1921
Volume 88, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

In 2009, an increased proportion of suspected dengue cases reported to the surveillance system in Puerto Rico were laboratory negative. As a result, enhanced acute febrile illness (AFI) surveillance was initiated in a tertiary care hospital. Patients with fever of unknown origin for 2–7 days duration were tested for , enteroviruses, influenza, and dengue virus. Among the 284 enrolled patients, 31 dengue, 136 influenza, and 3 enterovirus cases were confirmed. Nearly half (48%) of the confirmed dengue cases met clinical criteria for influenza. Dengue patients were more likely than influenza patients to have hemorrhage (81% versus 26%), rash (39% versus 9%), and a positive tourniquet test (52% versus 18%). Mean platelet and white blood cell count were lower among dengue patients. Clinical diagnosis can be particularly difficult when outbreaks of other AFI occur during dengue season. A complete blood count and tourniquet test may be useful to differentiate dengue from other AFIs.

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2013-03-06
2017-09-23
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References

  1. Afifi S, Earhart K, Azab M, Youssef F, Sakka H, Wasfy M, Mansour H, Oun SE, Rakha M, Mahoney F, , 2005. Hospital-based surveillance for acute illness in Egypt: a focus on community-acquired bloodstream infections. Am J Trop Med Hyg 73: 392399.
  2. Murdoch D, Woods C, Zimmerman M, Dull P, Belbase R, Keenan A, Scott RM, Archibald LK, Reller LB, , 2004. The etiology of febrile illness in adults presenting to Patan Hospital in Kathmandu, Nepal. Am J Trop Med Hyg 70: 670675.
  3. Parker T, Murray C, Richards A, Samir A, Ismail T, Fadeel M, Jiang J, Wasfy MO, Pimentel G, , 2007. Concurrent infections in acute febrile illness patients in Egypt. Am J Trop Med Hyg 77: 390392.
  4. Manock S, Jacobsen K, Brito N, Russell K, Negrete M, Olson J, Sanchez JL, Blair PJ, Smalligan RD, Quist BK, Espín JF, Espinoza WR, MacCormick F, Fleming LC, Kochel T, , 2009. Etiology of acute undifferentiated febrile illness in the Amazon Basin of Ecuador. Am J Trop Med Hyg 81: 146151.
  5. Archibald LK, den Dulk MO, Pallangyo KJ, Reller LB, , 1998. Fatal Mycobacterium tuberculosis bloodstream infections in febrile hospitalized adults in Dar es Salaam, Tanzania. Clin Infect Dis 26: 290296.[Crossref]
  6. Ssali FN, Kamya MR, Wabwire-Mangen F, Kasasa S, Joloba M, Williams D, Mugerwa RD, Ellner JJ, Johnson JL, , 1998. A prospective study of community-acquired bloodstream infections among febrile adults admitted to Mulago Hospital in Kampala, Uganda. J Acquir Immune Defic Syndr Hum Retrovirol 19: 484489.[Crossref]
  7. Archibald LK, McDonald LC, Rheanpumikankit S, Tansuphaswadikul S, Chaovanich A, Eampokalap B, Banerjee SN, Reller LB, Jarvis WR, , 1999. Fever and human immunodeficiency virus infection as sentinels for emerging mycobacterial and fungal bloodstream infections in hospitalized patients 15 years old, Bangkok. J Infect Dis 180: 8792.[Crossref]
  8. Archibald LK, McDonald LC, Nwanyanwu O, Kazembe P, Dobbie H, Tokars J, Reller LB, Jarvis WR, , 2000. A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy. J Infect Dis 181: 14141420.[Crossref]
  9. Bell M, Archibald LK, Nwanyanwu O, Dobbie H, Tokars J, Kazembe PN, Reller LB, Jarvis WR, , 2001. Seasonal variation in the etiology of bloodstream infections in a febrile inpatient population in a developing country. Int J Infect Dis 5: 6369.[Crossref]
  10. World Health Organization, 2010. Impact of Dengue, 2010. Global Alert and Response (GAR) Available at: http://www.who.int/csr/disease/dengue/impact/en/index/html. Accessed June 2, 2010.
