Specific Infections in Children
Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar in Handbook of Refugee Health, 2021
In children, dengue is often a milder disease than in adults and may go unnoticed but is sometimes severe. Severity is increased after previous exposure to a different serotype and in the presence of genetic susceptibility. The self-limiting dengue fever consists predominantly of fever, rash, headache and muscle and joint pain, without any clinical warning signs. Dengue haemorrhagic fever is more serious and involves plasma leakage characterised by a rise in haematocrit (>20%) and thrombocytopaenia. Clinical signs include pleural effusions and ascites, and signs of bleeding ranging from a positive tourniquet test to active bleeding (e.g. from mucosae, the gastrointestinal tract and injection sites). Severe plasma leakage leads to dengue shock, multi-organ failure and potentially death.
Dengue Hemorrhagic Fever
James H. S. Gear in CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
Severe pediatric dengue is seen in two stages: a first stage febrile illness begins abruptly and is accompanied by various dengue-like symptoms. Following what appears to be the normal course of dengue fever, and as the temperature falls, the condition of the patient may suddenly deteriorate. In cases of this sort, the skin becomes cold and clammy, the pulse rapid, and the patient complains of abdominal pain and becomes lethargic and restless. The pulse pressure progressively narrows. If not treated promptly and appropriately, the patient may expire in a few hours. Case fatality rates, calculated to the bases of all hospitalization, in many countries vary between 5 to 10%, but, may with careful triage and intensive care, fall below 1%.2 Minor hemorrhagic signs, such as epistaxis, scattered petechiae, or bleeding gums may be seen during the febrile phase. After onset of shock, an enlarged liver can usually be felt and, in severe cases, gastrointestinal bleeding may occur.
Medical microbiology
Lois N. Magner, Oliver J. Kim in A History of Medicine, 2017
West Nile fever presented a rare opportunity for scientists to chart the ways in which a virus established itself in new ecological niches in the modern “global village.” But the rapid detection of West Nile fever does indicate significant improvements in diagnosing and monitoring new and emerging diseases. Without such improvements, the first cases of West Nile fever in New York City might have been dismissed as just another fever of unknown origin. Many epidemiologists warned that West Nile might be just the first of many old and new mosquito-borne diseases to expand into new territories and find appropriate vectors among some 3,000 known species of mosquitoes. For example, the mosquito-borne illness known as chikungunya fever was first identified in the 1950s in Tanzania. The symptoms of chikungunya are very similar to those of dengue, including a potentially fatal encephalitis. Both of these viral diseases are transmitted by the same mosquito vectors—Aedes albopictus and Aedes aegypti. Since 2000, chikungunya has caused outbreaks of varying virulence in Asia, Europe, and the Americas. Dengue fever outbreaks have occurred in South and Central America, Cuba, the Bahamas, Florida, and Hawaii. Most patients recover from dengue fever, but some people develop a life-threatening condition known as dengue hemorrhagic fever with circulatory failure and hemorrhages leading to fatal dengue shock syndrome.
Using first-contact serum ferritin to predict severe thrombocytopenia in dengue patients: determination and validation in independent cohorts
Published in Infectious Diseases, 2022
Abhijit Lodha, Ashwin Pillai, Pavan Reddy, Nita Munshi
Patients who had clinical features consistent with dengue fever (viz. fever, arthralgia, myalgia, retro-orbital eye pain, rash, nausea, vomiting generalized abdominal pain, mucosal bleeding) were tested for dengue serology. Serum ferritin levels were measured in patients who were positive for dengue serology, at the first point of medical contact. Patients were subsequently monitored with serial daily hemograms. The nadir level, observed over the serial blood counts, was recorded. Patients were observed until 5 days after resolution of fever. In patients who developed thrombocytopenia, daily hemograms were conducted even after defervescence, until three successive reports confirmed a rising trend. An additional hemogram was conducted on day 5 post defervescence to confirm haematologic recovery.
Dengue Fever Presenting as Purtscher-like Retinopathy
Published in Ocular Immunology and Inflammation, 2018
Luiz H. Lima, Silvana Vianello, Sérgio Pimentel, Gabriel Costa de Andrade, Claudio Zett, Léo Muller, Michel E. Farah, Rubens Belfort
Dengue fever is a type of flavivirus infection transmitted by the Aedes mosquito, usually by its predominant vector, Aedes aegypti. There are four serotypes of dengue virus, and the disease is generally found in the tropical areas of the world. Dengue is classically a self-limiting infection characterized by an acute onset of fever in conjunction with severe malaise, headache, myalgia, arthralgia, nausea, anorexia retroorbital, and cutaneous rash. Symptoms are reported from 3 to 14 days after the viral infection. Several consecutive infections with other dengue serotypes may increase the risk of severe systemic disease that are life threatening, such as dengue hemorrhagic fever and shock syndrome.1–3 Although the diagnosis of dengue is usually made by clinical symptoms, the infection confirmation is performed with laboratory tests. During the first five days of illness, polymerase chain reaction (PCR), virus isolation, or viral antigens may be used for diagnosis confirmation. After this initial period, immunoglobulin M (IgM) or immunoglobulin G (IgG) enzyme immunoassays should be used because of reduced systemic viral load.1,4,5
Dengue: a growing threat requiring vaccine development for disease prevention
Published in Pathogens and Global Health, 2018
Sandra Bos, Gilles Gadea, Philippe Despres
Dengue virus circulates in many parts of the world, impacting most tropical and subtropical countries. Millions of people are affected each year and global dengue incidence has dramatically increased in recent decades. Dengue fever is a flu-like illness that usually heals after three to seven days. However, dengue disease sometimes causes life-threatening complications. Although dengue disease has been twice classified by the World Health Organization (WHO) in 1997 and in 2009, severe disease prediction and monitoring still remain unsatisfactory. In addition, the burden of dengue disease represents a real threat to affected countries, some of which are facing economic difficulties. An efficient prophylactic vaccine strategy is urgently needed to tackle dengue infections worldwide. We hope that this work, by reviewing the global trends of dengue virus epidemiology, biology, and clinical disease, will help to better understand current vaccination strategies.
Related Knowledge Centers
- Bleeding
- Dengue Virus
- Fever
- Rash
- Vomiting
- Arthralgia
- Headache
- Mosquito-Borne Disease
- Tropical Disease
- Myalgia