An Undescribed Idiopathic Fever on the Isthmus of Panama

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Two hundred and fifty cases of a syndrome of tropical fever occurring in the general population from 1945 to 1947 on the Isthmus of Panama and the reports of dengue and dengue-like fevers in this region during the last 50 years are reviewed.

Although specific etiology was not determined for this syndrome, there was a characteristic clinical pattern which included an acute onset with shaking chills, fever of varying severity and duration, usually persisting for six days, prominent grippe-like symptoms such as severe frontal headaches, pains in muscles and joints, nausea and vomiting, and a prolonged period of convalescence with extreme asthenia and moderate mental depression.

A seasonal increase in incidence and the history of repeated exposure to insect bites in many cases suggested an insect vector.

Author Notes

Formerly Staff Member of Department of Internal Medicine, Gorgas Hospital, Ancon, Canal Zone.

Present Address—Research Fellow, Evans Memorial, Massachusetts Memorial Hospitals; and Instructor in Medicine, Boston University School of Medicine, Boston, Mass.