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Subdural haematoma and axonal polyneuropathy complicating dengue fever.

The authors report a case of dengue fever presenting with aseptic meningoencephalitis and developing subdural haematoma and pure motor quadriparesis due to axonal polyneuropathy. This 27-year-old female patient presented to us during the latter part of the dengue epidemic in India in 2010. She had mild thrombocytopaenia and subtle signs of capillary leak. Dengue-specific IgM antibody was positive. She presented initially with recurrent seizures. Initial CT scan of brain was normal with cerebrospinal fluid showing albuminocytologic dissociation. After 6 days, the patient developed quadriparesis…

Dengue fever treatment with Carica papaya leaves extracts.

The main objective of the current study is to investigate the potential of Carica papaya leaves extracts against Dengue fever in 45 year old patient bitten by carrier mosquitoes. For the treatment of Dengue fever the extract was prepared in water. 25 mL of aqueous extract of C. papaya leaves was administered to patient infected with Dengue fever twice daily i.e. morning and evening for five consecutive days. Before the extract administration the blood samples from patient were analyzed. Platelets count (PLT), White Blood Cells (WBC) and Neutrophils (NEUT) decreased from 176×10(3)/µL, 8.10×10(3…

Dextran fractional clearance studies in acute dengue infection.

BACKGROUND: Although increased capillary permeability is the major clinical feature associated with severe dengue infections the mechanisms underlying this phenomenon remain unclear. Dextran clearance methodology has been used to investigate the molecular sieving properties of the microvasculature in clinical situations associated with altered permeability, including during pregnancy and in various renal disorders. In order to better understand the characteristics of the vascular leak associated with dengue we undertook formal dextran clearance studies in Vietnamese dengue patients and healthy…

Unusual dengue virus 3 epidemic in Nicaragua, 2009.

The four dengue virus serotypes (DENV1-4) cause the most prevalent mosquito-borne viral disease affecting humans worldwide. In 2009, Nicaragua experienced the largest dengue epidemic in over a decade, marked by unusual clinical presentation, as observed in two prospective studies of pediatric dengue in Managua. From August 2009-January 2010, 212 dengue cases were confirmed among 396 study participants at the National Pediatric Reference Hospital. In our parallel community-based cohort study, 170 dengue cases were recorded in 2009-10, compared to 13-65 cases in 2004-9. In both studies, signific…

Unusual manifestations in dengue outbreak 2009, Delhi, India.

Epidemics of Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are common in Southeast Asia. DF is defined & classified according to WHO criteria. Variable clinical manifestations of DF & DHF have been described in earlier studies. But some patients present with unusual clinical features and clinical profile not classifiable according to the present WHO criteria. Some of these complications if not recognized early and treated properly can even prove fatal. So this study was done to describe various clinical features in Dengue fever with special emphasis on unusual manifestations. This study…

Structure-based discovery of dengue virus protease inhibitors.

Dengue virus belongs to the family Flaviviridae and is a major emerging pathogen for which the development of vaccines and antiviral therapy has seen little success. The NS3 viral protease is a potential target for antiviral drugs since it is required for virus replication. The goal of this study was to identify novel dengue virus (type 2; DEN2V) protease inhibitors for eventual development as effective anti-flaviviral drugs. The EUDOC docking program was used to computationally screen a small-molecule library for compounds that dock into the P1 pocket and the catalytic site of the DEN2V NS3 p…

Recent progress on sanofi pasteur's dengue vaccine candidate.

The sanofi pasteur candidate dengue tetravalent vaccine (TV) is a recombinant live attenuated vaccine. It is based on a backbone of yellow fever vaccine (YF 17D) replication genes and incorporates the envelope genes of the four dengue virus serotypes. Pre-clinical studies have demonstrated that dengue TV is genetically stable, non-hepatotropic, less neurovirulent than YF 17D and does not infect mosquitoes by the oral route. Dengue TV reactogenicity, viraemia induction and antibody responses were investigated in three Phase II trials in the USA, the Philippines and Mexico. Participants were ran…

Серьезные эпидемии денге в Шри-Ланке, 2003-2006 годы.

Недавняя вспышка геморрагической лихорадки денге на индийском субконтиненте хорошо задокументирована в Шри-Ланке. Мы сравниваем последние (2003-2006 годы) и прошлые (1980-1997 годы) данные наблюдения за денге по Шри-Ланке. Серотипы 4 денге (DENV) в Шри-Ланке соотносятся более 30 лет. За этот период новый генотип DENV-1 заменил старый генотип. Кроме того, новые клещи вирусов генотипа III DENV-3 заменили старые клинки. Возникновение новых клинков DENV-3 в 1989 и 2000 годах совпало с резким увеличением числа зарегистрированных случаев заболевания денге, связанных с этим серотипом в серьезных эпид

Совпадение в аннотации оригинала
Recent emergence of dengue hemorrhagic fever in the Indian subcontinent has been well documented in Sri Lanka. We compare recent (2003-2006) and past (1980-1997) dengue surveillance data for Sri Lanka. The 4 dengue virus (DENV) serotypes have been cocirculating in Sri Lanka for >30 years. Over this period, a new genotype of DENV-1 has replaced an old genotyp…

[Hemorrhagic dengue without hemorrhaging: a novel diagnostic category?].

OBJECTIVE: Compare the clinical course of Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF). MATERIAL AND METHODS: Cross-sectional study among seropositive cases reported by the Northern Veracruz District IMSS Office in 2004. We analyzed the epidemiology, symptomology, clinical findings and disease progression. We calculated frequencies, proportions and averages. Clinical data and disease progression were compared. RESULTS: We studied 404 patients, divided into three groups: 75 with CD, 120 DHF and 212 cases with no hemorrhagic data although displaying Dengue with Thrombocytopenia (DwT). …

Neutralizing antibody response variation against dengue 3 strains.

