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Dengue virus infection among children with undifferentiated fever in Karachi
D S Akram1, A Igarashi, T Takasu
1Department of Paediatrics, Dow Medical College, Civil Hospital, Karachi, Pakistan.
Insights
Dengue virus caused up to 26% of undifferentiated fever cases in children in Karachi, Pakistan. Researchers detected dengue IgM antibodies in patients, with some showing symptoms like anemia and enlarged liver or spleen.
Area of Science:
- Virology
- Epidemiology
- Pediatrics
Background:
- Undifferentiated fever is a common ailment in children, particularly in tropical and subtropical regions.
- Dengue virus infections, including dengue hemorrhagic fever (DHF), pose a significant public health challenge globally.
- Accurate diagnosis of dengue fever is crucial for effective patient management and disease surveillance.
Purpose of the Study:
- To investigate the prevalence of dengue virus infection among children presenting with undifferentiated fever in Karachi, Pakistan.
- To identify specific dengue virus serotypes (Dengue type 1 and Dengue type 2) responsible for febrile illnesses.
- To explore the association between dengue virus infection and clinical manifestations in pediatric patients.
Main Methods:
- Sera from 122 children (117 with undifferentiated fever, 5 with DHF) collected between June-September 1994 in Karachi, Pakistan.
- IgM-capture ELISA used to detect antibodies against Dengue type 1 (D1), Dengue type 2 (D2), West Nile (WN), and Japanese Encephalitis (JE) viral antigens.
- Clinical data, including symptoms and signs such as anemia, hepatomegaly, and splenomegaly, were analyzed in relation to serological findings.
Main Results:
- IgM antibodies against dengue viruses were detected in 26% of undifferentiated fever cases.
- Dengue type 1 and Dengue type 2 IgM antibodies were identified in 5 and 8 single sera, and 3 and 6 paired sera, respectively.
- Four out of five DHF cases showed IgM antibodies for both D1 and D2; clinical signs like anemia, hepatomegaly, and splenomegaly were more frequent in dengue-positive patients.
Conclusions:
- Dengue virus infection is a significant cause of undifferentiated fever in children in Karachi, Pakistan.
- The study highlights the importance of considering dengue fever in the differential diagnosis of febrile illnesses in this region.
- Further research is warranted to understand the full spectrum of dengue virus disease and its impact on child health in Pakistan.
Abstract:
Sera were collected from a total of 122 children, comprising 117 cases with undifferentiated fever and 5 cases with dengue hemorrhagic fever (DHF), during June to September 1994 in Karachi, Pakistan. Sera were tested by the IgM-capture ELISA using dengue type 1 (D1), dengue type 2 (D2), West Nile (WN), and Japanese encephalitis (JE) viral antigens. Among 92 single sera from undifferentiated fever cases, IgM antibodies were detected in 5 cases by D1, 8 cases by D2, and 5 cases by WN antigens, respectively. Corresponding number of positives among 25 paired sera from undifferentiated fever cases were 3 by D1, 6 by D2, and 1 by WN antigen. Four out of 5 DHF cases possessed anti-D1 as well as anti-D2 IgM antibodies. Only a single DHF case was positive for anti-WN IgM antibodies. Anti-JE IgM antibodies were not detected in any of the tested serum specimens. Clinical manifestations of undifferentiated fever patients were generally non specific, but the percentage of children with anemia, hepatomegaly and splenomegaly was higher in patients possessing anti-dengue IgM antibodies than those without. Among the groups with anti-dengue IgM antibodies, those possessing only anti-D2 but not anti-D1 IgM antibodies showed higher percentages with cough, edema, and splenomegaly. The results indicated that up to 26% of the undifferentiated fever cases were caused by dengue virus infection in Karachi, Pakistan.