title: Dengue fever outbreak: a clinical management experience.
abstract: OBJECTIVE
  To determine the frequency of dengue as a cause of fever and compare the clinical and haematological characteristics of Dengue-probable and Dengue-proven cases.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  The Combined Military Hospital, Malir Cantt., Karachi, from August 2005 to December 2006.
  
  
  METHODS
  All patients with age above 14 years, who were either hospitalized or treated in medical outdoor clinic due to acute febrile illness, were evaluated for clinical features of Dengue Fever (DF), Dengue haemorrhagic fever (DHF) and Dengue Shock Syndrome (DSS). Patients showing typical clinical features and haematological findings suggestive of Dengue fever (As per WHO criteria) were evaluated in detail for comparison of probable and confirmed cases of Dengue fever. All other cases of acute febrile illness, not showing clinical features or haematological abnormalities of Dengue fever, were excluded. The clinical and laboratory features were recorded on SPSS 11.0 programme and graded where required, for descriptive and statistical analysis.
  
  
  RESULTS
  Out of 5200 patients with febrile illness, 107(2%) presented with typical features of DF, 40/107(37%) were Dengue-proven while 67/107(63%) were Dengue-probable. Out of Dengue-proven cases, 38 were of DF and 2 were of DHF. Day 1 temperature ranged from 99-1050C (mean 1010C). Chills and rigors were noticed in 86 (80%), myalgia in 67%, headache in 54%, pharyngitis in 35%, rash in 28%, and bleeding manifestations in 2% cases. Hepatomegaly in 1(0.5%), lymphadenopathy in 1(0.5%) and splenomegaly in 12 (11.2%) cases. Leucopoenia (count<4x109 /L) was noted in 73%, platelet count<150 x109 /L in 84% and ALT>40 U/L in 57% cases.
  
  
  CONCLUSIONS
  Frequency of clinically suspected dengue virus infection was 107 (2%), while confirmed dengue fever cases were 40 (0.8%) out of 5200 fever cases. Fever with chills and rigors, body aches, headache, myalgia, rash, haemorrhagic manifestations, platelet count, total leukocyte count, and ALT, are parameters to screen the cases of suspected dengue virus infection; the diagnosis cannot be confirmed unless supported by molecular studies or dengue specific IgM .
authors.affiliation: Department of Medicine, Combined Military Hospital, Malir Cantt., Karachi, Pakistan. shahidahmed833@hotmail.com
authors.forename: Shahid
authors.initials: S
authors.lastname: Ahmed
authors.forename: Nadir
authors.initials: N
authors.lastname: Ali
authors.forename: Shahzad
authors.initials: S
authors.lastname: Ashraf
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ilyas
authors.forename: Waheed-Uz-Zaman
authors.initials: WU
authors.lastname: Tariq
authors.forename: Rashid A
authors.initials: RA
authors.lastname: Chotani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D019595:Severe Dengue / Q000175:diagnosis / Q000453:epidemiology*