title: Incidence and risk factors of probable dengue virus infection among Dutch travellers to Asia.
abstract: We studied the incidence of dengue virus (DEN) infections in a cohort of Dutch short-term travellers to endemic areas in Asia during 1991-92. Sera were collected before and after travel. All post-travel sera were tested for DEN immunoglobulin M (IgM) [IgM capture (MAC)-enzyme-linked immunosorbent assay (ELISA)] and IgG (indirect ELISA). Probable DEN infection was defined as IgM seroconversion or a fourfold rise in IgG ratio in the absence of cross-reaction with antibody to Japanese encephalitis virus (JEV). Infections were considered clinically apparent in case of febrile illness (> 24 H) with headache, myalgia, arthralgia or rash. Probable DEN infection was found in 13 of 447 travellers (incidence rate 30/1000 person-months, 95% CI 17.4-51.6). One infection was considered secondary; no haemorrhagic fever occurred. The clinical-to-subclinical infection rate was 1 : 3.3. The risk of infection showed marked seasonal variation. DEN infections are frequent in travellers to endemic areas in Asia; most remain subclinical.
authors.affiliation: Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, The Netherlands. cobelensf@kncvtbc.nl
authors.forename: Frank G J
authors.initials: FG
authors.lastname: Cobelens
authors.forename: Jan
authors.initials: J
authors.lastname: Groen
authors.forename: Albert D M E
authors.initials: AD
authors.lastname: Osterhaus
authors.forename: Anne
authors.initials: A
authors.lastname: Leentvaar-Kuipers
authors.forename: Pauline M E
authors.initials: PM
authors.lastname: Wertheim-van Dillen
authors.forename: Piet A
authors.initials: PA
authors.lastname: Kager
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000302:isolation & purification*; D001208:Asia; D003715:Dengue / Q000453:epidemiology* / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012621:Seasons; D011795:Surveys and Questionnaires; D014195:Travel
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M