Dengue in the elderly: a review

Lin, Ray Junhao; Lee, Tau Hong; Leo, Yee Sin

doi:10.1080/14787210.2017.1358610

Cited by 49 publications

(36 citation statements)

References 51 publications

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“…Several dengue endemic countries (such as the Philippines, Thailand, Malaysia, and Indonesia) have reported DF prevalence to be predominant in children aged <15 years (Agrupis et al, 2019;Anderson et al, 2007;Sasmono et al, 2018). In recent years, some countries such as Cuba, Puerto Rico, Singapore, and Bangladesh have reported cases of adult DHF, but older adults have only accounted for a small number of DHF cases in these countries (Lee et al, 2008;Lin et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

A clinical and epidemiological survey of the largest dengue outbreak in Southern Taiwan in 2015

Wang

Lin

Chang

et al. 2019

International Journal of Infectious Diseases

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This study examined the epidemiological, clinical, and immunological characteristics of the 2015 dengue outbreak in Taiwan. Methods: Clinical data were collected from dengue fever (DF) and dengue hemorrhagic fever (DHF) patients. A phylogenetic tree was used to analyze the source of the outbreak strain. Paired plasma samples from DF/DHF patients were used for antibody-dependent enhancement (ADE) assay and cytokine multiplex biometric immunoassay to validate the immunological mechanism. Results: This outbreak mainly occurred in two of the southern cities of Taiwan: Tainan (n = 22 777; 52%) and Kaohsiung (n = 19 784; 45%). A high DHF death rate was noted (34.6%). The case (DHF) and control (DF) study indicated that older age (>60 years), type II diabetes, and hypertension were risk factors correlated with the development of DHF (p < 0.0001). The phylogenetic tree results suggested that the outbreak-associated strain was dengue virus serotype 2 and cosmopolitan genotype, forming a stable cluster with the isolates from Thailand and Indonesia (bootstrap value of 99%). Cytokine analyses demonstrated that levels of interleukin (IL)-6, IL-4, IL-13, IL-1β, interferon gamma (IFN-g), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were significantly higher in DHF patients compared to DF patients (p < 0.001). The ADE assay showed that diluted plasma containing preexisting dengue antibodies from DHF patients significantly enhanced dengue infection (p < 0.05). Conclusion: The results suggest that older age, type II diabetes, hypertension, immunological cytokine dysregulation, and preexisting dengue antibodies inducing ADE infection are correlated with dengue severity. This study also indicates that the largest dengue outbreak in Taiwan might have been a result of imported DF from dengue epidemic regions.

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Section: Discussionmentioning

confidence: 99%

A clinical and epidemiological survey of the largest dengue outbreak in Southern Taiwan in 2015

Wang

Lin

Chang

et al. 2019

International Journal of Infectious Diseases

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“…However, dengue is a dynamic and complicated disease resulting from complex immunologic reactions between host genetic factors [ 9 ], preexisting comorbidities [ 10 ], and viral strains [ 11 ], and fatality has been reported in some cases, mainly in elderly individuals, despite a timely diagnosis [ 12 , 13 ]. This is particularly true during the last decade of the dengue epidemic, and the emergence of dengue has been associated with a predominance in adults, rather than in children [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors in Adult Patients with Dengue: Developing Risk Scoring Models and Emphasizing Factors Associated with Death ≤7 Days after Illness Onset and ≤3 Days after Presentation

Lee

Huang

et al. 2018

JCM

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Dengue is a mosquito-borne viral disease that is a threat to global health. However, information relating to mortality ≤7 days after dengue onset and ≤3 days after presentation is limited. We retrospectively analyzed 1086 adults with dengue during a 12-year period. Three scoring models were established: model-1 (death ≤3 days after presentation), model-2 (death ≤7 days after illness onset), and model-3 (overall fatality). In total, 39 patients with fatal dengue were identified, of which 17 and 14 patients died ≤7 days after illness onset and ≤3 days after presentation, respectively. In model-1 (range: 0‒4 points), gastrointestinal bleeding ≤72 h after presentation, thrombocytopenia (<50 × 109 cells/L) at presentation, and acute kidney injury after hospitalization, using a cutoff level of 2 points, exhibited good discrimination (area under the receiver curve (AUC): 0.975) between survivors and non-survivors. In model-2, the significant predictors were gastrointestinal bleeding ≤72 h after presentation, and hemoconcentration and leukocytosis after hospitalization. Model-2 (range: 0–4 points) showed an AUC of 0.974, with a cutoff value of 2 points. The independent factors in model-2 were the predictors of overall mortality (model-3), which include thrombocytopenia (<50 × 109 cells/L) at presentation. Using a cutoff value of 2 points, model-3 (range: 0–7 points) revealed an excellent discrimination between survivors and non-survivors (AUC: 0.963).

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“…So far, the classic pattern of dengue fever endemicity is that the pediatric population was most likely to experience dengue infection due to the absence of protective immunity. However, recent epidemiological data would tend to clearly nuance this assertion [79]. A set of systematic reviews based on outbreaks from 2000 pointed out a gradual shift in the burden of dengue from the children to the adult population among five of the seven hyperendemic regions [58,[80][81][82][83][84][85].…”

Section: Discussionmentioning

confidence: 99%

Dengue: a growing threat requiring vaccine development for disease prevention

Bos

Gadéa

Desprès

2018

Pathogens and Global Health

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Dengue disease is the most prevalent mosquito-borne viral infection in humans. At least one half of the global population is estimated at risk of infection and an estimated 390 million people are infected each year. Over the past few years, dengue burden continued to increase, mainly impacting developing countries. Alarming changes in dengue epidemiology were observed highlighting a spread from tropical to subtropical regions as well as urban to rural areas. An increase in the co-infections with the four serotypes has also been noticed, involving a shift in the targeted population from pediatric to adult. Facing these global changes, authorities will have to reinforce preventive actions and adapt healthcare management. New prophylactic strategies are urgently needed to prevent severe forms of dengue disease. The lack of specific antiviral therapies available turns vaccine development into a socio-economic challenge. In this review, we propose an update on the dengue global trends and different vaccine strategies in development. A particular attention will be paid to up-to-date information on dengue transmission and the protective efficacy of newly commercialized tetravalent dengue vaccine Dengvaxia®, as well as the most advanced candidate vaccines in clinical development.

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Dengue in the elderly: a review

Cited by 49 publications

References 51 publications

A clinical and epidemiological survey of the largest dengue outbreak in Southern Taiwan in 2015

A clinical and epidemiological survey of the largest dengue outbreak in Southern Taiwan in 2015

Prognostic Factors in Adult Patients with Dengue: Developing Risk Scoring Models and Emphasizing Factors Associated with Death ≤7 Days after Illness Onset and ≤3 Days after Presentation

Dengue: a growing threat requiring vaccine development for disease prevention

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