Cuadro clinico de la fiebre hemorragica del dengue/sindrome del choque del dengue en el adulto

Previous descriptions of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) in adults have been limited. This article assesses the disease cases of 130 Cuban adults who became ill during the 1981 dengue epidemic in that country and who were diagnosed as having hemorrhagic dengue. One hundred and four of these subjects (comprising Group 1) were admitted to one of three major Havana hospitals and recovered. The other 26 (comprising Grupo 2) died. The information cited was obtained from the two groups' clinical histories, serologic testing of the Grupo 1 subjects, and autopsy reports on the Group 2 subjects. Age did no appear to be a risk factor among these adult subjects; but race and sex appeared to play a role in the disease, a disproportionate share of both groups being white and female. Classical dengue symptoms (fever, headache, asthemnia, myalgia, arthralgia, retroorbital pain, and occasionally rash) predominated in both groups. Digestive symptoms (nausea and vomiting, anorexia, abdominal pain, diarrhea, and hepatomegaly) were also common. Hemorrhagic symptoms were confirmed in 90. and 65. of the Group 1 and Group 2 subjects, respectively, and shock occurred in all the fatal cases. The study subjects typically developed classical dengue symptoms at the outset, followed by digestive and hemorrhagic symptoms. The Group 1 subjects recovered after an average of seven days of illness

Fiebre hemorragica del dengue con sindrome de choque en ninos Cubanos / Clinical and serologic study of Cuban children with dengue hemorrhagic fever

During the 1981 epidemic of dengue type 2 in Cuba a study was done of 124 children from 0 to 14 years of age who had dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), degress III and IV. Almost all these children (98 percent) had neutralizing antibodies against the dengue type 1 and 2 viruses, indicating that they had already been previously infected with the type 1 virus. Neither sex was predominant among the patients. The frequency of the serious form of the disease was significantly greater among white children (p0.01) than among black or mulatto. Subjects between the ages of 4 and 11 were most apt to suffer serious clinical manifestations of the disease. In most of the cases the shock occurred four or five days after the appearance of the signs and symptoms, often preceded by abdominal pain. The most frequent clinical manifestations were fever, vomiting, and hepatomegaly. In 68.5 percent of the children there were hemorrhagic manifestations, mainly petechia and hematemesis. It was noted that and unusually high percentage of the children in the study had a personal or family background of asthma. In general, the results confirm that infection with the dengue type 1 virus shortly before infection with the type 2 virus is closely related to the appearance of DHF/DSS. In addition, the high percentage of children with a background of asthma supports the theory that this and other forms

Dengue hemorragico en Cuba, 1981.Diagnostico rapido del agente etiologico. / Hemorrhagic dengue in Cuba in 1981. Rapid diagnosis of the etiologic agent

A fines de mayo de 1981, en Cuba se produjo en forma explosiva una epidemia de fiebre hemorragica de dengue, con casos de hemorragia grave e incluso shock y muerte.Con objeto de precisar rapidamente el agente etiologico, se realizaron estudios de serologia, empleandose la prueba de inhibicion de hemaglutinacion, como tambien aislamiento virico, con reduccion de placas e inmunofluorescencia indirecta para identificar las cepas aisladas. Los datos obtenidos sugieren que el causante de la epidemia fue el serotipo 2 del virus de dengue, del cual se aislaron cuatro cepas. Sin embargo, aun se desconoce cual pudo haber sido la fuente de esta epidemia, ya que no se habia comunicado ninguna actividad de dengue tipo 2 en la zona, ni en los paises con que Cuba mantiene relaciones estrechas. Por tanto, se alerta a otros paises de la zona para que aumenten su vigilancia, como asimismo el control de Aedes aegypti, con el proposito de evitar situaciones similares