Dengue in China: a clinical review

Three etiologically proven outbreaks of dengue fever and one etiologically confirmed epidemic of dengue haemorrhagic fever have occurred in south China since 1978. The first of these, an epidemic of dengue due to virus type 4 took place in Shiwan town, Foshan city, Guangdong Province, in 1978; the epidemic began in May and ended in November. The clinical manifestations of 583 hospitalized patients were observed from August to October. The majority (81.3%) of patients were aged 21-50 years (male:female = 1.2:1). The course of illness was about 1 week in most cases; three patients (0.5%) died. A local outbreak of dengue due to virus type 1 occurred in Shiqi town, Zhongshan County, Guangdong Province, from September to November 1979. The majority of patients were older children and adolescents. There was no marked difference between males and females in terms of the course of the illness, and there were no complications or deaths. A large epidemic of dengue due to virus type 3 occurred on Hainan Island in 1980. The clinical manifestations of 510 hospitalized patients (mostly adolescents and adults) were observed from April to September. Some patients developed rare complications, such as loss of hair, acute intravascular haemolysis, and multiple peripheral paralysis; there were four deaths (0.78%). The first known epidemic of dengue haemorrhagic fever in China occurred among 10-29-year-olds on Hainan Island in 1985 and 1986. There were no essential differences between males and females. Some cases had rare complications such as acute intravascular haemolysis, while others had diffuse intravascular coagulation and altered mental status; 10 patients (6.5%) died.