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Sequential blood samples were obtained from eight Thai children before, during and 35 months after hospitalization for dengue shock syndrome. All patients experienced a secondary-type antibody response as evidenced by hemagglutination-inhibition antibody responses in acute and convalescent sera. Dengue 2 viruses were recovered from two patients. In their pre-illness blood sample, all children had monotypic neutralizing antibodies; five to dengue 1, two to dengue 3 and one to dengue 4. The highest neutralizing antibody titers in acute phase and late convalescent sera were to the initial infecting virus type. This report documents for sequential dengue infections the existence of an original antigenic sin antibody response. It may be possible to apply this phenomenon to identify initial dengue serotype infection in individuals experiencing secondary dengue infections, thus helping to clarify the antecedents to dengue shock syndrome.
Accepted for publication June 10, 1982.
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