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Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand.
Trop Med Int Health. 2004 Sep; 9(9):1022-9.TM

Abstract

OBJECTIVES

Dengue haemorrhagic fever (DHF) is an important cause of morbidity in South-east Asia and used to occur almost exclusively in young children. In recent years, there has been a progressive shift in age-distribution towards older children and adults. We investigated an outbreak in 2001 in both children and adults, in an endemic area of Thailand.

METHODS

Retrospective study of 347 patients with serologically confirmed dengue infection admitted to Chonburi Hospital during an epidemic in 2001.

RESULTS

A total of 128 (37%) patients had dengue fever (DF) and 219 (63%) had DHF. Patients with DHF were significantly older than patients with DF (11 years vs. 8 years). Clinical bleeding was noted in 124 individuals, both with DF (n = 24) and DHF (n = 100), and significantly more frequently in adults. Twenty-nine (13.2%) of all DHF cases were caused by primary infection. Secondary dengue infection was associated significantly with the development of DHF in children, OR (95% CI) = 3.63 (1.94-6.82), P < 0.0001, but not in adults, OR (95% CI) = 0.6 (0.02-6.04), P = 1. Unusual clinical manifestations were observed in 23 patients: three presented with encephalopathy and 20 with highly elevated liver-enzymes. In the latter group, four patients were icteric and nine had gastrointestinal bleeding.

CONCLUSION

These results indicate that DHF in South-east Asia is common in both children and adults. In dengue-endemic countries, dengue should be considered as a differential diagnosis in patients with clinical gastrointestinal bleeding in association with increased liver enzymes.

Authors+Show Affiliations

Institute of Tropical Medicine, Humboldt University, Berlin, Germany. ole.wichmann@charite.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15361117

Citation

Wichmann, Ole, et al. "Risk Factors and Clinical Features Associated With Severe Dengue Infection in Adults and Children During the 2001 Epidemic in Chonburi, Thailand." Tropical Medicine & International Health : TM & IH, vol. 9, no. 9, 2004, pp. 1022-9.
Wichmann O, Hongsiriwon S, Bowonwatanuwong C, et al. Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand. Trop Med Int Health. 2004;9(9):1022-9.
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. Tropical Medicine & International Health : TM & IH, 9(9), 1022-9.
Wichmann O, et al. Risk Factors and Clinical Features Associated With Severe Dengue Infection in Adults and Children During the 2001 Epidemic in Chonburi, Thailand. Trop Med Int Health. 2004;9(9):1022-9. PubMed PMID: 15361117.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand. AU - Wichmann,Ole, AU - Hongsiriwon,Suchat, AU - Bowonwatanuwong,Chureeratana, AU - Chotivanich,Kesinee, AU - Sukthana,Yoawalark, AU - Pukrittayakamee,Sasithon, PY - 2004/9/14/pubmed PY - 2004/10/27/medline PY - 2004/9/14/entrez SP - 1022 EP - 9 JF - Tropical medicine & international health : TM & IH JO - Trop Med Int Health VL - 9 IS - 9 N2 - OBJECTIVES: Dengue haemorrhagic fever (DHF) is an important cause of morbidity in South-east Asia and used to occur almost exclusively in young children. In recent years, there has been a progressive shift in age-distribution towards older children and adults. We investigated an outbreak in 2001 in both children and adults, in an endemic area of Thailand. METHODS: Retrospective study of 347 patients with serologically confirmed dengue infection admitted to Chonburi Hospital during an epidemic in 2001. RESULTS: A total of 128 (37%) patients had dengue fever (DF) and 219 (63%) had DHF. Patients with DHF were significantly older than patients with DF (11 years vs. 8 years). Clinical bleeding was noted in 124 individuals, both with DF (n = 24) and DHF (n = 100), and significantly more frequently in adults. Twenty-nine (13.2%) of all DHF cases were caused by primary infection. Secondary dengue infection was associated significantly with the development of DHF in children, OR (95% CI) = 3.63 (1.94-6.82), P < 0.0001, but not in adults, OR (95% CI) = 0.6 (0.02-6.04), P = 1. Unusual clinical manifestations were observed in 23 patients: three presented with encephalopathy and 20 with highly elevated liver-enzymes. In the latter group, four patients were icteric and nine had gastrointestinal bleeding. CONCLUSION: These results indicate that DHF in South-east Asia is common in both children and adults. In dengue-endemic countries, dengue should be considered as a differential diagnosis in patients with clinical gastrointestinal bleeding in association with increased liver enzymes. SN - 1360-2276 UR - https://www.unboundmedicine.com/medline/citation/15361117/Risk_factors_and_clinical_features_associated_with_severe_dengue_infection_in_adults_and_children_during_the_2001_epidemic_in_Chonburi_Thailand_ L2 - https://doi.org/10.1111/j.1365-3156.2004.01295.x DB - PRIME DP - Unbound Medicine ER -