Long-term persistence of clinical symptoms in dengue-infected persons and its association with immunological disorders

Garcı́a, Gissel; González, Narjara; Pérez, Ana B.; Sierra, Beatríz; Aguirre, Eglys; Rizo, Damaris; Izquierdo, Alienys; Sánchez, Lizet; Díaz, Danay; Lezcay, Magnolia; Pacheco, Betsi; Hirayama, Kenji; Guzmán, María G.

doi:10.1016/j.ijid.2010.09.008

Cited by 110 publications

(92 citation statements)

References 25 publications

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“…15 Nevertheless, host immunological factors may be important, as others have shown that genotypic differences in the immune receptor FcγRII correlate with long-term persistence of symptoms after DENV infection. 13 Although only a handful of prior reports describe and enumerate symptom persistence after the acute febrile period with dengue fever, this phenomenon has been described for other arboviral infections. For example, the alphaviruses CHIKV, MAYV, and Ross River virus may cause joint pain that lasts weeks to years.…”

Section: Discussionmentioning

confidence: 99%

“…22 Looking at time periods beyond the acute visit, a study from Singapore evaluating fatigue after 2 months and a study from Cuba examining multiple symptoms after 2 years both noted higher levels of persistent symptoms in females. 10,13 Females have also been noted to have a worse prognosis or slower recovery after West Nile virus (WNV), CHIKV, and tick-borne encephalitis virus (TBEV) infections. [23][24][25] Consistent with our findings, others have shown that older age impacts many different outcomes of DENV infection, both in the acute presentation and subsequent outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…4 A few case studies have detailed persistence of very specific endpoints such as decreased visual acuity, cardiomyopathy, neurological deficits, and elevated liver transaminases weeks to months after DENV infection, and a handful of others have described more general signs and symptoms. [5][6][7][8][9][10][11][12][13][14][15] However, these prior studies were small in size and only two used a control group of DENV uninfected subjects to better ascribe the source of lingering symptoms to DENV infection. 13,15 We collected clinical data from febrile individuals in Peru with or without DENV infection to measure the frequency of persistence of symptoms within 2 months after acute symptom onset and the association of persistence with prior DENV exposure history, DENV serotype, and demographic factors.…”

Section: Introductionmentioning

confidence: 99%

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Occurrence and Correlates of Symptom Persistence Following Acute Dengue Fever in Peru

Halsey¹,

Williams²,

Laguna-Torres³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Dengue virus (DENV) infection causes an acute febrile illness generally considered to result in either complete recovery or death. Some reviews describe persistent symptoms after the febrile phase, although empirical data supporting this phenomenon is scarce. We evaluated symptom persistence in acute febrile DENV-infected and DENVnegative (controls) individuals from Peru. Self-reported solicited symptoms were evaluated at an acute and a follow-up visit, occurring 10-60 days after symptom onset. Rate of persistence of at least one symptom was 7.7% and 10.5% for DENV infected and control subjects, respectively (P 0.01). The DENV-infected individuals had lower rates of persistent respiratory symptoms, gastrointestinal symptoms, headache, and fatigue, but higher rates of persistent rash compared with controls. Older age and female gender were positively associated with symptom persistence. As dengue cases continue to increase annually, even a relatively low frequency of persistent symptoms may represent a considerable worldwide morbidity burden.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Occurrence and Correlates of Symptom Persistence Following Acute Dengue Fever in Peru

Halsey¹,

Williams²,

Laguna-Torres³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…Su etiología aún no se ha descrito con precisión, de la fase aguda, entre los cuales predominó el cansancio físico (65,6 %), la cefalea (37,5 %), el insomnio (31,3 %), el mareo, el cansancio mental (25 %) y el dolor muscular (18,8 %). Estos hallazgos coinciden con las observaciones registradas en otros estudios (16,(28)(29)(30). Al evaluar la presencia de fatiga física y mental después de la infección aguda por dengue, se evidenció que esta se mantuvo en 34,4 % de los pacientes durante su convalecencia, con síntomas como el Convalecencia de la infección del dengue Figura 2.…”

