Min-Sheng Lee1, Kao-Pin Hwang, Tun-Chieh Chen, Po-Lian Lu, Tyen-Po Chen. 1. Division of Pediatric Infectious Disease, Department of Pediatrics, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Abstract
BACKGROUND AND PURPOSE: This study investigated the clinical manifestations and risk factors for dengue fever (DF) and dengue hemorrhagic fever (DHF) and disease severity during the 2002 outbreak in the Kaohsiung area. METHODS: We analyzed the clinical characteristics of 644 patients with virologically or serologically positive results for dengue virus at Kaohsiung Medical University Hospital from January 1 to December 31, 2002. RESULTS: The case rate peaked in November. The male-to-female ratio was 1:1.2 and the mean age was 47.5 +/- 17.9 years (range, 7 months to 88 years). The criteria for DHF were fulfilled in 232 cases, including 12 cases of dengue shock syndrome (DSS). The most common symptoms were fever (96.1%), myalgia (68.5%), headache (55.4%), and skin rash (53.7%). Hemorrhagic manifestations were noted in 73.0% of patients. The mean age of patients with DHF/DSS was 53.6 +/- 16.3 years, and the highest incidence occurred in those aged 60-69 years (27.2%). Significant risk factors for DHF/DSS were age >65 years, diabetes mellitus, hypertension, and uremia. Gallbladder wall thickening was found in 64.7% of DHF cases who underwent abdominal ultrasound examination. 164 of the 232 DHF cases (71%) were discharged without a diagnosis of DHF. The number of DHF cases identified by our study was nearly equal to that reported through the established passive surveillance system (232 cases vs 242). CONCLUSIONS: DHF was under-reported in hospital, suggesting that continuous surveillance and education for clinicians in the recognition of DHF, especially in elderly patients and those with chronic pre-existing comorbidities, is needed.
BACKGROUND AND PURPOSE: This study investigated the clinical manifestations and risk factors for dengue fever (DF) and dengue hemorrhagic fever (DHF) and disease severity during the 2002 outbreak in the Kaohsiung area. METHODS: We analyzed the clinical characteristics of 644 patients with virologically or serologically positive results for dengue virus at Kaohsiung Medical University Hospital from January 1 to December 31, 2002. RESULTS: The case rate peaked in November. The male-to-female ratio was 1:1.2 and the mean age was 47.5 +/- 17.9 years (range, 7 months to 88 years). The criteria for DHF were fulfilled in 232 cases, including 12 cases of dengue shock syndrome (DSS). The most common symptoms were fever (96.1%), myalgia (68.5%), headache (55.4%), and skin rash (53.7%). Hemorrhagic manifestations were noted in 73.0% of patients. The mean age of patients with DHF/DSS was 53.6 +/- 16.3 years, and the highest incidence occurred in those aged 60-69 years (27.2%). Significant risk factors for DHF/DSS were age >65 years, diabetes mellitus, hypertension, and uremia. Gallbladder wall thickening was found in 64.7% of DHF cases who underwent abdominal ultrasound examination. 164 of the 232 DHF cases (71%) were discharged without a diagnosis of DHF. The number of DHF cases identified by our study was nearly equal to that reported through the established passive surveillance system (232 cases vs 242). CONCLUSIONS: DHF was under-reported in hospital, suggesting that continuous surveillance and education for clinicians in the recognition of DHF, especially in elderly patients and those with chronic pre-existing comorbidities, is needed.
Authors: Maria G Guzman; Scott B Halstead; Harvey Artsob; Philippe Buchy; Jeremy Farrar; Duane J Gubler; Elizabeth Hunsperger; Axel Kroeger; Harold S Margolis; Eric Martínez; Michael B Nathan; Jose Luis Pelegrino; Cameron Simmons; Sutee Yoksan; Rosanna W Peeling Journal: Nat Rev Microbiol Date: 2010-12 Impact factor: 60.633
Authors: Subhamoy Pal; Allison L Dauner; Andrea Valks; Brett M Forshey; Kanya C Long; Butsaya Thaisomboonsuk; Gloria Sierra; Victor Picos; Sara Talmage; Amy C Morrison; Eric S Halsey; Guillermo Comach; Chadwick Yasuda; Michael Loeffelholz; Richard G Jarman; Stefan Fernandez; Ung Sam An; Tadeusz J Kochel; Louis E Jasper; Shuenn-Jue L Wu Journal: J Clin Microbiol Date: 2015-01-14 Impact factor: 5.948