Clinico-epidemiologic characteristics of the 2019 dengue outbreak in Bangladesh

Abstract

Background Dengue fever shows a broad range of clinical presentations worldwide. Here we report on our clinical findings during the 2019 dengue outbreak in one of the largest tertiary care hospitals in Dhaka, the capital of Bangladesh. Methods A total of 747 suspected dengue cases (553 confirmed and 194 probable) were interviewed with a pro forma case record form. Statistical analyses were conducted using SPSS 20.0. Ethical clearance was obtained from the Dhaka Medical College. Results The mean age of the dengue cases was 27 y and approximately two-thirds were male. Positive tests for NS1 and anti-dengue immunoglobulin M antibody were present in 91.9% and 59.4% of the cases, respectively. Thrombocytopenia was present in 69% of cases and fever was present in 99.1% of cases. Gastrointestinal (GI) features, including anorexia and/or vomiting (69.4%), abdominal pain (39.8%) and diarrhoea (25.6%), were more prevalent than typical rash and pain symptoms. Hypotension was present in approximately one-quarter of patients (25.4%). Probable and confirmed dengue cases have shown similar clinical characteristics and laboratory findings. Conclusions The 2019 outbreak of dengue fever in Bangladesh was characterized by increased presentation with GI features. Recognition of this trend would permit early diagnosis and proper management of patients.

Detection of Anti-Nucleocapsid Antibody in COVID-19 Patients in Bangladesh Is not Correlated with Previous Dengue Infection

“…Patients presenting COVID-19 symptoms in the period between May 2020 and November 2020 were enrolled after referral of their nasopharyngeal (NP) oropharyngeal (OP) specimens for confirmatory SARS-CoV-2 rT-PCR testing and after consent to serum donations; cohort 1, residents in the Dhaka area (n = 48) with a median age of 33 ranged between 10 and 72 years, which tested SARS-CoV-2 rT-PCR positive at the National Reference Laboratory-Dhaka, and cohort 2, residents in Narayanganj or Dhaka (n = 67) with a median age of 48 ranged between 4 and 72 years, which tested SARS-CoV-2 rT-PCR negative at the National Reference Laboratory-Dhaka. Dengue fever patients hospitalized at Dhaka Medical College (n = 30) with a median age of 32 ranged between 16 and 70 with residual sera samples collected in the period between April 2019 and July 2019 [ 7 ] and stored at −80 °C. The control subjects, cohort 4, were non-febrile healthy subjects (n = 9) with a median age of 29 ranged between 22 and 50 and were employed at the University Mymensingh or Dhaka Medical College and did not report a history of dengue or COVID-19, and consented to donate serum between October and November 2020.…”

“…The single-stranded (ss) RNA and enveloped dengue fever viruses (DENV) and related flaviviruses are different to the circulating SARS-CoV-2 virus with respect to their modes of transmission, viral tropism, and molecular determinants of post-entry viral replication [ 3 , 4 ]. Despite the differences in molecular structure and replication, the clinical features of dengue fever and symptomatic COVID-19 exhibit striking similarities, acute flu-like symptoms 4–5 days and 5–7 days, respectively, after viral exposure, and fever, headache, cough, breathing difficulty, muscle ache, nausea and fatigue, and the release of pro-inflammatory cytokines [ 5 , 6 , 7 , 8 , 9 ]. The course of dengue fever and COVID-19 disease is usually mild and self-limiting after supportive care [ 6 ].…”

“…The course of dengue fever and COVID-19 disease is usually mild and self-limiting after supportive care [ 6 ]. In hospitalized intensive care unit (ICU) patients, the viral illness suffering from either disease often leads to life-threatening cardiovascular and organ complications [ 7 , 8 , 9 ].…”

Chikungunya outbreak in Bangladesh (2017): sociodemographic and clinical characteristics of patients from three hotspots

“…However, one possibility accounting for the variance in the clinical presentation may reflect temporal changes in the virus as the outbreak is prolonged and extends to different geographical locations. The erythematous generalized rash was predominantly seen in early febrile periods and is also found in other viral infections, such as dengue fever [ 25 , 26 ]. Therefore, the rash may not provide a reliable sign for diagnosing CF during outbreaks.…”

Caracterización clínica y laboratorial de pacientes pediátricos con dengue sin signos de alarma en un hospital de referencia de Paraguay

“…En cuanto a los signos y síntomas manifestados, se observó que el 100% de los pacientes presentaron fiebre, seguido en frecuencia por cefalea (45%), dolor corporal (36%) y síntomas gastrointestinales (vómitos 18% y dolor abdominal 16%), contrario a los hallazgos (7) en el estudio realizado por Iramain et al , que en el año 2018 arrojó una mayor prevalencia de síntomas respiratorios, lo cual podría explicarse por el serotipo circulante predominante (DENV1 en el año 2018 y DENV4 en 2019-2020). En un estudio realizado en Bangladesh en el brote de Dengue del año 2019 por Hasan et al, se observó que la mayoría de los (8) pacientes presentó sintomatología gastrointestinal , en el que el serotipo circulante en dicho brote ha sido el DENV3.…”