Section: Discussionunclassified

Caracterización del estado de salud de las personas en su periodo de convalecencia de un episodio de dengue

et al. 2015

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Introducción. El dengue y sus manifestaciones agudas se han descrito ampliamente en la literatura, sin embargo, los síntomas en la fase de convalecencia se han estudiado poco. Objetivo. Describir las manifestaciones clínicas de una población durante su periodo de convalecencia de un episodio de dengue. Materiales y métodos. Se hizo un estudio observacional en sujetos que estuvieron hospitalizados con dengue diagnosticado por serología. Después del alta se les visitó para evaluar la persistencia de la sintomatología clínica, la fatiga (evaluada mediante el Fatigue Questionnaire de Chalder) y la calidad de vida (evaluada mediante el cuestionario EuroQoL-5D). Se determinó como fatiga significativa aquella con un puntaje igual o superior a cuatro en la escala empleada. Se hizo seguimiento telefónico y domiciliario de los participantes con fatiga hasta tres meses después del alta hospitalaria. Resultados. La prevalencia de fatiga en los 32 sujetos seleccionados (edad media: 35 años, sexo femenino: 59 %) fue de 34,4 % (IC95% 17,0-51,8). No se observaron diferencias sociodemográficas en relación con la fatiga, pero sí con relación a una mayor frecuencia de cansancio físico (100,0 % Vs. 47,6 %; p=0,005) y mental (54,6 % Vs. 9,5 %; p=0,010). Aunque los pacientes con fatiga reportaron una peor calidad de vida, esta no fue estadísticamente diferente a la del grupo sin fatiga al ajustar por edad y sexo (OR=5,5; IC95% 0,83-36,5). Además, el puntaje de fatiga decayó en promedio medio punto por cada diez días de seguimiento (p=0,007). Conclusiones. Estos resultados demuestran que la carga de enfermedad de la infección por el virus del dengue no se ha descrito del todo, pues en la fase de convalecencia se siguen presentando síntomas clínicos que dificultan la recuperación normal del individuo.

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“…Naturally, these health problems (and avoiding them via vaccination) can impact educational attainment, adult earnings, and social functioning (31)(32)(33)(34)(35). Thus, outcome-related productivity gains are benefits that follow on from improved health due to vaccination.…”

Section: Broader Perspective On the Value Of Vaccinationmentioning

confidence: 99%

Valuing vaccination

Bärnighausen

Bloom

Cafiero-Fonseca

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

169

149

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Vaccination has led to remarkable health gains over the last century. However, large coverage gaps remain, which will require significant financial resources and political will to address. In recent years, a compelling line of inquiry has established the economic benefits of health, at both the individual and aggregate levels. Most existing economic evaluations of particular health interventions fail to account for this new research, leading to potentially sizable undervaluation of those interventions. In line with this new research, we set forth a framework for conceptualizing the full benefits of vaccination, including avoided medical care costs, outcome-related productivity gains, behavior-related productivity gains, community health externalities, community economic externalities, and the value of risk reduction and pure health gains. We also review literature highlighting the magnitude of these sources of benefit for different vaccinations. Finally, we outline the steps that need to be taken to implement a broad-approach economic evaluation and discuss the implications of this work for research, policy, and resource allocation for vaccine development and delivery.benefit-cost analysis | immunization

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Long-term persistence of clinical symptoms in dengue-infected persons and its association with immunological disorders

Cited by 110 publications

References 25 publications

Occurrence and Correlates of Symptom Persistence Following Acute Dengue Fever in Peru

Occurrence and Correlates of Symptom Persistence Following Acute Dengue Fever in Peru

Caracterización del estado de salud de las personas en su periodo de convalecencia de un episodio de dengue

Valuing vaccination

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