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Published on: April 10, 2018
Dengue in the early febrile phase: viremia and antibody responses
D W Vaughn1, S Green, S Kalayanarooj
1Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok Children's Hospital, Thailand.
Insights
This study found that all four dengue virus serotypes can cause dengue hemorrhagic fever. Viremia, or virus in the blood, is present in all dengue patients during fever and decreases as the fever subsides.
Area of Science:
- Virology
- Infectious Diseases
- Pediatrics
Background:
- Dengue is a significant global health concern, particularly in tropical and subtropical regions.
- Understanding dengue pathophysiology is crucial for effective disease management and prevention.
- Previous studies may have had limitations in patient selection bias.
Purpose of the Study:
- To characterize the pathophysiology of dengue infections in children.
- To investigate the correlation between viremia, temperature, and disease severity.
- To identify the prevalence of different dengue virus serotypes in pediatric cases.
Main Methods:
- A multicenter study enrolled children with undifferentiated fever for less than 72 hours.
- Enrollment included all eligible children to minimize patient selection bias.
- Virus isolation from plasma and serological testing were performed.
Main Results:
- 32% of enrolled children had dengue infections (60/189).
- 93% of dengue cases were secondary infections, indicating prior exposure.
- A high virus isolation rate (98%) was observed, with viremia correlating strongly with temperature.
- All four dengue virus serotypes were detected.
Conclusions:
- All four dengue virus serotypes can cause dengue hemorrhagic fever.
- Viremia is consistently present in dengue patients during the febrile phase.
- Viremia diminishes as the patient's fever subsides.
Abstract:
A multicenter effort was begun in 1994 to characterize the pathophysiology of dengue using a study design that minimized patient selection bias by offering enrollment to all children with undifferentiated fever for <72 h. In the first year, 189 children were enrolled (age range, 8 months to 14 years). Thirty-two percent of these children had dengue infections (60 volunteers). The percentage of children with a secondary dengue infection was 93%, with only 4 (7%) having a primary dengue infection. The virus isolation rate from the plasma of children with dengue was 98%. Viremia correlated highly with temperature. All four dengue virus serotypes were isolated at both study sites. This study demonstrates that all four serotypes of dengue virus can cause dengue hemorrhagic fever, that all dengue patients as defined by serology experience viremia during the febrile phase, and that as fever subsides, so does viremia.
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