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Dengue hemorrhagic fever in infants: research opportunities ignored
Scott B Halstead1, Nguyen Trong Lan, Thein Thein Myint
1Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. halsteads@erols.com
Insights
This study reports on dengue hemorrhagic fever and dengue shock syndrome (DHF/DSS) in infants across Southeast Asia. Findings highlight the need for further research into infant DHF/DSS, particularly primary infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Dengue hemorrhagic fever and dengue shock syndrome (DHF/DSS) pose significant health risks globally.
- Infant DHF/DSS, especially with primary dengue infections, remains understudied compared to secondary infections.
- Limited research exists on the unique immunological aspects of DHF/DSS in infants.
Purpose of the Study:
- To report the age distribution of DHF/DSS cases in infants (<1 year) from key Southeast Asian cities.
- To highlight the occurrence of primary dengue infections in infants with DHF/DSS.
- To discuss challenges and considerations for future research on infant DHF/DSS.
Main Methods:
- Retrospective analysis of DHF/DSS case data in infants from Bangkok, Ho Chi Minh City, Yangon, and Surabaya.
- Isolation and identification of dengue virus serotypes from affected infants.
- Review of existing literature and animal models relevant to infant DHF/DSS.
Main Results:
- DHF/DSS cases in infants under one year were documented in Thailand, Vietnam, Myanmar, and Indonesia.
- All dengue viruses isolated from Thai infants were associated with primary dengue infections.
- The study underscores the distinct immunological profile of infant DHF/DSS.
Conclusions:
- Infant DHF/DSS, particularly primary infections, requires dedicated research focus.
- Animal models, such as feline infectious peritonitis virus (FIPV) in kittens from immune queens, may offer insights.
- Further investigation is crucial to understand and manage infant DHF/DSS effectively.
Abstract:
The age distribution of cases of dengue hemorrhagic fever and dengue shock syndrome (DHF/DSS) in infants under the age of 1 year are reported from Bangkok, Thailand, and for the first time for Ho Chi Minh City, Vietnam; Yangon, Myanmar; and Surabaya, Indonesia. The four dengue viruses were isolated from Thai infants, all of whom were having a primary dengue infection. Progress studying the immunologically distinct infant DHF/DSS has been limited; most contemporary research has centered on DHF/DSS accompanying secondary dengue infections. In designing research results obtained in studies on a congruent animal model, feline infectious peritonitis virus (FIPV) infections of kittens born to FIPV-immune queens should be considered. Research challenges presented by infant DHF/DSS are discussed.