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CURRENT PERSPECTIVE
Year : 2006  |  Volume : 51  |  Issue : 1  |  Page : 57-59
The recent epidemic of dengue fever in West Bengal: Clinico-serological pattern


1 Departments of Pediatric Dermatology, Institute of Child Health, Kolkata, India
2 Departments of Pediatric Medicine, Institute of Child Health, Kolkata, India

Correspondence Address:
Sandipan Dhar
Flat 2A2, Block 2, 5, NSC Bose Road, Kolkata - 700 040
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.25201

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Keywords: Dengue fever, Epidemic, Clinical, Serology


How to cite this article:
Dhar S, Malakar R, Ghosh A, Kundu R, Mukhopadhyay M, Banerjee R. The recent epidemic of dengue fever in West Bengal: Clinico-serological pattern. Indian J Dermatol 2006;51:57-9

How to cite this URL:
Dhar S, Malakar R, Ghosh A, Kundu R, Mukhopadhyay M, Banerjee R. The recent epidemic of dengue fever in West Bengal: Clinico-serological pattern. Indian J Dermatol [serial online] 2006 [cited 2019 Oct 15];51:57-9. Available from: http://www.e-ijd.org/text.asp?2006/51/1/57/25201



  Introduction Top


Dengue virus infection is increasingly recognized as one of the world's major emerging infectious diseases. Dengue virus with four distinct serotypes belongs to the Flaviviridae family and is transmitted by mosquitoes of the genus Aedes. [1],[2],[3]

Infection with any of the four serotypes of dengue virus causes a spectrum of illness ranging from no symptoms or mild fever to severe and fatal hemorrhage and shock depending largely on the patient's age and immunological condition [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]. Classical dengue fever is reported to present with macular or maculopapular rash in half the cases and may also have hemorrhagic manifestations. [4],[5],[6] The most commonly used test for the diagnosis of dengue is the IgM capture ELISA.[7]

We herein report a series of cases of dengue fever with rash in children seen at the Institute of Child Health, Kolkata, a referral pediatric hospital of Eastern India during the dengue epidemic of 2005.


  Materials and Methods Top


Twelve consecutive cases with a probable diagnosis of dengue fever with rash presenting in the out patient department of the Institute of Child Health from July to December 2005 were included in the case series. In each case a detailed history was taken and a careful examination was conducted. IgG and IgM for dengue were also assessed in each case. The probable diagnosis of dengue fever was made on the basis of a combination of clinical, epidemiological and serological features. The parameters of the dengue fever recorded were the duration of fever, the day of onset of fever and onset of rash, the type of rash, the distribution of rash and the IgG and IgM estimates. Cases with fever with features suggesting dengue but without rash were not included in the present case series.

The main objective of the case series is to assess any alteration in the clinical presentation of the cases of dengue fever with rash in the last dengue epidemic of West Bengal in 2005.


  Results Top


The base line demography of the case series is given below [Table - 1] and [Table - 2]


  Discussion Top


As per our observation, the rash in dengue developed mostly on the 3rd to 4th day of fever. The rash was mainly localized to extremities and trunk with some involvement of face. The rash was by and large maculopapular with some hemorrhagic components in some patients. Serological estimates show that IgM positivity for dengue was the principle finding (about 80%) which suggests predominant primary infections as IgM antibodies are the first dengue specific antibodies to be detected after about 4to 5 days of fever while IgG is detectable only after 7 to 10 days.[8] Absence of IgM generally suggests secondary infection.[9] The pattern of rash, its onset and distribution follows the well documented classical pattern.[10] We observed no significant shift in the cutaneous clinical presentation of dengue fever in the last epidemic.

Continuous monitoring of clinical presentations of viral infection is necessary for their inherent propensity of change from one epidemic to another.



 
  References Top

1.Gubler DJ. The global emergence/resurgence of arboviral diseases as public health problems. Arch Med Res 2002;33:330-42  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Idem. Epidemic dengue/dengue hemorrhagic fever as a public health, social and economic problem in the 21st century. Trends Microbiol 2002;10:100-3  Back to cited text no. 2    
3.Halstead SB. Is there an inapparent dengue explosion? Lancet 1999;353:1100-1  Back to cited text no. 3  [PUBMED]  
4.Jelinick T, Muhlberger N, Harms G, et al . Epidemiology and clinical feature of imported dengue fever in Europe: sentinel surveillance data from TropNetEurop. Clin Infect Dis 2002; 35:1047-52.  Back to cited text no. 4    
5.Schwartz E, Mendelson E, Sidi Y.Dengue fever among travelers. Am J Med 1996; 101: 516-20  Back to cited text no. 5    
6.Watt G, Jongsakul K, Chouriyagune C, Paris R. Differentiating dengue virus infection from scrub typhus in thai adults with fever. Am J Trop Med Hyg 2003;68:536-8  Back to cited text no. 6  [PUBMED]  [FULLTEXT]
7.Schertz E, Mileguir F, Grossman Z, Mendelsen E Evaluation of ELISA based sero diagnosis of dengue fever in travelers. J Clin Virol 2000; 19:169-73.  Back to cited text no. 7    
8.Vaughn DW, Green S, Kalayanarooj S, et al .Dengue in the early febrile phase: viremia and antibody responses.J Infect Dis 1997;176:322-30.  Back to cited text no. 8    
9.Guzman MG, Kouri G. Dengue: an update. Lancet Infect Dis 2002; 2:33-42.  Back to cited text no. 9  [PUBMED]  
10.Caumes E, Santi C, Felix H et al . Signes cutanes de la dengue.Apropos detrois cas. Bull Soc Pathol Exot 1993; 86:7-11.  Back to cited text no. 10    


    Figures

[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]

    Tables

[Table - 1], [Table - 2]

This article has been cited by
1 Clinical manifestations of dengue and leptospirosis in children in Mumbai: an observational study
S. A. Zaki, P. Shanbag
Infection. 2010; 38(4): 285
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   Introduction
   Materials and Me...
   Results
   Discussion
   References
   Article Figures
   Article Tables

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