acute sera and the sequential development of IgM antibodies followed by IgG antibodies during convalescence. Three patients, aged 4, 8, and 12 years, had primary dengue infections with shock. Although no convalescent sera could be tested two other patients, aged 7 and 12 years, with fatal disease also appeared to have primary infections. At the time of shock patients with primary infections had subnormal concentrations of complement factor 3. The data show that in older children dengue shock syndrome associated with complement depression can occur during primary as well as secondary infections.

Accepted for publication May 1, 1976.


* Address reprint requests to: Robert McNair Scott, M.D., Department of Virology, U. S. Army Medical Component, SEATO, APO San Francisco 96346.




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Copyright © 1976 by the American Society of Tropical Medicine and Hygiene.