title: Dengue fever in US military personnel in Haiti.
abstract: OBJECTIVE
  To describe clinical manifestations and public health implications of an outbreak of dengue fever (DF) during Operation Uphold Democracy, Haiti, 1994.
  
  
  METHODS
  Consecutive sample.
  
  
  METHODS
  Military combat support hospital, Port-au-Prince, Haiti.
  
  
  METHODS
  A total of 101 US military personnel with acute febrile illnesses.
  
  
  METHODS
  A disease surveillance team collected clinical and epidemiologic data from US military clinics throughout Haiti. Febrile patients admitted to the combat support hospital were evaluated with standardized clinical and laboratory procedures. The surveillance team followed patients daily.
  
  
  METHODS
  Arbovirus isolation and specific antibody determination and symptoms and physical findings.
  
  
  RESULTS
  Febrile illnesses accounted for 103 (25%) of the 406 combat support hospital admissions during the first 6 weeks of deployment. All patients with febrile illness recovered. A total of 30 patients had DF; no patient had evidence of infection with malaria. Dengue virus serotypes 1, 2, and 4 were isolated from 22 patients, and 8 patients developed IgM antibody to dengue virus. Patients with DF could not be distinguished from other febrile patients on clinical grounds alone. No arboviruses other than dengue were identified.
  
  
  CONCLUSIONS
  Active surveillance, with clinical and laboratory evaluation directed by an epidemiologic team, led to the timely recognition of an outbreak of febrile illness among US troops in Haiti. Viral isolation and serological studies were essential in confirming DF. During the surveillance period, DF accounted for at least 30% of the febrile illnesses among hospitalized US troops. Dengue fever is a significant threat to military personnel and civilian travelers in Haiti and has the potential for introduction to and transmission in the United States.
authors.affiliation: Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: Trofa
authors.forename: R F
authors.initials: RF
authors.lastname: DeFraites
authors.forename: B L
authors.initials: BL
authors.lastname: Smoak
authors.forename: N
authors.initials: N
authors.lastname: Kanesa-thasan
authors.forename: A D
authors.initials: AD
authors.lastname: King
authors.forename: J M
authors.initials: JM
authors.lastname: Burrous
authors.forename: P O
authors.initials: PO
authors.lastname: MacArthy
authors.forename: C
authors.initials: C
authors.lastname: Rossi
authors.forename: C H
authors.initials: CH
authors.lastname: Hoke
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology*; D003716:Dengue Virus / Q000145:classification / Q000302:isolation & purification*; D004196:Disease Outbreaks; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008889:Military Personnel; D012698:Serologic Tests; D012703:Serotyping; D014481:United States
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M