A Cluster of Dengue Cases in Travelers: A Clinical Series from Thailand

Abstract

Dengue is an overlooked tropical disease for which billions of people are at risk. The disease, caused by a Flavivirus with four distinct serotypes, is transmitted primarily by urban Aedes mosquito species. The infection leads to a spectrum of clinical manifestations, with the majority being asymptomatic. Primary dengue fever and, to a greater extent, a subsequent infection with a different serotype is associated with increased severity. Increased global travel and recreational tourism expose individuals naïve to the dengue viruses, the most common arboviral infections among travelers. We describe a cluster of possible primary acute dengue infections in a group of 12 individuals who presented to Bangkok Hospital for Tropical Diseases in 2017. Infection was confirmed by dengue NS1 antigen and multiplex real-time RT-PCR. Nine individuals required hospitalization, and four developed dengue warning signs. Leukocytes, neutrophils, and platelets declined towards defervescence and were negatively correlated with day of illness. Six clinical isolates were identified as dengue serotype-1, with 100% nucleotide identity suggesting that these patients were infected with the same virus.

Dengue as a Disease Threatening Global Health: A Narrative Review Focusing on Latin America and Brazil

“…Thus, the prevalence and incidence of dengue fever worldwide have been associated with, among other factors, issues linked to globalization [ 60 ]. Infected individuals undertaking international travel can carry the virus from endemic regions to nonendemic locations, thus facilitating the wide spreading of dengue [ 61 ]. Another factor that deserves mention is climate change, a problem that has had critical public health outcomes, including its influence on dengue epidemiological rates [ 62 ].…”

The macroeconomic impact of a dengue outbreak: Case studies from Thailand and Brazil

“…Dengue-related illness also causes a substantial societal and economic impact in dengue-endemic countries and affects direct foreign investment. However, dengue's macroeconomic effects are routinely overlooked in burden-of-illness studies and traditional evaluations of vaccines as are other dengue-related health interventions [14,[33][34][35][36][37]. Furthermore, because dengue is often selfmanaged and underreported, estimating its full disease burden has been a challenge [6,12,38].…”

Novel Antiviral Efficacy of Hedyotis diffusa and Artemisia capillaris Extracts against Dengue Virus, Japanese Encephalitis Virus, and Zika Virus Infection and Immunoregulatory Cytokine Signatures

“…Over a third of the global population are at risk of flavivirus infection [ 1 , 2 , 3 ]. In the recent decade, flaviviruses have caused several global epidemics with high morbidity and mortality rates, in which a majority of these epidemics were caused by dengue virus (DENV), Zika virus (ZIKV), and Japanese encephalitis virus (JEV) [ 4 , 5 ]. Flaviviruses are encoded by a positive-sense single-stranded RNA that can immediately hijack the ribosome for translation [ 4 , 6 ].…”