AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Am. J. Trop. Med. Hyg., 51(4), 1994, pp. 408-415
Copyright © 1994 by The American Society of Tropical Medicine and Hygiene

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Rigau-Perez, J. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rigau-Perez, J. G.

Dengue Severity Throughout Seasonal Changes in Incidence in Puerto Rico, 1989–1992

Jose G. Rigau-Perez, Agustin Ayuso-Lamadrid, Don R. Wolff, Paul Peiter, Goro Kuno AND The Puerto Rico Association of Epidemiologists
Dengue Branch, Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico; Institute of Statistics, School of Business Administration, University of Puerto Rico, Rio Piedras, Puerto Rico; Stanford University Medical School, Palo Alto, California; Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado

To determine whether the proportion of severe dengue cases increased with the yearly seasonal increase in dengue incidence, we examined reports of disease symptoms in case surveillance data and laboratory testing results in Puerto Rico from January 1989 to July 1992. A computer algorithm was designed to identify severe cases, i.e., those that fulfilled three or all four of the World Health Organization criteria for dengue hemorrhagic fever (DHF). A monthly severity index (SI) was defined as the ratio of severe cases to laboratory-positive and indeterminate (all non-negative) cases for each month, while a more restrictive severity rate (SR) was defined as the ratio of severe laboratory-positive cases to the total number of laboratory-positive cases for each month. Monthly SI and SR were compared in two ways: within an epidemic cycle, and month-by-month. Linear regression analysis was performed over the monthly averages of the SI and SR. For a month-by-month examination of SI and SR, we examined the 43-month sequence by means of a linear model with autocorrelated disturbances. We found no statistically significant or cyclical change in the proportion of severe cases from month to month in this period. Our conclusions differ from the observations during the Cuban DHF epidemic of 1981, in which case severity was shown to increase markedly as the epidemic progressed; they agree with the conclusions of most previous studies in that dengue severity does not change significantly throughout a period of increased incidence.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1994 by the American Society of Tropical Medicine and Hygiene.