Clinical and Laboratory Observations on Patients with Primary and Secondary Dengue Type 1 Infections with Hemorrhagic Manifestations in Fiji

Dengue and Dengue Hemorrhagic Fever

“…These results could not be repeated in macaque monkeys infected naturally by a mosquito bite or in chimpanzees infected parenterally; primary and secondary infections of all serotypes and combinations routinely showed that monkeys with primary infection had viremia of the same or higher titer and longer duration (126,134). Clinical and laboratory studies on humans have shown the same results (35,47,49,51,87).…”

“…Viremia usually peaks at the time of or shortly after the onset of illness and may remain detectable for various periods ranging from 2 to 12 days, depending on the strain of virus and the immune status of the individual (35,43,47,49,51,87,147). It has been suggested that the severity of the disease associated with dengue infection is determined by the number of cells infected with the virus and that the number of cells infected is related to ADE infection of peripheral blood leukocytes in secondary infections (77).…”

Dengue severity in the elderly in Puerto Rico

“…Although dengue infection in adults has been described in prior publications (11,(14)(15)(16)(17)(18)(19)(20)(31)(32)(33)(34)(35)(36), this study provides the first detailed analysis of clinical manifestations of dengue in the elderly (aged 65 years or older). Three markers of disease severity were evaluated in this study: the presence of hemorrhage, hospitalization, and fatal outcome.…”

Epidemiology of dengue in Sri Lanka before and after the emergence of epidemic dengue hemorrhagic fever.

“…10 However, ADE alone does not sufficiently explain severe disease because DHF is observed in primary cases, and not all secondary cases develop DHF. [11][12][13][14][15][16][17] Epidemiologic studies point to particular dengue virus strains being more virulent than others. [16][17][18][19] Historically the dengue genotypes endemic to Central and South America have caused mild disease, while the introduction of Asian genotypes to the region has led to DHF epidemics.…”