Effect of age on outcome of secondary dengue 2 infections.
OBJECTIVE
Dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is a growing global health problem. It is not known how age affects the outcome of secondary dengue infections. In an island setting, a large DHF/DSS outbreak in Cuba occurred in 1981. Involved were individuals, 3-40 year old, whose only lifetime dengue exposure was to DEN-1 in 1977 and DEN-2 in 1981. In this report we calculate age-specific DHF/DSS hospitalization and death rates based on secondary DEN 2 infections.


METHODS
Published and unpublished hospital and seroepidemiologic data from the 1981 DHF/DSS outbreak were used for the analysis.


RESULTS
Children, aged 3 and 4 years, with secondary DEN-2 infections were found to have a high death rate (25.4/10 000 secondary DEN-2 infections). The death rate fell with increasing age, being 15.9-fold lower in the 10-14-year age group. The death rate for children aged 3-14 years was 14.5-fold higher than in young adults aged 15-39 years. The death rate rose somewhat in adults aged 50 years and older. DHF/DSS hospitalization rates showed the same trend as death rates.


CONCLUSIONS
Age is an important variable in the outcome of secondary DEN-2 infections. DHF/DSS case fatality and hospitalization rates are highest in young infants and the elderly. The risk that a child will die during a secondary DEN-2 infection is nearly 15-fold higher than the risk in adults.
Guzmán
María G
MG
Department of Virology, PAHO/WHO Collaborating Center for Viral Diseases, Tropical Medicine Institute of Havana, Cuba.
Kouri
Gustavo
G
Bravo
Jose
J
Valdes
Luis
L
Vazquez
Susana
S
Halstead
Scott B
SB
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003462:Cuba / Q000453:epidemiology; D004198:Disease Susceptibility; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D012306:Risk; D016036:Seroepidemiologic Studies; D019595:Severe Dengue / Q000453:epidemiology / Q000276:immunology / Q000401:mortality*; D012737:Sex Factors