Clinical and Virological Features of Dengue in Vietnamese Infants
| Autor: | Le Thi Phuong, Jeremy Farrar, Mai Ngoc Lanh, Nguyen Thi Hong Tham, Tran Nguyen Bich Chau, Stephen S. Whitehead, Le Bich Lien, Lu Thi Minh Hieu, Tran Thi Nhu Thuy, Cameron P. Simmons, Katherine L. Anders, Nguyen Minh Tuan, Nguyen Thanh Hung |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics lcsh:Arctic medicine. Tropical medicine Cross-sectional study lcsh:RC955-962 Vietnamese 030231 tropical medicine Pediatrics and Child Health Public Health and Epidemiology/Infectious Diseases Viremia Dengue virus Viral Nonstructural Proteins medicine.disease_cause Dengue fever Dengue 03 medical and health sciences Young Adult 0302 clinical medicine Epidemiology Infectious Diseases/Viral Infections medicine Humans Prospective Studies Young adult Prospective cohort study 030304 developmental biology 0303 health sciences business.industry lcsh:Public aspects of medicine Public Health Environmental and Occupational Health Infant lcsh:RA1-1270 Virology/Diagnosis Dengue Virus Middle Aged medicine.disease language.human_language 3. Good health Hospitalization Infectious Diseases Cross-Sectional Studies Vietnam Immunology language Female business Research Article |
| Zdroj: | PLoS Neglected Tropical Diseases PLoS Neglected Tropical Diseases, Vol 4, Iss 4, p e657 (2010) |
| ISSN: | 1935-2735 1935-2727 |
| Popis: | Background Infants account for a small proportion of the overall dengue case burden in endemic countries but can be clinically more difficult to manage. The clinical and laboratory features in infants with dengue have not been extensively characterised. Methodology/Principal Findings This prospective, cross-sectional descriptive study of infants hospitalized with dengue was conducted in Vietnam from November 2004 to December 2007. More than two-thirds of 303 infants enrolled on clinical suspicion of dengue had a serologically confirmed dengue virus (DENV) infection. Almost all were primary dengue infections and 80% of the infants developed DHF/DSS. At the time of presentation and during hospitalization, the clinical signs and symptoms in infants with dengue were difficult to distinguish from those with other febrile illnesses, suggesting that in infants early laboratory confirmation could assist appropriate management. Detection of plasma NS1 antigen was found to be a sensitive marker of acute dengue in infants with primary infection, especially in the first few days of illness. Conclusions/Significance Collectively, these results provide a systematic description of the clinical features of dengue in infants and highlight the value of NS1 detection for diagnosis. Author Summary Dengue is a major public health problem in tropical and subtropical countries, including Vietnam. Dengue cases occur in children and young adults; however, severe dengue also occurs in infants less than 1 year of age. Prompt recognition of dengue is important for appropriate case management, particularly in infants in whom febrile illness from other causes is common. We describe the clinical picture, virological and immunological characteristics of infants with dengue admitted to three hospitals in southern Vietnam, compared with infants admitted with fever not due to dengue. We show that infants with dengue are difficult to distinguish from those with other febrile illnesses based on signs and symptoms at presentation, and so laboratory tests to confirm dengue virus infection may be useful for diagnosis and management. Conventional diagnostic methods for dengue have low sensitivity early in infection, and we show that an alternative antigen-detection assay that has demonstrated good sensitivity and specificity in older age groups also performs well in infants. This study will help to inform the diagnosis and management of dengue in infants. |
| Databáze: | OpenAIRE |
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