1921
Volume 73, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

To investigate age-related differences in dengue severity, 114 infants, 1,211 children, and 346 adults with laboratory-confirmed dengue virus (DEN) infections presenting to three hospitals in major urban centers in Nicaragua were recruited from 1999 to 2001. The age distribution of dengue cases and the circulating serotype (predominantly DEN2) were representative of national data. Similar results were obtained when either dengue hemorrhagic fever/dengue shock syndrome or its principal manifestations (vascular permeability, internal hemorrhage, marked thrombocytopenia, and/or shock) were analyzed in relation to age and immune status. The burden of disease and of severe dengue was found predominantly in infants 4–9 months of age and in children 5–9 years old, and secondary DEN infection was a risk factor for severity in children. Age-related differences were identified in the prevalence of specific clinical manifestations as well as in their association with a confirmed DEN diagnosis. This represents one of the few comprehensive studies to analyze characteristics of dengue in infants, children, and adults in the same population and highlights age-related differences in dengue severity.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2005.73.1063
2005-12-01
2017-07-24
Loading full text...

Full text loading...

/deliver/fulltext/14761645/73/6/0731063.html?itemId=/content/journals/10.4269/ajtmh.2005.73.1063&mimeType=html&fmt=ahah

References

  1. Gibbons RV, Vaughn DW, 2002. Dengue: an escalating problem. BMJ 324 : 1563–1566.
  2. Burke DS, Monath TP, 2001. Flaviviruses. Knipe DM, Howley PM, eds. Fields Virology. Philadelphia: Lippincott Williams & Wilkins, 1043–1126.
  3. Halstead SB, Lan NT, Myint TT, Shwe TN, Nisalak A, Kalyanarooj S, Nimmannitya S, Soegijanto S, Vaughn DW, Endy TP, 2002. Dengue hemorrhagic fever in infants: Research opportunities ignored. Emerg Infect Dis 8 : 1474–1479.
  4. Hung NT, Lan NT, Lei HY, Lin YS, Lien LB, Huang KJ, Lin CF, Ha DQ, Huong VT, My LT, Yeh TM, Huang JH, Liu CC, Halstead SB, 2005. Association between sex, nutritional status, severity of dengue hemorrhagic fever, and immune status in infants with dengue hemorrhagic fever. Am J Trop Med Hyg 72 : 370–374.
  5. Kalayanarooj S, Nimmannitya S, 2003. Clinical presentations of dengue hemorrhagic fever in infants compared to children. J Med Assoc Thai 86 : S673–S680.
  6. Garcia-Rivera EJ, Rigau-Perez JG, 2003. Dengue severity in the elderly in Puerto Rico. Rev Panam Salud Publica 13 : 362–368.
  7. Wichmann O, Hongsiriwon S, Bowonwatanuwong C, Chotivanich K, Sukthana Y, Pukrittayakamee S, 2004. Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand. Trop Med Intl Health 9 : 1022–1029.
  8. Guzman M, Kouri G, 2003. Dengue and dengue hemorrhagic fever in the Americas: lessons and challenges. J Clin Virol 27 : 1–13.
  9. World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control, 2nd ed. Geneva: WHO.
  10. Pan American Health Organization, 1994. Dengue and Dengue Hemorrhagic Fever in the Americas: Guidelines for Prevention and Control. Washington, DC: PAHO.
  11. Harris E, Videa E, Perez L, Sandoval E, Tellez Y, Perez ML, Cuadra R, Rocha J, Idiaquez W, Alonso RE, Delgado MA, Campo LA, Acevedo F, Gonzalez A, Amador JJ, Balmaseda A, 2000. Clinical, epidemiologic, and virologic features of dengue in the 1998 epidemic in Nicaragua. Am J Trop Med Hyg 63 : 5–11.
  12. Vives JL, Aguilar JL, 1997. Manual de Técnicas de Laboratorio en Hematología. Barcelona: Masson SA.
  13. Kuno G, Gomez I, Gubler DJ, 1991. An ELISA procedure for the diagnosis of dengue infections. J Virol Meth 33 : 101–113.
  14. Balmaseda A, Guzman MG, Hammond S, Robleto G, Flores C, Tellez Y, Videa E, Saborio S, Perez L, Sandoval E, Rodriguez Y, Harris E, 2003. Diagnosis of dengue virus infection by detection of specific immunoglobulin M (IgM) and IgA antibodies in serum and saliva. Clin Diagn Lab Immunol 10 : 317–322.
  15. Fernandez R, Vasquez S, 1990. Serological diagnosis of dengue by an ELISA inhibition method. Mem Inst Oswaldo Cruz 85 : 347–351.
  16. Balmaseda A, Sandoval E, Pérez L, Gutiérrez C, Harris E, 1999. Application of molecular typing techniques in the the 1998 dengue epidemic in Nicaragua. Am J Trop Med Hyg 61 : 893–897.
  17. Harris E, Roberts TG, Smith L, Selle J, Kramer LD, Valle S, Sandoval E, Balmaseda A, 1998. Typing of dengue viruses in clinical specimens and mosquitoes by single- tube multiplex reverse transcriptase PCR. J Clin Microbiol 36 : 2634–2639.
  18. Lanciotti R, Calisher C, Gubler D, Chang G, Vorndam A, 1992. Rapid detection and typing of dengue viruses from clinical samples by using reverse transcriptase-polymerase chain reaction. J Clin Microbiol 30 : 545–551.
