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Serological studies by the haemagglutinin inhibition test to confirm a clinical diagnosis of dengue were done on 406 patients during the dengue 2 epidemic in Cuba in 1981. 49% of the cases were serologically positive; of these 64% was classified as primary and 36% as secondary. The frequency of symptoms is described: the most frequent were fever, headache, malaise and vomiting. Haemorrhagic manifestations predominated significantly in the secondary cases. The white race and female sex were found to predominate in the positive cases.
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PMID:Dengue haemorrhagic fever in Cuba. I. Serological confirmation of clinical diagnosis. 646 13

Clinical and serological studies were carried out on 114 patients admitted to hospital in Havana, Cuba with Dengue Haemorrhagic Fever and Dengue Shock Syndrome (DHF/DSS). Serological confirmation of dengue was obtained in 90% of cases, with 5% of cases primary and 95% secondary. Fever, haemorrhagic manifestations, vomiting and headache were the most frequent signs and symptoms. Among haemorrhagic manifestations, petechiae and vaginal bleeding were reported in a larger number of patients. 21 patients presented shock and, of these, 20 were secondary infections. The disease appeared more frequently in white persons and in women. The aetiopathogenicity of the syndromes is discussed. 95% of the cases could be explained on the basis of the secondary infection hypothesis.
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PMID:Dengue haemorrhagic fever in Cuba. II. Clinical investigations. 646 14

The authors investigated the role of secondary immunologic response, virus serotype, age, and sex on the clinical manifestations of dengue fever in Puerto Rico. From surveillance data for 1990 and 1991, this study identified 3,926 laboratory-positive cases, including 889 for whom dengue immunologic status and symptoms could be ascertained. Of those, 622 cases were virologically confirmed, and 267 cases were serologically confirmed. More than 50% of all positive patients reported fever, chills, headache, eye pain, body pains, joint pains, nausea, vomiting, or skin rash. The frequency of reporting signs, symptoms, and hospitalization was significantly higher among persons with secondary infections diagnosed by serological methods. Only rash was more common among those with primary infections. Symptom reporting increased with age; body pains, joint pains, and rash were significantly more frequently reported by female patients. No significant difference in symptom frequency was found among the virologically confirmed cases, comparing primary and secondary cases or infections due to different serotypes. The data for serologically confirmed cases suggest that in Puerto Rico the manifestations of dengue fever are, as with dengue hemorrhagic fever in Asia, more prominent among those who are experiencing secondary infections, and this effect may be more marked in the younger age groups.
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PMID:Symptoms of dengue fever in relation to host immunologic response and virus serotype, Puerto Rico, 1990-1991. 748 67

Dengue fever is a viral disease, transmitted to man via mosquito bites. It is endemic in tropical regions (10 million infected annually) and is characterized by high fever, headache, myalgia, lethargy, vomiting, rash and neutropenia. The upward trend in the number of young Israelis visiting tropical countries increases the number of those potentially exposed to this disease. We present 4 Israelis who returned with dengue fever from Thailand.
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PMID:[Dengue fever]. 755 5

Researchers reviewed the medical records of all cases of dengue and dengue-like illness in Fiji since 1971. During March-April 1990, in Fiji, interviews were conducted with 426 occupants of 81 randomly selected houses in Suva and its surrounding areas to examine the relationship between the incidence of true dengue and dengue-like illnesses and the reported incidence. 60% of the persons interviewed were Fijians and 31% were Indians. Health workers collected blood samples from acute cases. 36 strains of dengue 1 virus was isolated. A fever lasting more than 3 days accompanied by at least one of the following symptoms denoted dengue or dengue-like illness: headache, joint pains, muscle pains, rash, epigastric discomfort, and bleeding. There was an outbreak of clinical dengue 1 during 1989-1990 involving 3686 cases. The 1975 outbreak involved 1600-2400 cases of dengue hemorrhagic fever. The 1989-1990 incidence was higher among Fijians than Indians (60% vs. 37%). The dengue epidemic peaked in November 1989 (about 900 cases). The rate of dengue hemorrhagic fever was 8% (15 cases). Hemorrhage manifestations included nosebleeds (8 persons), gingival bleeding (2), vomiting of blood (2), blood in the urine (3), and passage of dark stools stained with blood (3). The case fatality rate was 8%. Hemorrhages of the stomach and lungs occurred in most fatal cases. 10 of the 15 fatal cases were aged 10-15 years. 182 (43%) of the respondents in the household survey had reported dengue-like illness in the last 6 months. Children were more likely to have had dengue than adults (51% of 0-9 year olds and 61% of 10-19 year olds vs. 32-33% for all other age groups). Among hospitalized dengue cases, 43% experienced hemorrhages.
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PMID:Dengue type 1 epidemic with haemorrhagic manifestations in Fiji, 1989-90. 761 60

