Clinical, epidemiological and virological features of dengue virus infections in vietnamese patients presenting to primary care facilities with acute undifferentiated fever

Thai, Khoa T. D.; Phuöng, Hoang Lan; Nga, Tran Thi Thanh; Giao, Phan T.; Hung, Le Quoc; Nam, Nguyễn Đăng; Bình, Trần Quang; Simmons, Cameron P.; Farrar, Jeremy; Hien, Tran T.; Doorn, H. Rogier van; Jong, Menno D. de; Vries, Peter J. de

doi:10.1016/j.jinf.2010.01.003

Cited by 41 publications

(45 citation statements)

References 29 publications

(26 reference statements)

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“…Where these findings differed from those reported previously for other dengue surveillance studies in this region, it was most likely because dengue incidences can vary from year to year, even at the same site [2], [5], [7], [17], [24], [25]. For example, in an active surveillance study of acute febrile illness among school children in Ratchaburi, Thailand from 2006 to 2009, dengue (confirmed by IgM/IgG ELISA) caused 6.74% of all acute febrile illnesses during the total study period, and the incidence ranged from 1.77% in 2006 to 5.74% in 2008 [5].…”

Section: Discussioncontrasting

confidence: 93%

Dengue and Other Common Causes of Acute Febrile Illness in Asia: An Active Surveillance Study in Children

Chua²,

et al. 2013

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BackgroundCommon causes of acute febrile illness in tropical countries have similar symptoms, which often mimic those of dengue. Accurate clinical diagnosis can be difficult without laboratory confirmation and disease burden is generally under-reported. Accurate, population-based, laboratory-confirmed incidence data on dengue and other causes of acute fever in dengue-endemic Asian countries are needed.Methods and principal findingsThis prospective, multicenter, active fever surveillance, cohort study was conducted in selected centers in Indonesia, Malaysia, Philippines, Thailand and Vietnam to determine the incidence density of acute febrile episodes (≥38°C for ≥2 days) in 1,500 healthy children aged 2–14 years, followed for a mean 237 days. Causes of fever were assessed by testing acute and convalescent sera from febrile participants for dengue, chikungunya, hepatitis A, influenza A, leptospirosis, rickettsia, and Salmonella Typhi. Overall, 289 participants had acute fever, an incidence density of 33.6 per 100 person-years (95% CI: 30.0; 37.8); 57% were IgM-positive for at least one of these diseases. The most common causes of fever by IgM ELISA were chikungunya (in 35.0% of in febrile participants) and S. Typhi (in 29.4%). The overall incidence density of dengue per 100 person-years was 3.4 by nonstructural protein 1 (NS1) antigen positivity (95% CI: 2.4; 4.8) and 7.3 (95% CI: 5.7; 9.2) by serology. Dengue was diagnosed in 11.4% (95% CI: 8.0; 15.7) and 23.9% (95% CI: 19.1; 29.2) of febrile participants by NS1 positivity and serology, respectively. Of the febrile episodes not clinically diagnosed as dengue, 5.3% were dengue-positive by NS1 antigen testing and 16.0% were dengue-positive by serology.ConclusionsDuring the study period, the most common identified causes of pediatric acute febrile illness among the seven tested for were chikungunya, S. Typhi and dengue. Not all dengue cases were clinically diagnosed; laboratory confirmation is essential to refine disease burden estimates.

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Section: Discussioncontrasting

confidence: 93%

Dengue and Other Common Causes of Acute Febrile Illness in Asia: An Active Surveillance Study in Children

Chua²,

et al. 2013

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“…Also we found that patients with secondary dengue were younger than those with primary dengue. Some other studies have reported otherwise [24]. …”

Section: Discussionmentioning

confidence: 99%

Differentiating secondary from primary dengue using IgG to IgM ratio in early dengue: an observational hospital based clinico-serological study from North India

Changal

Raina

et al. 2016

BMC Infect Dis

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BackgroundSecondary dengue causes more severe disease than the primary. Early on, it is important to differentiate the two. We tried to find important clinical and laboratory differences between the two for the purpose of early differentiation.MethodsOne hundred fourteen patients confirmed on reverse transcriptase-polymerase chain reaction (RT PCR) were studied. On day 2 of illness IgM and IgG indices were studied for calculation of IgG/IgM ratio. A one-step immunochromatographic assay was used for classification of patients into primary and secondary dengue. Patient characteristics were also studied.ResultsDengue serotype 1 was the most common found in 60.5% patients. 66.7% (76 patients) had secondary dengue. Secondary dengue cases had a higher mean temperature (101.56 ± 1.55 vs. 100.79 ± 1.25,°F, p 0.015), lower platelet counts (50.51 ± 38.91 vs. 100.45 ± 38.66, x 103/micl, p <0.0001) and a significantly higher percentage of Dengue hemorrhagic fever/Dengue shock syndrome (38.2% vs. 2.6%, p <0.0001). In early phase of dengue NS1 and PCR were found to be better tests for diagnosis and later IgM is better. The IgG/IgM ratio of ≥ 1.10 had a sensitivity of 100%, specificity of 97.4% and accuracy of 67.5% in differentiating secondary from primary dengue.ConclusionEarly on in the clinical course, IgG/ IgM ratio can play an important role to differentiate the two. We found the ratio of ≥ 1.10 to be the best cut off for the same.

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“…However, recogition of the importance of dengue in semi-urban and rural areas is increasing [15,20]. Some studies have suggested that transmission at rural schools may play a role [21,22].…”

Section: Discussionmentioning

confidence: 99%

Unsuspected Dengue as a Cause of Acute Febrile Illness in Children and Adults in Western Nicaragua

et al. 2016

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BackgroundDengue is an emerging infectious disease of global significance. Suspected dengue, especially in children in Nicaragua’s heavily-urbanized capital of Managua, has been well documented, but unsuspected dengue among children and adults with undifferentitated fever has not.Methodology/Principal FindingsTo prospectively study dengue in semi-urban and rural western Nicaragua, we obtained epidemiologic and clinical data as well as acute and convalescent sera (2 to 4 weeks after onset of illness) from a convenience sample (enrollment Monday to Saturday daytime to early evening) of consecutively enrolled patients (n = 740) aged ≥ 1 years presenting with acute febrile illness. We tested paired sera for dengue IgG and IgM and serotyped dengue virus using reverse transcriptase-PCR. Among 740 febrile patients enrolled, 90% had paired sera. We found 470 (63.5%) were seropositive for dengue at enrollment. The dengue seroprevalance increased with age and reached >90% in people over the age of 20 years. We identified acute dengue (serotypes 1 and 2) in 38 (5.1%) patients. Only 8.1% (3/37) of confirmed cases were suspected clinically.Conclusions/SignificanceDengue is an important and largely unrecognized cause of fever in rural western Nicaragua. Since Zika virus is transmitted by the same vector and has been associated with severe congenital infections, the population we studied is at particular risk for being devastated by the Zika epidemic that has now reached Central America.

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Clinical, epidemiological and virological features of dengue virus infections in vietnamese patients presenting to primary care facilities with acute undifferentiated fever

Cited by 41 publications

References 29 publications

Dengue and Other Common Causes of Acute Febrile Illness in Asia: An Active Surveillance Study in Children

Dengue and Other Common Causes of Acute Febrile Illness in Asia: An Active Surveillance Study in Children

Differentiating secondary from primary dengue using IgG to IgM ratio in early dengue: an observational hospital based clinico-serological study from North India

Unsuspected Dengue as a Cause of Acute Febrile Illness in Children and Adults in Western Nicaragua

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