Risk Factors in Dengue Shock Syndrome

Soe Thein Virology Research Division, Department of Medical Research and Yangon Children's Hospital, World Health Organization Collaborative Centre for Arbovirus Reference and Research, School of Life Science, Queensland University of Technology, Yangon, Myanmar

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Myo Min Aung Virology Research Division, Department of Medical Research and Yangon Children's Hospital, World Health Organization Collaborative Centre for Arbovirus Reference and Research, School of Life Science, Queensland University of Technology, Yangon, Myanmar

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Than Nu Shwe Virology Research Division, Department of Medical Research and Yangon Children's Hospital, World Health Organization Collaborative Centre for Arbovirus Reference and Research, School of Life Science, Queensland University of Technology, Yangon, Myanmar

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Myo Aye Virology Research Division, Department of Medical Research and Yangon Children's Hospital, World Health Organization Collaborative Centre for Arbovirus Reference and Research, School of Life Science, Queensland University of Technology, Yangon, Myanmar

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Aung Zaw Virology Research Division, Department of Medical Research and Yangon Children's Hospital, World Health Organization Collaborative Centre for Arbovirus Reference and Research, School of Life Science, Queensland University of Technology, Yangon, Myanmar

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Kathy Aye Virology Research Division, Department of Medical Research and Yangon Children's Hospital, World Health Organization Collaborative Centre for Arbovirus Reference and Research, School of Life Science, Queensland University of Technology, Yangon, Myanmar

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Khin Mar Aye Virology Research Division, Department of Medical Research and Yangon Children's Hospital, World Health Organization Collaborative Centre for Arbovirus Reference and Research, School of Life Science, Queensland University of Technology, Yangon, Myanmar

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John Aaskov Virology Research Division, Department of Medical Research and Yangon Children's Hospital, World Health Organization Collaborative Centre for Arbovirus Reference and Research, School of Life Science, Queensland University of Technology, Yangon, Myanmar

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Despite a growing body of evidence predominantly, but not exclusively, from Thailand suggesting that the risk of developing dengue shock syndrome (DSS) is greatest following an anamnestic dengue infection, particularly if the most recent infection was with dengue 2 virus, there continues to be debate about the justification for these claims. This report describes a five-year, prospective study in two townships (suburbs) in Yangon (Rangoon) Myanmar (Burma) in which attempts were made to confirm the data from an earlier prospective study in Thailand and to address some of the criticism of earlier studies. This investigation found the incidence of anamnestic dengue infections in DSS patients to be significantly higher than in the community from which they were drawn and a significantly higher risk of developing DSS following an anamnestic infection (particularly with dengue 2 virus) than following a primary infection with any serotype.

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