Dengue Fever in a Puerto Rican Community1

Neff, John M.; Morris, Leo; González-Alcover, Rafael; Coleman, Philip H.; Lyss, Stanley B.; Negron, H.

doi:10.1093/oxfordjournals.aje.a120722

Cited by 62 publications

(54 citation statements)

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“…Thus, phylogenetic analysis suggested focal transmission and possible infection outside the local area. This finding is consistent with the known focal nature of DENV transmission 5,[23][24][25][26] and with DENV infection in mobile populations.…”

Section: Discussionsupporting

confidence: 88%

Index Cluster Study of Dengue Virus Infection in Nicaragua

Reyes¹,

Mercado²,

Standish³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. Traditional study designs do not identify acute asymptomatic or pre-symptomatic dengue virus (DENV) infections, thus limiting our understanding of immunologic and viral factors that modulate infection outcome. In the 2006 and 2007 dengue seasons, we conducted a pilot index cluster study in Managua, Nicaragua, in which 442 persons living within 50 meters of 22 index cases identified through an ongoing pediatric cohort study were evaluated for DENV infection. Post-enrollment and pre-enrollment DENV infections were confirmed in 12 (2.7%) and 19 (4.3%) contacts, respectively. Five (42%) post-enrollment infections were asymptomatic, and DENV-2 was identified in 9 (75%) infections. Phylogenetic analysis with full-length DENV genomic sequence from contacts, index cases, and cohort dengue cases indicated focal transmission and infection outside the local area. We demonstrate the feasibility of identification of acute asymptomatic and pre-symptomatic cases in urban Latin America, the first report of such a study in the Americas, and identify age and concomitant immunity to DENV of contacts as a key factor in index cluster study design.

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Section: Discussionsupporting

confidence: 88%

Index Cluster Study of Dengue Virus Infection in Nicaragua

Reyes¹,

Mercado²,

Standish³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…Elsewhere in the Caribbean, DEN-3 and DEN-2 viruses were circulating. 22,23 With no DHF occurring in the American region at that time, the essentially silent transmission of one or more DEN viruses in Haiti was not surprising.…”

Section: Discussionmentioning

confidence: 98%

Haiti: absence of dengue hemorrhagic fever despite hyperendemic dengue virus transmission.

Halstead¹,

Streit²,

Lafontant³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

177

114

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Abstract. In 1994-1996, 185 strains of dengue (DEN) virus types 1, 2, and 4 were recovered from febrile United States and other United Nations military personnel in Haiti. We wondered whether risk factors for dengue hemorrhagic fever (DHF) existed and, if so, were DHF cases occurring among Haitian children. Dengue transmission rates were studied in 210 school children (6-13 years old) resident in Carrefour Borough, Port-au-Prince, Haiti. When sera were tested for plaque-reduction neutralizing antibodies to DEN 1-4 viruses, nearly 85% had antibodies to two or more DEN serotypes. The annual transmission rate was estimated at 30%, a rate observed in countries endemic for DHF. Haitian DEN 2 isolates were genotype I, which are repeatedly associated with DHF cases in Southeast Asia and American regions. Despite positive virologic pre-conditions, DHF cases were not recorded by experienced Port-auPrince pediatricians. These observations, which are reminiscent of those in Africa, provide further evidence of a dengue resistance gene in black populations.

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“…A larger number of cases (over 27,000) was reported in the DEN-3 epidemic of 1963-1964, but the number represents reports of clinically diagnosed patients. 27,28 The data for 1994-1995 consist of cases for which diagnostic samples were submitted, and therefore do not include the large number of clinically-diagnosed patients for whom samples were not sent to CDC. Although cases of influenza or meningococcal disease may have been included in the reports of suspected dengue, the 1994-1995 epidemic produced, without question, the largest number of hospitalizations, DHF cases, and deaths from any dengue epidemic in Puerto Rico.…”

Section: Discussionmentioning

confidence: 99%