A clinical, epidemiology and virological study of a dengue fever outbreak in Guangzhou, China-2002-2006.
AbstractWe analysed the clinical and epidemiological characteristics of dengue fever (DF) during the dengue virus (DENV)-1 outbreak in Guangzhou, China. Clinical and epidemiological data of 1342 patients with DF from May 2002 to November 2006 were analyzed retrospectively. The average age was 34.7±13.2 years. The ratio of male to female was 1.05:1. The peak time of the epidemic lasted from August to October. The most common manifestations included fever (100%), headache (85.9%), myalgia (64.5%), bone soreness (46.6%), fatigue (78.2%), skin rash (65.9%) and positive tourniquet test (51.3%). Leukopenia, thrombocytopenia, elevated alanine aminotransferase (ALT), elevated aspartate aminotransferase (AST) and hypopotassemia were found in 66%, 61.3%, 69%, 85.7% and 28.4% of the patients respectively. Only 2(0.15%) patients fulfilled the WHO case definition criteria for dengue haemorrhagic fever (DHF), the others were all diagnosed as classic DF. However, 64(4.8%) patients had severe clinical manifestations (internal haemorrhage, shock, marked thrombocytopenia, myocarditis, sepsis, pneumonia and encephalopathy). Anti-dengue IgM was detected in 90% of patients. Dengue viruses were isolated using the Aedes albopictus C6/36 cell line and identified as DENV-1 by RT-PCR. A 346bp fragment from RT-PCR product of every isolate was sequenced to compare with published sequences of other DENV-1 viruses. The nucleotide homology were 97%, 97% and 98% compared with those of DENV-1 strains of dengue fever outbreak in Cambodia, in 1997 and 1999 in China, respectively. In conclusion, the epidemic of dengue fever was caused by DENV-1 infection from 2002 to 2006 in Guangzhou. Patients with severe clinical manifestations are few, but in some of them, the diagnosis of DHF may be missed if the WHO classification is strictly applied, especially in adults.
Zhang, Fuchun, Tang, Xiaoping, Hu, Xuchu, Lu, Yecheng, Chen, Yanging. et al. (2007). A clinical, epidemiology and virological study of a dengue fever outbreak in Guangzhou, China-2002-2006.. WHO Regional Office for South-East Asia.. http://www.who.int/iris/handle/10665/170456