Severe dengue virus infection in travelers: risk factors and laboratory indicators

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It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_3CD17D1EBC85
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Severe dengue virus infection in travelers: risk factors and laboratory indicators
Journal
Journal of Infectious Diseases
Author(s)
Wichmann  O., Gascon  J., Schunk  M., Puente  S., Siikamaki  H., Gjorup  I., Lopez-Velez  R., Clerinx  J., Peyerl-Hoffmann  G., Sundoy  A., Genton  B., Kern  P., Calleri  G., de Gorgolas  M., Muhlberger  N., Jelinek  T.
ISSN
0022-1899 (Print)
Publication state
Published
Issued date
04/2007
Volume
195
Number
8
Pages
1089-96
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Apr 15
Abstract
BACKGROUND: Dengue fever is the most common arboviral disease in travelers. In countries where dengue virus is endemic, sequential (secondary) infections with different dengue virus serotypes are associated with disease severity. Data on severity and secondary infection rates in a population of travelers are lacking. METHODS: Intensified surveillance of dengue fever in travelers was performed within the European Network on Surveillance of Imported Infectious Diseases. Data were collected at 14 European clinical referral centers between 2003 and 2005. RESULTS: A total of 219 dengue virus infections imported from various regions of endemicity were reported. Serological analysis revealed a secondary immune response in 17%. Spontaneous bleeding was observed in 17 (8%) patients and was associated with increased serum alanine and aspartate aminotransferase levels and lower median platelet counts. Two (0.9%) patients fulfilled the World Health Organization (WHO) case definition for dengue hemorrhagic fever. However, 23 (11%) travelers had severe clinical manifestations (internal hemorrhage, plasma leakage, shock, or marked thrombocytopenia). A secondary immune response was significantly associated with both spontaneous bleeding and other severe clinical manifestations. CONCLUSIONS: In travelers, severe dengue virus infections are not uncommon but may be missed if the WHO classification is strictly applied. High liver enzyme levels and low platelet counts could serve as indicators of disease severity.
Keywords
Adolescent Adult Aged Antibodies, Viral/blood Blood Chemical Analysis Child Dengue/blood/diagnosis/*epidemiology/*physiopathology Dengue Hemorrhagic Fever/epidemiology/physiopathology Dengue Virus/genetics/immunology/isolation & purification Europe/epidemiology Female Geography Hemorrhage/virology Hospitalization Humans Immunoglobulin G/blood Immunoglobulin M/blood Male Middle Aged *Population Surveillance Risk Factors *Travel
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 12:49
Last modification date
25/09/2019 7:08
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