查看文章

A large outbreak of dengue fever (DF)/dengue haemorrhagic fever (DHF) occurred in Dhaka city, Bangladesh, in 2000. The present study was conducted on 105 clinically-suspected cases of DF to confirm the diagnosis, determine the major clinical manifestations and correlate the haemorrhagic manifestations with different dengue serotypes circulating during the outbreak. A total of 97 cases were positive for anti-dengue IgM and were considered as recent dengue infection; 52.6% patients had secondary and 47.4% had primary dengue infection. According to WHO case-definition, 79 cases were classified as DF, 17 as DHF and 1 as DSS. Among the 18 DHF/DSS cases, 14 had secondary and 4 had primary type of antibody response. The mean age of the dengue patients was 29.2±12.9 years and most of them (37.1%) belonged to the 20-29-year age group. All the clinically-suspected patients had fever ranging from 100-104 ºF, but the secondary dengue fever patients had higher (101.6±1.4 ºF) mean body temperature. Common complaints included myalgia (84.5%), headache (82.5%), arthralgia (68.0%), lethargy (80.4%) and retro-orbital pain (49.5%). Rash, especially maculopapular type, was significantly higher in primary infection (P< 0.01), while hepatomegaly was higher in secondary infections (P< 0.01). Haemorrhagic manifestations were observed both in primary and secondary dengue patients and were mostly associated with serotypes DEN-3. In 22.7% of cases, the platelet count was< 1x105/mm3 and was associated more with secondary infection. Haematocrit more than 45% was found in 16.5% patients and a significantly higher …