Effect of age on outcome of secondary dengue 2 infections

Guzmán, María G.; Kourı́, Gustavo; Bravo, José; Valdés, Luís; Vázquez, Susana; Halstead, Scott B.

doi:10.1016/s1201-9712(02)90072-x

Cited by 281 publications

(233 citation statements)

References 12 publications

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“…The high fatality in the elderly is concordant with samples analysed in different countries [11][12][13][14][15][16], implying an influence of age independent from ethnicity or local epidemiological aspects. Even with different serotypes circulating in the study period, in all years the proportion of elderly individuals presenting severe dengue was higher than the sample average.…”

Section: Discussionsupporting

confidence: 69%

Influence of demographics on clinical outcome of dengue: a cross-sectional study of 6703 confirmed cases in Vitória, Espírito Santo State, Brazil

Vicente¹,

Cerutti

Fröschl³

et al. 2016

Epidemiol. Infect.

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SUMMARYDengue presents a wide clinical spectrum of signs and symptoms, with characteristics of the host potentially influencing the disease evolution. Therefore, the purpose of this study was to evaluate the influence of gender and age on dengue clinical outcomes in a recent outbreak situation in Brazil, applying a cross-sectional design and including 6703 dengue cases with laboratory confirmation, occurring in Vitória, Espírito Santo State, Brazil, between 2007 and 2013. Data were obtained from the Information System for Notifiable Diseases. Overall, 11·3% of the sample presented with severe dengue, which affected 13·0% of males, 10·0% of females, 8·8% of children, 12·5% of adolescents, 10·5% of adults and 15·5% of the elderly. Age was higher in the severe dengue group (P = 0·03). Severe dengue was associated with males and the elderly (P < 0·01); however, considering only severe cases, children presented haemorrhage and plasma leakage more frequently than older age groups. The results emphasize the importance of a differentiated protocol for management of dengue cases, taking into consideration host factors like age. These findings also suggest the elderly and children as priority groups for immunization in a future implementation of a vaccine.

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Section: Discussionsupporting

confidence: 69%

Influence of demographics on clinical outcome of dengue: a cross-sectional study of 6703 confirmed cases in Vitória, Espírito Santo State, Brazil

Vicente¹,

Cerutti

Fröschl³

et al. 2016

Epidemiol. Infect.

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“…Como lo han señalado otros autores, la edad avanzada es, per se, un factor de riesgo para desarrollar formas graves de dengue con desenlaces fatales (14)(15)(16)18,19), lo cual se ha explicado aduciendo los cambios en el sistema inmunitario, la menor efectividad de la activación y diferenciación de las células en la reacción primaria, y la disminución en la reacción de los linfocitos T y B. Otros hallazgos han demostrado la disminución de algunas citocinas, como la IL-2, y el aumento de la IL-6 (19,(22)(23)(24). Por otro lado, se ha reportado un mayor riesgo de bacteriemia, hemorragia gastrointestinal y complicaciones renales, así como estancias hospitalarias más largas (3,(18)(19)(20).…”

Section: Discussionunclassified

“…Esto respondería a la posible presencia de infección por serotipos de dengue con mayor capacidad para producir las condiciones graves (4,22). Además, alrededor de 50 % de los pacientes del estudio con infecciones secundarias presentó al menos un signo de alarma.…”

Section: Discussionunclassified

Prevalencia y curso clínico de la infección por dengue en adultos mayores con cuadro febril agudo en un hospital de alta complejidad en Cali, Colombia

