Epidemiologic, Clinical, and Virologic Observations on Dengue in the Kingdom of Tonga

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  • Department of Tropical Medicine and Medical Microbiology, School of Medicine, University of Hawaii, South Pacific Commission, Pacific Research Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, World Health Organization, Honolulu, Hawaii 96816, New Caledonia

An outbreak of dengue type 2 infection occurred in the Pacific island Kingdom of Tonga in 1974 and an outbreak of dengue type 1 occurred there in 1975. The 1974 outbreak was characterized by relatively mild clinical disease with few hemorrhagic manifestations, a low attack rate, and relatively low viremia levels. The 1975 outbreak was characterized by relatively severe disease with frequent hemorrhagic manifestations and a high attack rate. The differences between the outbreaks could not be attributed to differences in abundance of, or susceptibility to infection of, mosquito vectors or to the prior immune status or other characteristics of the human population. It appeared that a difference in viral virulence was the most likely explanation.

Author Notes

Present address: Department of Health, State of California, Berkeley, California.