  19. Seah CLK, Chow VTK, Tan HC, Chan YC, 1995. Rapid, single-step RT-PCR typing of dengue viruses using five NS3 gene primers. J Virol Meth 51 : 193–200.
  20. Miagostovich MP, dos Santos FB, Gutiérrez CM, Riley LW, Harris E, 2000. Rapid subtyping of dengue virus serotypes 1 and 4 by restriction site-specific (RSS)-PCR. J Clin Microbiol 38 : 1286–1289.
  21. Aggarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK, 1998. An epidemic of dengue hemorrhagic fever and dengue shock syndrome in children in Delhi. Indian Pediatr 35 : 727–732.
  22. Rahman M, Rahman K, Siddque AK, Shoma S, Kamal AHM, Ali KS, Nisaluk A, Breiman R, 2002. First outbreak of dengue hemorrhagic fever, Bangladesh. Emerg Infect Diseases 8 : 738–740.
  23. da Cunha RV, Dias M, Nogueira RMR, Chagas N, Miagostovich MP, Shatzmayr HG, 1995. Secondary dengue infection in schoolchildren in a dengue endemic area in the state of Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo 37 : 517–521.
  24. Narayanan M, Aravind MA, Thilothammal N, Prema R, Sargunam CSR, Ramamurty N, 2002. Dengue fever epidemic in Chennai—a study of clinical profile and outcomes. Indian Pediatr 39 : 1027–1033.
  25. Kliks SC, Nimmannitya S, Nisalak A, Burke DS, 1988. Evidence that maternal dengue antibodies are important in the development of dengue hemorrhagic fever in infants. Am J Trop Med Hyg 38 : 411–419.
  26. Hongsiriwon S, 2002. Dengue hemorrhagic fever in infants. Southeast Asian J Trop Med Public Health 33 : 49–55.
  27. Pengsaa K, Yoksan S, Limkittikul K, Wisetsing P, Sirivichayakul C, Hutacharoen P, Chanthavanich P, Sabchareon A, 2003. Maternally transferred neutralising dengue antibodies in Thai infants: a pilot study. Annals Trop Paediatr 23 : 159–165.
  28. Vaughn DW, 2000. Invited commentary: dengue lessons from Cuba. Am J Epidemiol 152 : 800–803.
  29. Vaughn DW, Green S, Kalayanarooj S, Innis BL, Nimmannitya S, Suntayakorn S, Endy T, Raengsakulrach B, Rothman AL, Ennis FA, Nisalak A, 2000. Dengue viremia titer, antibody response pattern, and virus serotype correlate with disease severity. J Infect Dis 181 : 2–9.
  30. Krishnamurti C, Kalayanarooj S, Cutting MA, Peat RA, Rothwell SW, Reid TJ, Green S, Nisalak A, Endy TP, Vaughn DW, Nimmannitya S, Innis BL, 2001. Mechanisms of hemorrhage in dengue without circulatory collapse. Am J Trop Med Hyg 65 : 840–847.
  31. Gamble J, Bethell D, Day NPJ, Loc PP, Phu NH, Gartside IB, Farrar JF, White NJ, 2000. Age-related changes in microvascular permeability: a significant factor in the susceptibility of children to shock? Clin Sci 98 : 211–216.
  32. Bethell DB, Gamble J, Pham PL, Nguye MD, Tran TH, Ha TH, Tran TN, Dong TH, Gartside IB, White NJ, Day NP, 2001. Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever. Clin Infect Dis 32 : 243–253.
  33. Ngo NT, Cao XT, Kneen R, Wills B, Nguyen VM, Nguyen TQ, Chu VT, Nguyen TT, Simpson JA, Solomon T, White NJ, Farrar J, 2001. Acute management of dengue shock syndrome: a randomized double-blind comparison of 4 intravenous fluid regimens in the first hour. Clin Infect Dis 32 : 204–213.
  34. Phuong CXT, Nhan NT, Wills B, Kneen R, Ha NTT, Mai TTT, Huynh TTT, Lien DTK, Solomon T, Simpson JA, White NJ, Farrar JJ, and the Dong Nai Pediatric Hospital Study Group, 2002. Evaluation of the World Health Organization standard tourniquet test and a modified tourniquet test in the diagnosis of dengue infection in Viet Nam. Trop Med Int Health 7 : 125–132.
  35. Mohan B, Patwari AK, Anand VK, 2000. Hepatic dysfunction in childhood dengue infection. J Trop Pediatr 46 : 40–45.
  36. Kabra SK, Jain Y, Pandey RM, Madhulika , Singhal T, Tripathi P, Broor S, Seth P, Seth V, 1999. Dengue haemorrhagic fever in children in the 1996 Delhi epidemic. Trans Royal Soc Trop Med Hyg 93 : 294–298.
  37. Kabilan L, Balasubramanian S, Keshava SM, Thenmozhi V, Sekar G, Tewari SC, Arunachalam N, Rajendran R, Satyanarayana K, 2003. Dengue disease spectrum among infants in the 2001 dengue epidemic in Chennai, Tamil Nadu, India. J Clin Microbiol 41 : 3919–3921.
  38. Murgue B, Deparis X, Chungue E, Cassar O, Roche C, 1999. Dengue: an evaluation of dengue severity in French Polynesia based on an analysis of 403 laboratory-confirmed cases. Trop Med Intl Health 4 : 763–773.
  39. Kalayanarooj S, Vaugh DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N, Viramitrachal W, Ratanachueke S, Kiatpolpoj S, Innis BL, Rothman AL, Nisalak A, Ennis FA, 1997. Early clinical and laboratory indicators of acute dengue illness. J Infect Dis 176 : 313–321.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2005.73.1063
Loading
/content/journals/10.4269/ajtmh.2005.73.1063
Loading

Data & Media loading...

  • Received : 06 May 2005
  • Accepted : 20 Aug 2005

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error