Dengue type 1 epidemic with haemorrhagic manifestations in Fiji, 1989-90

A dengue type 1 epidemic occurred in Fiji between July 1989 and July 1990. Virus isolation in C6/36 cell cultures and Toxorhynchites mosquitos yielded 36 strains. Of the 3686 cases recorded by the Ministry of Health, 60% involved indigenous Fijians and 37%, Indians. A house-to-house survey revealed that a large majority of patients had classical dengue symptoms and 8% reported haemorrhagic manifestations. Among the children and adults hospitalized for dengue, 43% had haemorrhagic manifestations, including epistaxis, gingival bleeding, haematemesis, melaena and haematuria. A total of 15 patients with haemorrhagic manifestations and/or shock died, 10 of whom were aged 0-15 years; the diagnoses were confirmed in four cases by virus isolation or serology.