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Influence of the dengue serotype, previous dengue infection, and plasma viral load on clinical presentation and outcome during a dengue-2 and dengue-4 co-epidemic.
Am J Trop Med Hyg. 2008 Jun; 78(6):990-8.AJ

Abstract

Martinique experienced a dengue outbreak with co-circulation of DENV-2 and DENV-4. In an emergency department-based study, we analyzed whether the clinical presentation and outcome of adult patients were related to serotype, immune status, or plasma viral load. Of the 146 adult patients who had confirmed dengue infection, 91 (62.3%) were classified as having classic dengue fever, 11 (7.5%) fulfilled World Health Organization criteria for dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), 21 other patients (14.4%) presented with at least one typical feature of DHF/DSS [i.e., internal hemorrhage, plasma leakage, marked thrombocytopenia (platelet count < or = 50,000 platelets/mm(3)) and/or shock], and 23 further patients (15.8%) had unusual manifestations. Four patients died. Severe illness was more frequent in patients with secondary dengue infection (odds ratio, 7.18; 95% confidence interval, 3.1-16.7; P < 0.001). Multivariate regression analysis showed that gastrointestinal symptoms and other unusual manifestations were independently associated with DENV-2 infection, whereas cough and DHF/DSS features were independently associated with secondary immune response. A high plasma viral load was associated with DENV-2 infection, increased serum liver enzymes, and with DHF/DSS features in patients presenting after the third day of illness. The most severe cases of dengue resulted from the combined effects of DENV-2 and secondary infection.

Authors+Show Affiliations

Service des Urgences, Centre Hospitalier Universitaire, Fort-de-France, Martinique. laurent.thomas@chu-fortdefrance.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

18541782

Citation

Thomas, Laurent, et al. "Influence of the Dengue Serotype, Previous Dengue Infection, and Plasma Viral Load On Clinical Presentation and Outcome During a Dengue-2 and Dengue-4 Co-epidemic." The American Journal of Tropical Medicine and Hygiene, vol. 78, no. 6, 2008, pp. 990-8.
Thomas L, Verlaeten O, Cabié A, et al. Influence of the dengue serotype, previous dengue infection, and plasma viral load on clinical presentation and outcome during a dengue-2 and dengue-4 co-epidemic. Am J Trop Med Hyg. 2008;78(6):990-8.
Thomas, L., Verlaeten, O., Cabié, A., Kaidomar, S., Moravie, V., Martial, J., Najioullah, F., Plumelle, Y., Fonteau, C., Dussart, P., & Césaire, R. (2008). Influence of the dengue serotype, previous dengue infection, and plasma viral load on clinical presentation and outcome during a dengue-2 and dengue-4 co-epidemic. The American Journal of Tropical Medicine and Hygiene, 78(6), 990-8.
Thomas L, et al. Influence of the Dengue Serotype, Previous Dengue Infection, and Plasma Viral Load On Clinical Presentation and Outcome During a Dengue-2 and Dengue-4 Co-epidemic. Am J Trop Med Hyg. 2008;78(6):990-8. PubMed PMID: 18541782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of the dengue serotype, previous dengue infection, and plasma viral load on clinical presentation and outcome during a dengue-2 and dengue-4 co-epidemic. AU - Thomas,Laurent, AU - Verlaeten,Olivier, AU - Cabié,André, AU - Kaidomar,Stéphane, AU - Moravie,Victor, AU - Martial,Jenny, AU - Najioullah,Fatiha, AU - Plumelle,Yves, AU - Fonteau,Christiane, AU - Dussart,Philippe, AU - Césaire,Raymond, PY - 2008/6/11/pubmed PY - 2008/8/7/medline PY - 2008/6/11/entrez SP - 990 EP - 8 JF - The American journal of tropical medicine and hygiene JO - Am J Trop Med Hyg VL - 78 IS - 6 N2 - Martinique experienced a dengue outbreak with co-circulation of DENV-2 and DENV-4. In an emergency department-based study, we analyzed whether the clinical presentation and outcome of adult patients were related to serotype, immune status, or plasma viral load. Of the 146 adult patients who had confirmed dengue infection, 91 (62.3%) were classified as having classic dengue fever, 11 (7.5%) fulfilled World Health Organization criteria for dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), 21 other patients (14.4%) presented with at least one typical feature of DHF/DSS [i.e., internal hemorrhage, plasma leakage, marked thrombocytopenia (platelet count < or = 50,000 platelets/mm(3)) and/or shock], and 23 further patients (15.8%) had unusual manifestations. Four patients died. Severe illness was more frequent in patients with secondary dengue infection (odds ratio, 7.18; 95% confidence interval, 3.1-16.7; P < 0.001). Multivariate regression analysis showed that gastrointestinal symptoms and other unusual manifestations were independently associated with DENV-2 infection, whereas cough and DHF/DSS features were independently associated with secondary immune response. A high plasma viral load was associated with DENV-2 infection, increased serum liver enzymes, and with DHF/DSS features in patients presenting after the third day of illness. The most severe cases of dengue resulted from the combined effects of DENV-2 and secondary infection. SN - 1476-1645 UR - https://www.unboundmedicine.com/medline/citation/18541782/Influence_of_the_dengue_serotype_previous_dengue_infection_and_plasma_viral_load_on_clinical_presentation_and_outcome_during_a_dengue_2_and_dengue_4_co_epidemic_ L2 - https://medlineplus.gov/dengue.html DB - PRIME DP - Unbound Medicine ER -