title: Serotype-specific differences in clinical manifestations of dengue.
abstract: Dengue, the most prevalent arthropod-borne viral disease of humans, is caused by four serotypes of dengue virus (DENV 1-4). Although all four DENV serotypes cause a range of illness, defining precisely which clinical characteristics are associated with the distinct serotypes has been elusive. A cross-sectional study was conducted on 984 and 313 hospitalized children with confirmed DENV infections during two time periods, respectively, in the same hospitals in Nicaragua: a 3-year period (1999-2001) when DENV-2 accounted for 96% of the viruses identified, and the 2003 dengue season when DENV-1 predominated (87% of identified serotypes). When the two periods were compared, more shock (OR 1.91, 95% CI 1.35-2.71) and internal hemorrhage (OR 2.05, CI 1.16-3.78) were observed in the period when DENV-2 predominated, whereas increased vascular permeability was associated to a greater degree with the DENV-1 period (OR 2.36, CI 1.80-3.09). Compared with the DENV-2 period, the DENV-1 season was associated with more hospitalized primary dengue cases (OR 3.86, CI 2.72-5.48) and more primary DENV infections with severe manifestations (OR 2.93, CI 2.00-4.28). These findings provide new data to characterize the pathogenic potential of distinct DENV serotypes in human populations.
authors.affiliation: Departamento de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Managua, Nicaragua.
authors.forename: Angel
authors.initials: A
authors.lastname: Balmaseda
authors.forename: Samantha N
authors.initials: SN
authors.lastname: Hammond
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: Ricardo
authors.initials: R
authors.lastname: Cuadra
authors.forename: Julio
authors.initials: J
authors.lastname: Rocha
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Pérez
authors.forename: Sheyla
authors.initials: S
authors.lastname: Silva
authors.forename: Crisanta
authors.initials: C
authors.lastname: Rocha
authors.forename: Eva
authors.initials: E
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003715:Dengue / Q000097:blood / Q000145:classification* / Q000473:pathology / Q000821:virology; D003716:Dengue Virus / Q000254:growth & development*; D005260:Female; D006400:Hematocrit; D006470:Hemorrhage / Q000473:pathology / Q000821:virology; D006801:Humans; D007223:Infant; D008297:Male; D010976:Platelet Count; D012703:Serotyping; D012769:Shock / Q000473:pathology / Q000821:virology; D013921:Thrombocytopenia / Q000473:pathology / Q000821:virology
chemical_list: D000914:Antibodies, Viral