Dengue haemorrhagic fever with unusual manifestations

A retrospective study on 18 cases of DHF presented with jaundice and neurological signs which were considered unusual manifestation of DHF reveals that the causes or contributing factors are multifactorial. Most commonly found associated conditions were prolonged shock with metabolic acidosis and severe DIC that lead to hypoxia/ischaemia and resulted in both hepatic and brain dysfunction. Gross haemorrhage in the brain was noted in 6 of the 10 fatal cases while brain oedema was noted in 3 cases. Electrolyte disturbance such as hyponatremia could be another cause of brain oedema. It is certain from this study that there is no pathological evidence of encephalitis. Hepatic dysfunction found in associated with jaundice and encephalopathy is possibly caused by toxic substances, drugs and/or associated with underlying liver conditions. Reye's or Reye's-like syndrome was postulated in one case.     

Dengue haemorrhagic fever in Thailand, 1987

In 1987, situation of DHF in Thailand was the worst for the past 30 years. There were 152,840 cases and 785 deaths from the preliminary report. The incidence was highest ever reported. Outbreak begun early in January and reached its peak in July. All 73 provinces were affected except six provinces which had incidence of less than 60 per 100,000 population. The highest attack rates were in school children, especially 5-9 year olds. Virus isolation in a north-eastern province recovered Den-3 and Den-2 more common than other serotypes. Although a large outbreak in 1987 is unlikely to happen in 1988 but with the endemic areas all over the country there is a potential for small outbreaks to occur. The Ministry of Public Health needs new approaches and increased resources to control this disease.     

Dengue haemorrhagic fever: questions of pathogenesis

The year under review has seen a remarkable proliferation of papers on dengue. Four prospective studies have been carried out across the dengue belt, many groups have been pushing at the question of pathogenesis of dengue haemorrhagic fever, and a breakthrough has been achieved in the development of a mouse model for human dengue haemorrhagic fever.     

Dengue haemorrhagic fever and Japanese B encephalitis in Indonesia

Dengue haemorrhagic fever (DHF) was first recognized in Indonesia in the cities of Jakarta and Surabaya in 1968, 15 years after its recognition in the Philippines. During the 1968 outbreak, a total of 58 clinical cases with 24 deaths were reported. The number of reported cases since then has increased sharply, with the highest number of cases recorded in the years 1973 (10,189 cases), 1983 (13,668 cases), and 1985 (13,588 cases). Outbreaks of the disease have spread to involve most of the major urban areas, as well as some of the rural areas. In 1985, the disease had spread to 26 of 27 Provinces and 160 of 300 regencies of municipalities. At present, the disease is endemic in many large cities and small towns. Interestingly, DHF has not been reported in some cities, even though dengue virus transmission rates in those cities are high. The epidemic pattern of DHF for the country as a whole has become irregular. Since 1982, the intensity and spread of DHF has created an increasing public health problem in Indonesia, particularly in Java where 60% of the total population of the country resides. Java contributed about 71% of all cases occurring in the country in 1982, 84% in 1983, and 91% in 1984. The peak monthly incidence of DHF was frequently reported during October through April, months which coincide with the rainy season. The morbidity rate for Indonesia, estimated from reported cases over five years (1981-1985), ranged between 3.39 to 8.65 per 100,000 population. The overall case fatality rate has steadily declined from 41.3% in 1968 to 3% in 1984.(ABSTRACT TRUNCATED AT 250 WORDS)     

Dengue haemorrhagic fever in adults: a prospective study of 110 cases.

One hundred and ten adult patients hospitalized with dengue haemorrhagic fever (DHF) during the recent outbreak in North India were prospectively studied. Of these, 48 (43.6%) were grade I, 40 (36.4%) grade II, 10 (9.1%) grade III and 12 (10.9%) grade IV DHF. Dengue shock syndrome (DSS) was seen in 22 (20%) patients. Fever, headache, myalgias and arthralgias were the common symptoms seen in 100%, 80.9%, 76.2% and 52.3% patients, respectively. Spontaneous bleeding was seen in 62 patients (56.4%) with mucocutaneous bleeding being the most common (46 patients). Gastrointestinal bleeding was seen in 38 (34.5%) patients. In as many as 40 patients, the haemorrhagic manifestations occurred after the fever had come down. Fifty-five patients (50%) required platelet transfusions. Twelve patients died, giving a mortality rate of 10.9% in the present study. Prompt recognition and supportive treatment can be lifesaving.     

Dengue fever/dengue haemorrhagic fever in Filipino children: clinical experience during the 1983-1984 epidemic

A total of 377 Filipino children out of a total of 5,427 admissions from October 31, 1983 to March 31, 1984 were found to have dengue fever/dengue haemorrhagic fever The present clinical presentation of these infections was basically similar to that in previous epidemics but hepatomegaly and pleural effusion were less frequent and cardiac involvement, more frequent. The discrepancies between the clinical syndromes and HI antibody responses were evident; thus, the values used for the interpretation of the antibody titers must be reassessed.     

Dengue fever in international travelers.

Dengue virus infection is becoming increasingly recognized as one of the world's major emerging infectious diseases. Although only a few systematic studies have been conducted to assess the incidence and clinical course of dengue fever in travelers, it is now possible to estimate risk factors for travelers to areas of endemicity. Dengue virus and its vector, Aedes mosquitoes, benefit from human habitation and travel-related aspects of human behavior. Thus, travelers serve an important double role as potential victims of the disease and as vehicles for further spread of dengue.     

埃博拉出血热

埃博拉出血热(Ebola haemorrhagic fever,EBHF)是一种病死率很高的出血热,病原属丝状病毒,与同科的马尔堡病毒同属高致病性的甲类病毒,但免疫原性不同.EBHF在中非热带雨林地区和东南非洲热带大草原已流行了几个世纪,但一直未引起注意,1976年EBHF在非洲苏丹和扎伊尔相继暴发流行,引起了广泛重视,该病毒以扎伊尔的埃博拉河命名为埃博拉病毒(Ebola virus,EBOV),是人类所知最为恐怖、致命病毒之一,同艾滋病病毒相比,它潜伏期短、病死快、病死率高[1-3].