Rosso¹,

Vanegas

Rodríguez

et al. 2016

biomedica

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Contribución de los autores:Róbinson Pacheco y Fernando Rosso: desarrollo de la idea, diseño del estudio y revisión crítica del contenido Sarita Rodríguez: creación de la base de datos, análisis de la información, revisión crítica del contenido Sara Vanegas: revisión de la literatura, diseño del estudio, recolección de datos y análisis de la información Todos los autores participaron en la redacción del manuscrito.Prevalencia y curso clínico de la infección por dengue en adultos mayores con cuadro febril agudo en un hospital de alta complejidad en Cali, Colombia Introducción. Hay pocas series de casos publicadas sobre la prevalencia y el curso clínico del dengue en adultos mayores con síndrome febril, habitantes en zonas endémicas para la infección. Se cree que tales casos presentan una baja prevalencia pero revisten mayor gravedad, y más complicaciones y mortalidad. Objetivos. Describir la prevalencia y el curso clínico del dengue en adultos mayores atendidos por síndrome febril agudo en un hospital de alta complejidad de una zona endémica de la enfermedad. Introduction: Little is known about the prevalence and clinical course of dengue infection in elderly patients living in endemic areas; it is presumed that there is a lower prevalence but higher severity, complications and mortality. Objective: To describe the prevalence and clinical course of dengue infection in elderly patients who were admitted to a referral care center for infectious diseases in an endemic region. Materials and methods:We conducted an observational and descriptive study between 2011 and 2014, using a cohort of elderly patients with serological diagnosis of dengue.Results: A total of 235 febrile elderly patients were assessed, of which 43 patients (18.3%) were found to have dengue. The median age was 71 years; 48.7% were female, and 89% of patients had at least one comorbid condition. According to the serological tests, 51.4% of cases were positive for NS1 Ag, 27% for IgM and 54.1% for IgG, while 64.8% were secondary infections. Dengue was diagnosed in 13 patients (35%), dengue with warning signs in 16 cases (43%), and severe dengue in 8 cases (22%). Nearly 56.7% of patients were admitted to hospital and 21.6%, to the intensive care unit. None died. 180Biomédica 2016;36(Supl.2):179-86 Rosso F, Pacheco R, Rodríguez S, Vanegas S Conclusion: We found dengue infection to be more frequent than expected in this sample of elderly patients, due to acute febrile syndrome. Elderly patients also required higher rate of hospitalization and had more complications, however there were no deaths due to good management.

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“…Successive infections increase the risk of DHF and dengue shock syndrome (DSS) by 40-to 80-fold 9 . Age is indicated as a risk Vicente CR et al -Factors related to severe dengue in Vitória, Brazil factor for death in patients with successive infection, and death is 15 times more frequent in children than in adults 10 . Most of the cases of severe dengue occurred in Maruípe and São Pedro, which, together with Santo Antônio, showed a higher incidence of severe dengue than in the Vitória municipality as a whole.…”

Section: Rev Soc Bras Med Trop 46(5):629-632 Sep-oct 2013mentioning

confidence: 99%

Factors related to severe dengue during an epidemic in Vitoria, State of Espirito Santo, Brazil, 2011

Vicente

Lauar

Santos

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Introduction:The prognosis of dengue depends on early diagnosis and treatment, which can help prevent severe forms whose characteristics were evaluated here. Methods: A cross-sectional study was conducted involving dengue cases in Vitória, State of Espírito Santo, Brazil, in 2011. Results: Two health regions registered 56.3% of 371 cases of severe dengue. Of these cases, 21.3% presented with dengue hemorrhagic fever. There were associations between dengue hemorrhagic fever with younger ages and a longer time before receiving care. Conclusions: There was a greater involvement of dengue hemorrhagic fever in young people. Delay in care, poor urban quality and high endemicity were identifi ed as possible risk factors for dengue severity.

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Effect of age on outcome of secondary dengue 2 infections

Abstract: Age is an important variable in the outcome of secondary DEN-2 infections. DHF/DSS case fatality and hospitalization rates are highest in young infants and the elderly. The risk that a child will die during a secondary DEN-2 infection is nearly 15-fold higher than the risk in adults.

Cited by 281 publications

References 12 publications

Influence of demographics on clinical outcome of dengue: a cross-sectional study of 6703 confirmed cases in Vitória, Espírito Santo State, Brazil

Influence of demographics on clinical outcome of dengue: a cross-sectional study of 6703 confirmed cases in Vitória, Espírito Santo State, Brazil

Prevalencia y curso clínico de la infección por dengue en adultos mayores con cuadro febril agudo en un hospital de alta complejidad en Cali, Colombia

Factors related to severe dengue during an epidemic in Vitoria, State of Espirito Santo, Brazil, 2011

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