Risk of severe dengue is higher in patients with sickle cell disease: a scoping review

Wilder-Smith, Annelise; Leong, Wei Yee

doi:10.1093/jtm/tay136

Cited by 15 publications

(16 citation statements)

References 6 publications

(5 reference statements)

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“…93 Travellers with sickle cell disease: Persons with sickle cell disease are thought to be at increased risk of severe dengue, although the strength of the evidence is limited due to the scarcity of data in this population. 94…”

Section: Sub-populations Of Travellersmentioning

confidence: 99%

Severe dengue in travellers: pathogenesis, risk and clinical management

Halstead

Wilder‐Smith

2019

Journal of Travel Medicine

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Rationale for review Dengue is a frequent cause of febrile illness among travellers and has overtaken malaria as the leading cause of febrile illness for those traveling to Southeast Asia. The purpose is to review the risk of dengue and severe dengue in travellers with a particular focus on the pathogenesis and clinical management of severe dengue. Risk, pathogenesis and clinical management The risk of travel-acquired dengue depends on destination, season and duration of travel and activities during travel. Seroconversion rates reported in travellers, therefore, vary between <1% and >20%. The most common life-threatening clinical response to dengue infection is the dengue vascular permeability syndrome, epidemiologically linked to secondary infection, but can also occur in primary infection. Tertiary and quaternary infections are usually associated with mild or no disease. Antibody-dependent enhancement, viral factors, age, host factors and clinical experience of the managing physician modulate the risk of progressing to severe dengue. The relative risk of severe dengue in secondary versus primary infection ranges from 2 to 7. The absolute risk of severe dengue in children in highly endemic areas is ~0.1% per year for primary infections and 0.4% for secondary infections. About 2–4% of secondary infections lead to severe dengue. Severe dengue and death are both relatively rare in general travellers but more frequently in those visiting friends and relatives. Clinical management of severe dengue depends on judicious use of fluid rehydration. Conclusions Although dengue is a frequent cause of travel illness, severe dengue and deaths are rare. Nevertheless, dengue infections can interrupt travel and lead to evacuation and major out-of-pocket costs. Dengue is more frequent than many other travel-related vaccine preventable diseases, such as hepatitis A, hepatitis B, rabies, Japanese encephalitis and yellow fever, indicating a need for a dengue vaccine for travellers.

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Section: Sub-populations Of Travellersmentioning

confidence: 99%

Severe dengue in travellers: pathogenesis, risk and clinical management

Halstead

Wilder‐Smith

2019

Journal of Travel Medicine

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“…Red blood cell (RBC) transfusion is still the main therapeutic alternative for both acute and chronic complications of sickle cell disease (SCD). Despite the lack of large studies on DF in SCD patients, the few published articles on the topic suggest a higher risk of severe clinical outcome and a higher case‐fatality rate in such patients 8‐10 . Herein, we report the first case, as far as we know, of a patient with sickle cell anemia who developed DF transmitted by blood transfusion.…”

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confidence: 95%

Vaso‐occlusive crisis in a sickle cell patient after transfusion‐transmitted dengue infection

et al. 2020

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Case Report A 26‐year‐old woman with sickle cell disease (SCD) on chronic transfusion therapy complained of severe arthralgia, myalgia, abdominal pain, headache, and fever 24 hours after transfusion of a red blood cells (RBCs). Dengue virus (DENV) infection was suspected and the patient was hospitalized for clinical support and RBC transfusion, to lower the hemoglobin S to less than 30%. The patientʼs clinical condition improved approximately 8 days after the onset of symptoms. Results DENV type 2 (DENV‐2) TaqMan real‐time polymerase chain reaction was negative in the patient's pretransfusion sample while the posttransfusion sample was positive (Ct, 27.8), suggesting a high viral load and an acute infection. To investigate DENV transfusion transmission (TT‐DENV) the stored donor serum was tested and was also positive (Ct, 25.8). Molecular typing confirmed the presence of DENV‐2. The phylogenetic analysis of the DENV‐2 strains obtained from both donor and patient samples were classified as the Southeast Asia‐American genotype (Genotype III) and demonstrated 100% genomic identity, indicating TT‐DENV. Conclusion This is the first description of TT‐DENV in a SCD patient. A presumed high viral load in the transfused RBC unit probably determined the early clinical manifestation. In endemic regions dengue fever should be considered as differential diagnosis in SCD patients with fever and acute pain crisis, mainly during DENV outbreaks.

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“…Dengue has also become a leading problem in international travelers [ 8 , 9 , 10 , 11 , 12 ]. Certain risk factors are predictive of more severe disease outcome such as young or old age, prior dengue infection, diabetes, sickle cell disease and underlying medical conditions [ 2 • , 13 ].…”

Section: Introduction To Dengue Vaccine Developmentmentioning

confidence: 99%

Dengue vaccine development by the year 2020: challenges and prospects

Wilder‐Smith

2020

Current Opinion in Virology

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Highlights As a tetravalent immune response is desired, each component would need to independently result in four different monotypic immune responses that are solid to each serotype. Plaque reduction neutralization assays do not reliably differentiate between serotype-specific versus heterotypic antibodies; hence identifying immune correlates remains elusive. All three leading dengue vaccine candidates are live-attenuated vaccines, with the main difference between them being the type of backbone and the extent of chimerization. Sequential immunization or heterologous prime-boost strategies should be considered to improve a balanced protection against all four serotypes.

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Risk of severe dengue is higher in patients with sickle cell disease: a scoping review

Cited by 15 publications

References 6 publications

Severe dengue in travellers: pathogenesis, risk and clinical management

Severe dengue in travellers: pathogenesis, risk and clinical management

Vaso‐occlusive crisis in a sickle cell patient after transfusion‐transmitted dengue infection

Dengue vaccine development by the year 2020: challenges and prospects

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