AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 53(1), 1995, pp. 89-94
Copyright © 1995 by The American Society of Tropical Medicine and Hygiene

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Dengue Fever in U.S. Troops during Operation Restore Hope, Somalia, 1992–1993

Trueman W. Sharp, Mark R. Wallace, Curtis G. Hayes, Jose L. Sanchez, Robert F. DeFraites, Ray R. Arthur, Scott A. Thornton, Roger A. Batchelor, Patrick J. Rozmajzl, R. Kevin Hanson, Shuenn Jue Wu, Craig Iriye AND James P. Burans
Naval Medical Research Institute, Bethesda, Maryland; Naval Medical Center, San Diego, California; Walter Reed Army Institute of Research, Washington, District of Columbia; U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Navy Environmental and Preventive Medicine Unit No. 7, Naples, Italy; Navy Environmental and Preventive Medicine Unit No. 6, Pearl Harbor, Hawaii; Naval Medical Center, Oakland, California; Johns Hopkins University, Baltimore, Maryland

Dengue fever (DF) was considered to be a potential cause of febrile illness in U.S. troops deployed to Somalia during Operation Restore Hope in 1992–1993. A prospective study of hospitalized troops with fever and a seroepidemiologic survey of 530 troops were conducted. Among 289 febrile troops hospitalized, 129 (45%) did not have an identified cause of their fever. Dengue (DEN) virus was recovered from 41 (43%) of 96 of these patients by inoculation of admission sera into C6/36 cell cultures. Thirty-nine (41%) of the isolates were identified as DEN-2 and two (2%) as DEN-3 by an indirect immunofluorescent antibody assay. An additional 18 (49%) of 37 culture-negative cases were shown by immunoglobulin M (IgM) antibody capture enzyme-linked immunosorbent assay to have anti-DEN virus antibody. All identified DF cases recovered within 1–2 weeks; no case of dengue hemorrhagic fever or shock syndrome was observed. A seroepidemiologic survey of a unit (n = 494) with 17 culture or serologically identified DF cases and a 13% attack rate of unidentified febrile illness revealed a 7.7% prevalence of anti-DEN virus IgM antibody. Failure to use bed nets was the only identified risk factor for DEN infection (adjusted odds ratio = 2.2, 95% confidence interval = 1.4–3.0). These data indicate that DF was an important cause of febrile illness among US troops in Somalia, and demonstrate the difficulties in preventing DEN infection in troops operating in field conditions.




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Copyright © 1995 by the American Society of Tropical Medicine and Hygiene.