title: Imported Dengue in The Netherlands.
abstract: Background: The clinical manifestations of imported dengue in adult Western travelers were analyzed. Methods: The charts of all adult patients with dengue, who were seen in an academic hospital in The Netherlands from 1985 to 1994, were studied. Results: Dengue was confirmed in 34 patients by a fourfold rise in complement fixation antibody titer or presence of IgM. Twelve probable cases with a single high titer in the complement fixation test were found. Annual numbers have increased since 1989. Most cases were imported from Asia. Malaise (98%), fever (96%), headache (64%), chills (58%), muscle pain (53%) and arthralgia (44%) were the main symptoms. A noncharacteristic skin eruption was seen in 84%. Leukocytopenia and thrombocytopenia were found in 87% and 75%, respectively during the first week, and elevated serum aminotransferase activities were noted in 75%. Only two patients developed dengue hemorrhagic fever. Conclusions: Dengue in Western travelers is usually a relatively mild disease. Leukocytopenia, thrombocytopenia, and elevation of serum aminotransferase activities are common laboratory features.
authors.affiliation: Division of Infectious Diseases, Tropical Medicine and AIDS, Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
authors.initials: RC
authors.lastname: Bakker
authors.initials: J
authors.lastname: Veenstra
authors.initials: AM
authors.lastname: Dingemans-Dumas
authors.initials: JCFM
authors.lastname: Wetsteyn
authors.initials: PA
authors.lastname: Kager