To evaluate the neutralizing antibody activity of a human sera panel against seven strains of the homotypic virus. Sera were collected from … gest that virus changed in the course of the epidemic. The implications of this finding in terms of dengue pathogenesis and vaccine development need to be considered.

Apoptosis in tissues from fatal dengue shock syndrome.

BACKGROUND: Apoptosis, or programmed cell death, has been implicated in dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) pathogenesis. OBJECTIVES: To determine the in vivo apoptosis contribution to the pathogenesis of fatal DHF/DSS during a Cuban dengue epidemic. STUDY DESIGN: We detected apoptosis by the TdT-mediated dUTP Nick-End Labeling (TUNEL) technique and dengue virus (DENV) antigens by an immunohistochemical assay in different tissues from six individuals who died of DHF/DSS during the Santiago de Cuba DENV-2 epidemic in 1997. RESULTS: DENV antigens were immunolocalized main…

Pathogenesis of liver involvement during dengue viral infections.

The dengue virus can infect many cell types and cause diverse clinical and pathological effects. We describe clinical and experimental observations that suggest that liver involvement occurs during dengue infections, and we outline the possible role played by host immune responses in this process.

Transplacentally transferred maternal-infant antibodies to dengue virus.

Antibodies of all four dengue virus serotypes were detected by hemagglutination inhibition (HI) in 97% of 2,000 infants' cord sera at the time of delivery. In comparison with 250 mother-infant's paired sera, we found that 53% of the infants' serum HI titers were higher than those of the mother's. The mother/infant IgG subclasses 1, 2, 3, and 4 titers were 53.1/87.0, 8.4/11.7, 0.14/0.11, and 1.1/1.0 mg/dL, respectively. In 18 months of follow-up of 100 infants studied, we observed that antibody to dengue virus disappeared in 3% by two months of age, in 19% by four months of age, in 72% by six m…

Dengue hemorrhagic fever in infants: research opportunities ignored.

The age distribution of cases of dengue hemorrhagic fever and dengue shock syndrome (DHF/DSS) in infants under the age of 1 year are reported from Bangkok, Thailand, and for the first time for Ho Chi Minh City, Vietnam; Yangon, Myanmar; and Surabaya, Indonesia. The four dengue viruses were isolated from Thai infants, all of whom were having a primary dengue infection. Progress studying the immunologically distinct infant DHF/DSS has been limited; most contemporary research has centered on DHF/DSS accompanying secondary dengue infections. In designing research results obtained in studies on a c…

Dengue infection presenting with central nervous system manifestation.

The objective of this study was to investigate the possibility of dengue virus infection causing an abnormal neurologic presentation. Between 1996 and 1998, all pediatric patients with clinical manifestations of encephalitis-like illness who were admitted to the Department of Pediatrics, Siriraj Hospital were prospectively studied for any evidence of dengue virus infection. The diagnosis of dengue virus infection was based on mosquito viral isolation and serologic and polymerase chain reaction (PCR) evidence. Of 44 patients with the preliminary diagnosis of acute viral encephalitis, 8 were dia…

Human Dengue antibodies against structural and nonstructural proteins.

Antibodies against dengue virus type 2 and 4 proteins in acute-phase sera of 10 primary and 10 secondary dengue fever and dengue hemorrhagic fever patients were studied by Western blotting. In the first group the immune response was barely detectable, while in the second group more proteins were detected, with a very strong reaction. Anti-NS1 and -NS3 antibodies were detected mainly in secondary cases. Anti-E, -NS3, and -NS5 antibodies were detected in a high number of cases. The possibility of implementing early diagnostic assays for antigen detection is suggested.

Impaired T cell proliferation in acute dengue infection.

Decreased proliferative responses to mitogens and recall Ags have been observed in PBMC obtained during several acute human viral infections. To determine whether cell-mediated responses are altered during acute dengue infection, we examined the proliferative responses of PBMC from children enrolled in a prospective study of dengue infections in Thailand. All responses of PBMC during acute illness were compared with the same patients' PBMC obtained at least 6 mo after their infection. Proliferative responses to PHA, anti-CD3, tetanus toxoid, and dengue Ags were decreased significantly in PBMC …

[Dengue epidemic in Fortaleza, Ceará: randomized seroepidemiologic survey].

OBJECTIVE: A seroepidemiological random survey was carried out in Fortaleza city, State of Ceará, Brazil, following an epidemic of dengue virus type 2 (DEN 2), with the purpose of evaluating the frequency of clinical manifestations (signs and symptoms) and the prevalence of dengue infection. METHOD: A questionnaire calling for information on address, sex, age, clinical, epidemiological and economic status was applied to the population, followed by venupuncture collection of 5-10 ml of blood for testing by hemagglutination-inhibition (HI). The sample was calculated to obtain a prevalence of 20…

Fatal cerebral oedema associated with primary dengue infection.

Encephalopathy associated with dengue fever is considered to be a rare condition in adults. We describe a patient with a primary dengue infection who, in the absence of overt signs of dengue shock syndrome, died due to progressive cerebral oedema. Autopsy findings demonstrated loss of integrity of cerebral vascular endothelium and involvement of complement activation.

Mechanisms of dengue virus-induced bone marrow suppression.

Infection with many flaviviruses is associated with transient suppression of haematopoiesis. Of the flaviviruses of man, none are more accessible to clinical and laboratory study than dengue. Consequently, the clinical syndrome of dengue-associated bone marrow suppression has been well documented. A review of experimental dengue infections of volunteers and histopathological studies of bone marrow from patients with severe dengue virus infection suggests that marrow suppression evolves rapidly through several phases: (1) onset of marrow suppression within 3-4 days of infection; (2) onset of ho…