Dengue is a mosquito-transmitted acute disease caused by any of four virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4) and characterized by the sudden onset of fever, headache, myalgia, rash, nausea, and vomiting. The disease is endemic in most tropical areas of the world and has occurred in U.S. residents returning from travel to such areas. This report summarizes information about cases of imported dengue among U.S. residents during 1993 and 1994.
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PMID:Imported dengue--United States, 1993-1994. 773 51

The aim of this work was to offer a description of the clinical manifestations developed by patients under 1 year who had dengue virus infection and dengue hemorrhagic fever during the epidemic which broke out in 1981, and to determine if the passive transfer of maternal dengue antibodies to the fetuses influenced the occurrence of a severe development of the disease, through a retrospective study. In 20 cases, type 2 dengue virus infection was confirmed. Eight patients showed the clinical manifestations of dengue hemorrhagic fever of dengue shock syndrome (DHF/DSS), and the other 12 had the typical dengue virus infection. The former were of the white racial phenotype, aged under 6 months. There was a predominance of type 1 dengue antibodies in the mothers of children with DHF/DSS. Fever, rash, vomiting and diarrheas (not frequent) appeared in the two clinical manifestations of the infection; blood leukocytes were predominantly lymphocytic; and erythrocyte sedimentation was always normal. Patients with DHF/DSS presented with some bleeding (87.5%); cyanosis and ascites (37.5%); and shock (25%), as well as hepatomegaly. All these infants with DHF/DSS had thrombocytopenia and most of them showed hemoconcentration. No deaths occurred.
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PMID:[Dengue fever and hemorrhagic dengue in infants with a primary infection]. 798 23

Dengue is a mosquito-transmitted acute disease caused by any of four virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4) and characterized by the sudden onset of fever, headache, myalgia, rash, nausea, and vomiting. The disease is endemic in most tropical areas of the world and can occur in U.S. residents returning from international travel. Serum samples from 68 persons with suspected imported dengue with onset in 1992 (1) were submitted to CDC from 23 states (Table 1). Of these, 17 (25%) cases (from 10 states) were serologically or virologically diagnosed as dengue. This report summarizes information about these 17 cases.
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PMID:Imported dengue--United States, 1992. 830 65

To describe the clinical manifestations of dengue haemorrhagic fever (DHF) all children with a clinical diagnosis of DHF admitted to the paediatric ward of the Dr. Hassan Sadikin General Hospital (Bandung, Indonesia) between April 1st 1991 and September 30th 1993 were enrolled in a prospective study. Of the 306 children with a clinical diagnosis of DHF on admission in only 128 (41.8%) the diagnosis of DHF was confirmed by HI test. Of the confirmed cases, 24 (19%) developed shock and 1 (0.7%) died. Of the 174 cases with a negative HI test, 33 (19%) developed shock and 4 (2%) died. Four of the children died of shock before an hemagglutination inhibitor (HI) test was performed. The overall case mortality rate was 2.9%. The symptoms and signs of the 128 children with serologically confirmed DHF included fever or a history of fever (100%), petechiae (29.7%), epistaxis (39.1%), other forms of bleeding (5.5%), a positive Tourniquet test (78.1%), hepatomegaly (46.9%), epigastric pain (61.7%), vomiting (55.5%), thrombocytopenia < 100,000/mm3 (3.2% on admission and 15.3% during hospitalisation). Four (3%) children developed encephalopathy and 1 child an acute liver failure. In order to decrease the mortality associated with DHF early diagnosis and adequate case management are essential.
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PMID:Clinical manifestations of dengue haemorrhagic fever in children in Bandung, Indonesia. 866 76

Dengue is a mosquito-transmitted acute disease caused by any of four virus serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) and is characterized by acute manifestations that can include fever, headache, myalgia, arthralgia, rash, nausea, and vomiting. On August 25, 1995, public health authorities in Mexico notified the Texas Department of Health (TDH) of an ongoing outbreak of dengue fever in the state of Tamaulipas, which borders south Texas. Because of the year-round presence of the Aedes aegypti mosquito (a major vector for dengue) in southernmost Texas and the frequent movement of persons across the U.S.-Mexico border, the outbreak in adjacent Tamaulipas suggested an increased potential for imported and autochthonous cases in Texas, as had occurred during 1980 and 1986. In response to the notification from Mexico, TDH intensified surveillance efforts for dengue, resulting in identification of 29 laboratory-diagnosed cases in Texas residents, including seven persons with no history of travel outside the state. This report summarizes results of dengue surveillance in the U.S.-Mexico border area during 1995-1996.
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PMID:Dengue fever at the U.S.-Mexico border, 1995-1996. 892 3


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