title: Differences in dengue severity in infants, children, and adults in a 3-year hospital-based study in Nicaragua.
abstract: To investigate age-related differences in dengue severity, 114 infants, 1,211 children, and 346 adults with laboratory-confirmed dengue virus (DEN) infections presenting to three hospitals in major urban centers in Nicaragua were recruited from 1999 to 2001. The age distribution of dengue cases and the circulating serotype (predominantly DEN2) were representative of national data. Similar results were obtained when either dengue hemorrhagic fever/dengue shock syndrome or its principal manifestations (vascular permeability, internal hemorrhage, marked thrombocytopenia, and/or shock) were analyzed in relation to age and immune status. The burden of disease and of severe dengue was found predominantly in infants 4-9 months of age and in children 5-9 years old, and secondary DEN infection was a risk factor for severity in children. Age-related differences were identified in the prevalence of specific clinical manifestations as well as in their association with a confirmed DEN diagnosis. This represents one of the few comprehensive studies to analyze characteristics of dengue in infants, children, and adults in the same population and highlights age-related differences in dengue severity.
authors.affiliation: Division of Infectious Diseases, School of Public Health, University of California, Berkeley, California 94720-7360, USA.
authors.forename: Samantha Nadia
authors.initials: SN
authors.lastname: Hammond
authors.forename: Angel
authors.initials: A
authors.lastname: Balmaseda
authors.forename: Leonel
authors.initials: L
authors.lastname: Pérez
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Tellez
authors.forename: Saira Indira
authors.initials: SI
authors.lastname: Saborío
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Mercado
authors.forename: Elsa
authors.initials: E
authors.lastname: Videa
authors.forename: Yoryelin
authors.initials: Y
authors.lastname: Rodriguez
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Pérez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cuadra
authors.forename: Soraya
authors.initials: S
authors.lastname: Solano
authors.forename: Julio
authors.initials: J
authors.lastname: Rocha
authors.forename: Wendy
authors.initials: W
authors.lastname: Idiaquez
authors.forename: Alcides
authors.initials: A
authors.lastname: Gonzalez
authors.forename: Eva
authors.initials: E
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003715:Dengue / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009527:Nicaragua / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index