  11. Franco RM, Casta Vélez A, , 1997. Eradication of malaria in Puerto Rico [in Spanish]. Am J Public Health 2: 146150.
  12. Novel Swine-Origin Influenza A (H1N1), Virus Investigation Team Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM, , , 2009. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 360: 26052615.[Crossref]
  13. López-Rodríguez E, Tomashek K, Gregory CJ, Munoz J, Hunsperger E, Lorenzi OD, Irizarry JG, Garcia-Gubern C, , 2010. Co-infection with dengue virus and pandemic (H1N1) 2009 virus. EID 16: 882883.
  14. Centers for Disease Control and Prevention (CDC), 2009. Passive Dengue Surveillance System Data. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
  15. Caribbean Business, 2010. Puerto Rico's Largest Private Hospitals. Available at: http://www.caribbeanbusinesspr.com. Accessed June 1, 2010.
  16. Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kumentrasai N, , 1997. Early clincal and laboratory indicators of acute dengue illness. JID 176: 313321.[Crossref]
  17. World Health Organization, 2009. WHO Information for Laboratory Diagnosis of Pandemic (H1N1) 2009 Virus in Humans. Revised 2009. Available at: http://www.who.int/csr/resources/publications/swineflu/WHO_Diagnostic_RecomendationsH1N1_20090521.pdf. Accessed July 31, 2010.
  18. Johnson BW, Russell BJ, Lanciotti RS, , 2005. Serotype-specific detection of dengue viruses in a fourplex real-time reverse transcriptase PCR assay. J Clin Microbiol 43: 49774983.[Crossref]
  19. Bessoff K, Phoutrides E, Delorey M, Acosta LN, Hunsperger E, , 2010. Defining the utility of a commercial NS1 antigen capture kit as a dengue virus (DENV) diagnostic test. Clin Vaccine Immunol 17: 949953.[Crossref]
  20. Dikken H, Kmety E, Bergan T, Norris JR, , (1978) Serological typing methods of leptospires. , eds. Methods in Microbiology. London: Academic Press, 259307.
  21. Nix WA, Oberste MS, Pallansch MA, , 2006. Sensitive, seminested PCR amplification of VP1 sequences for direct identification of all enterovirus serotypes from original clinical specimens. J Clin Microbiol 44: 26982704.[Crossref]
  22. Miagostovich MP, Nogueira RM, dos Santos FB, Schatzmayr HG, Araújo ES, Vorndam V, , 1999. Evaluation of an IgG enzyme-linked immunosorbent assay for dengue diagnosis. J Clin Virol 14: 183189.[Crossref]
  23. World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Second edition. Geneva: World Health Organization.
  24. The Harriet Lane Handbook, 2002. A Manual for Pediatric House Officers. Sixteenth edition. Philadelphia, PA: Mosby, Inc.
  25. Hollowell JG, van Assendelft OW, Gunter EW, Lewis BG, Najjar M, Pfeiffer C, , 2005. Hematological and iron-related analytes: reference data for persons aged 1 year and over: United States, 1988–94. Vital Health Stat 11: 1156.
  26. Tietz Textbook of Clinical Chemistry, 1999. Second edition. St. Louis, MO: W.B. Saunders.
  27. Lockitch G, Halstead AC, Quigley G, MacCallum C, , 1988. Age- and sex-specific pediatric reference intervals: study design and methods illustrated by measurement of serum proteins with the Behring LN Nephelometer. Clin Chem 34: 16181621.
  28. World Health Organization, 2009. Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization.
  29. Oberste MS, Peñaranda S, Rogers SL, Henderson E, Nix WA, , 2010. Comparative evaluation of Taqman real-time PCR and semi-nested VP1 PCR for detection of enterovirus in clinical specimens. J Clin Virol 49: 7374.[Crossref]
  30. Romero JR, , 1999. Reverse-transcription polymerase chain reaction detection of the enterovirus. Arch Pathol Lab Med 123: 11611169.
  31. Gregory CJ, Santiago LM, Argüello DF, Hunsperger E, Tomashek K, , 2010. Clinical and laboratory features that differentiate dengue from other febrile illness in an endemic area-Puerto Rico, 2007–2008. Am J Trop Med Hyg 82: 922929.[Crossref]
  32. Morens DM, Rigau-Perez JG, Lopez-Correa RH, Moore CG, Ruiz-Tiben EE, Sather GE, Chiriboga J, Eliason DA, Casta-Velez A, Woodall JP, , 1986. Dengue in Puerto Rico, 1977: public health response to characterize and control an epidemic of multiple serotypes. Am J Trop Med Hyg 35: 197211.
