NDLI: Multiple dengue serotypes and high frequency of dengue hemorrhagic fever at two tertiary care hospitals in Lahore during the 2008 dengue virus outbreak in Punjab, Pakistan.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Humayoun, Malik Asif Waseem, Tariq Jawa, Ali A. Hashmi, Mubashar S. Akram, Javed
Spatial Coverage	Pakistan
Description	Country affiliation: Pakistan Author Affiliation: Humayoun MA ( Department of Medicine, Allama Iqbal Medical College and Jinnah Hospital, Maulana Shabbir Ahmed Usmani Road, Lahore, Punjab, Pakistan. doctormalikasif@gmail.com)
Abstract	OBJECTIVE: The objective of this study was to investigate the clinical characteristics of patients with dengue viral infection during the 2008 outbreak in Lahore in order to better understand the clinical pattern and severity of disease in Lahore. METHODS: We analyzed the clinical characteristics of 110 patients infected with dengue virus; data were collected on standardized data collection sheets at two tertiary care hospitals from September to December 2008. Dengue infection was confirmed serologically or by real-time polymerase chain reaction (RT-PCR). RESULTS: Out of the total of 110 dengue infected patients, 70 were male and 40 were female. The most common symptoms included fever (100%), myalgia (68.2%), headache (55.5%), nausea (39.1%), skin rash (53.6%), mucocutaneous hemorrhagic manifestations (58.2%), and ocular pain (20%). Classic dengue fever (DF) was seen in 41.8% of the patients, 56.4% had dengue hemorrhagic fever (DHF), and only 1.8% developed dengue shock syndrome (DSS). The mean duration of fever was 6 days. Thrombocytopenia, leukopenia, and abnormal aspartate aminotransferase (AST)/alanine aminotransferase (ALT) were more frequently encountered in DHF and DSS as compared to DF. Viral RNA detection was done by RT-PCR in 17 patients. Ten patients had DEN4, five had DEN2, and two had DEN3 serotypes. The majority of the patients recovered completely without complications. CONCLUSION: The high frequency of DHF during the 2008 outbreak and the presence of three different dengue serotypes, emphasize the need to prevent and control dengue infection. Health authorities should consider strengthening surveillance for dengue infection, given the potential for future outbreaks with increased severity. It is also suggested that primary care physicians should be educated regarding recognition of DHF and to identify patients at high risk of developing DHF and DSS.
File Format	HTM / HTML
ISSN	12019712
e-ISSN	18783511
Journal	International Journal of Infectious Diseases
Issue Number	Suppl 3
Volume Number	14
Language	English
Publisher	Elsevier
Publisher Date	2010-09-01
Publisher Place	Canada
Access Restriction	Open
Subject Keyword	Discipline Communicable Diseases Dengue Virus Classification Dengue Epidemiology Virology Disease Outbreaks Severe Dengue Adolescent Diagnosis Isolation & Purification Hospitals, Teaching Pakistan Serotyping
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Microbiology (medical)

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