The Emperor's New Clothes Revisited, or Reflections on the Pathogenesis of Dengue Hemorrhagic Fever *

Rosen, Léon

doi:10.4269/ajtmh.1977.26.337

Cited by 217 publications

(121 citation statements)

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“…There has been some discussion of the possible role of virus variation in determining the severity of dengue virus infection (Rosen, 1977) and it has been suggested that oligonucleotide fingerprinting may be a useful approach to understanding the biological variation associated with the disease (Trent et al, 1983). Although the number of viruses examined in this study was relatively small, there was no indication that isolates from patients with disease of similar severity were more closely related than other isolates.…”

Section: Discussioncontrasting

confidence: 39%

Variation in Dengue Type 2 Viruses Isolated in Bangkok during 1980

Walker

Henchal

Blok

et al. 1988

Journal of General Virology

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SUMMARYDengue type-2 viruses isolated in metropolitan Bangkok during 1980 (Bangkok/80) were characterized by oligonucleotide fingerprinting, restriction enzyme (RE) mapping and antigenic analysis using monoclonal antibody probes. Of 10 isolates analysed by oligonucleotide fingerprinting, nine were very closely related, showing 72-5 ~o to 91.4 ~ oligonucleotide homology. One isolate (D80-141) produced a distinctly different fingerprint (55.7~ to 58"0~o homology) and was less related to other Bangkok/80 dengue-2 virus isolates than to a 1964 Bangkok isolate (16681). RE mapping conducted on complementary dsDNA prepared from three Bangkok/80 isolates, strain 16681 and the prototype New Guinea C strain confirmed that D80-141 was genetically distinct. On antigenic analysis, only one of 22 monoclonal antibody probes produced against representative 1980 Bangkok dengue-2 isolates, D80-100 and D80-141, was able to distinguish between these virus strains. Monoclonal antibody 47-10/10, prepared using D80-100 virus and directed at the NS1 non-structural glycoprotein, had a significantly lower (100-fold) solid phase radioimmune assay endpoint titre for D80-141 antigen than for D80-100 antigen. By the indirect immunofluorescence assay, 47-10/10 had lower antibody endpoint titres against D80-141, the NGC strain and 13 (12~o) of 110 Bangkok/80 isolates than to a control antibody preparation. These results suggest that strain D80-141 represents a second minor topotype of dengue-2 which was circulating concurrently with the major endemic topotype in Bangkok in early 1980.

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Section: Discussioncontrasting

confidence: 39%

Variation in Dengue Type 2 Viruses Isolated in Bangkok during 1980

Walker

Henchal

Blok

et al. 1988

Journal of General Virology

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“…7 The occurrence of DHF in primary infections could be related to viral strain and serotype; dengue viral virulence has long been proposed as an alternative to the immune enhancement hypothesis. [35][36][37] Interestingly, other studies have found that DEN-3 causes DHF in primary infections to a greater extent than DEN-2 or DEN-4. 28,33 It has been hy-pothesized that determinants for primary disease severity may be different from those associated with severe disease in secondary infections.…”

Section: Discussionmentioning

confidence: 99%

Clinical, epidemiologic, and virologic features of dengue in the 1998 epidemic in Nicaragua.

Harris¹,

Videa²,

Pérez³

et al. 2000

Am J Trop Med Hyg

262

206

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Abstract. From July to December 1998, a hospital-and health center-based surveillance system for dengue was established at selected sites in Nicaragua to better define the epidemiology of this disease. Demographic and clinical information as well as clinical laboratory results were obtained, and virus isolation, reverse transcriptase-polymerase chain reaction, and serologic assays were performed. World Health Organization criteria were used to classify disease severity; however, a number of patients presented with signs of shock in the absence of thrombocytopenia or hemoconcentration. Therefore, a new category was designated as ''dengue with signs associated with shock'' (DSAS). Of 1,027 patients enrolled in the study, 614 (60%) were laboratory-confirmed as positive cases; of these, 268 (44%) were classified as dengue fever (DF); 267 (43%) as DF with hemorrhagic manifestations (DFHem); 40 (7%) as dengue hemorrhagic fever (DHF); 20 (3%) as dengue shock syndrome (DSS); and 17 (3%) as DSAS. Interestingly, secondary infection was not significantly correlated with DHF/DSS, in contrast to previous studies in Southeast Asia. DEN-3 was responsible for the majority of cases, with a minority due to DEN-2; both serotypes contributed to severe disease. As evidenced by the analysis of this epidemic, the epidemiology of dengue can differ according to geographic region and viral serotype.

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“…Since such cases do not fit with the premises of the Halstead hypothesis of sequential infections 4 , research is needed to elucidate which other factors are involved, such as viral strain virulence, as reported since the 1970s 41 , host genetics 32 , presence of co-morbidtiy 37,39 , and others that can contribute to dengue severity.…”

Section: Revisiting Dengue Epidemiology In Brazilmentioning

confidence: 99%