  33. López-Correa RH, Moore CG, Sather GE, Morens DM, Chiriboga J, Banegura F, Woodall JP, , 1979. The 1977 dengue epidemic in Puerto Rico: epidemiologic and clinical observations. Pan American Health Organization Scientific Publication 375: 6067.
  34. Silarug N, Foy HM, Kudradinon S, Rojanasuphot S, Nisalak A, Pongsuwant Y, , 1990. Epidemic of fever of unknown origin in rural Thailand, cause by influenza A (H1N1) and dengue fever. Southeast Asian J Trop Med Public Health 21: 6167.
  35. Tomashek K, Rivera A, Muñoz-Jordan J, Hunsperger E, Santiago L, Padro O, Garcia E, Sun W, , 2009. Description of a large island-wide outbreak of dengue in Puerto Rico, 2007. Am J Trop Med Hyg 81: 467474.
  36. Kumar A, Zarychanski R, Pinto R, Cook D, Marshall J, Lacroix J, Stelfox T, Bagshaw S, Choong K, Lamontagne F, Turgeon AF, Lapinsky S, Ahern SP, Smith O, Siddiqui F, Jouvet P, Khwaja K, McIntyre L, Menon K, Hutchison J, Hornstein D, Joffe A, Lauzier F, Singh J, Karachi T, Wiebe K, Olafson K, Ramsey C, Sharma S, Dodek P, Meade M, Hall R, Fowler RA, Canadian Critical Care Trials Group H1N1 Collaborative; , 2009. Critically ill patients with 2009 influenza A (H1N1) infection in Canada. JAMA 302: E1E8.[Crossref]
  37. Dominguez-Cherit G, Lapinski S, Macias A, Pinto R, Espinoza-Pérez L, de la Torre A, Poblano-Morales M, Baltazar-Torres JA, Bautista E, Martinez A, Martinez MA, Rivero E, Valdez R, Ruiz-Palacios G, Hernández M, Stewart TE, Fowler RA, , 2009. Critically ill patients with 2009 influenza A (H1N1) in Mexico. JAMA 302: 18801887.[Crossref]
  38. Thein S, Ming CK, Thaung U, Shwe TN, Heng SB, Halstead SB, , 1975. Hemorrhagic manifestations of influenza A infection in children. J Trop Med Hyg 78: 7880.
  39. Thaung U, Ming CK, Thein S, , 1975. Dengue hemorrhagic fever in Burma. Southeast Asian J Trop Med Public Health 6: 580591.
  40. Kuberski TT, , 1977. Hemorrhage associated with influenza. Lancet 1: 709.[Crossref]
  41. Bruce M, Sanders EJ, Leake JAD, Zaidel O, Bragg SL, Aye T, Shutt KA, Deseda CC, Rigau-Perez JG, Tappero JW, Perkins BA, Spiegel RA, Ashford DA, , 2005. Leptospirosis among patients presenting with dengue-like illness in Puerto Rico. Acta Trop 96: 3646.[Crossref]
  42. Lynch MF, Blanton EM, Bulens S, Polyak C, Vojdani J, Stevenson J, Medalla F, Barzilay E, Joyce K, Barrett T, Mintz ED, , 2009. Typhoid fever in the United States, 1999–2006. JAMA 302: 859865.[Crossref]
  43. 1991. Measles occurrence in the Caribbean prior to the measles elimination campaign. CAREC Surveillance Report 17: 16.
  44. CDC, 1994. Measles – Puerto Rico 1993, and the measles elimination program. Morb Mortal Wkly Rep 43: 171173.
  45. Dietz VJ, Nieburg P, Gubler DJ, Gomez I, , 1992. Diagnosis of measles by clinical case definition in dengue-endemic areas: implication for measles surveillance and control. Bull World Health Organ 70: 745750.
  46. Kasper MR, Blair PJ, Touch S, Sokhal B, Yasuda CY, Williams M, Richards AL, Burgess TH, Wierzba TF, Putnam SD, , 2012. Infectious etiologies of acute febrile illness among patients seeking health care in south-central Cambodia. Am J Trop Med Hyg 86: 246253.[Crossref]
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  • Received : 10 Jun 2012
  • Accepted : 09 Dec 2012

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