Dengue haemorrhagic fever/dengue shock syndrome: an unwelcome arrival in Trinidad - abstract

ABSTRACT

Dengue is endemic throughout most of the Caribbean, and increased activity has been noted within recent times. The co-circulation of dengue virus serotypes 1, 2 and 4 has been a cause of concern regarding the development of dengue shock syndrome/dengue haemorrhagic fever. The clinical presentation, investigate findings and confirmatory evidence for dengue infection in four patients are described. In all cases, there were fever, marked thrombocytopenia and haemoconcentration. The youngest patient was 15 years old and the oldest was 53 years. In two cases, there was no haemorrhagic tendency but profound shock ensued. Bleeding occurred preterminally in one of these. Both patients with dengue shock syndrome died but the two cases of dengue haemorrhagic fever survived. Dengue infection was confirmed serologically in three cases and by viral isolation in the other. This, to our knowledge, is the first report of dengue haemorrhagic fever/dengue shock syndrome in Trinidad, and clinicians should be aware of the clinical features and management. It is also crucial that public health measures be put in place to minimize dengue virus-associated mortality in Trinidad (AU)