title: Four dengue virus serotypes found circulating during an outbreak of dengue fever and dengue haemorrhagic fever in Jakarta, Indonesia, during 2004.
abstract: Periodic outbreaks of dengue have emerged in Indonesia since 1968, with the severity of resulting disease increasing in subsequent years. In early 2004, a purported dengue outbreak erupted across the archipelago, with over 50,000 cases and 603 deaths reported. To confirm the disease aetiology and to provide an epidemiological framework of this epidemic, an investigation was conducted in ten hospitals within the capital city of Jakarta. Clinical and laboratory findings were determined from a cohort of 272 hospitalised patients. Exposure to dengue virus was determined in 180 (66.2%) patients. When clinically assessed, 100 (55.6%) of the 180 patients were classified as having dengue fever (DF), 31 (17.2%) as DF with haemorrhagic manifestations and 49 (27.2%) as dengue haemorrhagic fever (DHF). Evidence from haemagglutination inhibition assays suggested that 33/40 (82.5%) of those with DHF from which laboratory evidence was available suffered from a secondary dengue infection. All four dengue viruses were identified upon viral isolation, with DEN-3 being the most predominant serotype recovered, followed by DEN-4, DEN-2 and DEN-1. In summary, the 2004 outbreak of dengue in Jakarta, Indonesia, was characterised by the circulation of multiple virus serotypes and resulted in a relatively high percentage of a representative population of hospitalised patients developing DHF.
authors.affiliation: National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia.
authors.forename: Agus
authors.initials: A
authors.lastname: Suwandono
authors.forename: Herman
authors.initials: H
authors.lastname: Kosasih
authors.lastname: Nurhayati
authors.forename: Rita
authors.initials: R
authors.lastname: Kusriastuti
authors.forename: Syahrial
authors.initials: S
authors.lastname: Harun
authors.forename: Chairin
authors.initials: C
authors.lastname: Ma'roef
authors.forename: Suharyono
authors.initials: S
authors.lastname: Wuryadi
authors.forename: Bambang
authors.initials: B
authors.lastname: Herianto
authors.forename: Djoko
authors.initials: D
authors.lastname: Yuwono
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Porter
authors.forename: Charmagne G
authors.initials: CG
authors.lastname: Beckett
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Blair
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003715:Dengue / Q000453:epidemiology / Q000821:virology*; D003716:Dengue Virus / Q000145:classification* / Q000302:isolation & purification; D004196:Disease Outbreaks; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012703:Serotyping / Q000379:methods; D019595:Severe Dengue / Q000453:epidemiology / Q000821:virology; D012720:Severity of Illness Index; D017678:Sex Distribution
chemical_list: D000914:Antibodies, Viral