title: Dengue in travelers: kinetics of viremia and NS1 antigenemia and their associations with clinical parameters.
abstract: Despite the increasing numbers of travel-acquired dengue, few studies have assessed virologic markers of the disease in non-endemic populations. We examined the kinetics of diagnostic markers and their associations with clinical parameters in 93 patients with travel-acquired dengue fever. Kinetics analyses suggested a longer average duration for viremia (9 days, CI95%: 8-10) and non-structural protein 1 (NS1) antigenemia (15 days, CI95%: 12-20) than reported in endemic populations. While none of the tests sufficed alone, the best diagnostic coverage was achieved by combining antibody detection with RNA or NS1 testing. Studied by regression models, early relative levels of viremia and NS1 antigenemia proved to be significantly associated with several clinical parameters: high viremia predicted greater likelihood and increased length of hospitalization, the degree of NS1 antigenemia correlated positively with hematocrit and liver transaminases, and both viremia and NS1 antigenemia levels negatively with platelet counts in follow-up. Levels of viremia and NS1 antigenemia may serve as predictors of the clinical manifestations in travel-acquired dengue.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. elina.erra@gmail.com
authors.forename: Elina O
authors.initials: EO
authors.lastname: Erra
authors.forename: Essi M
authors.initials: EM
authors.lastname: Korhonen
authors.forename: Liina
authors.initials: L
authors.lastname: Voutilainen
authors.forename: Eili
authors.initials: E
authors.lastname: Huhtamo
authors.forename: Olli
authors.initials: O
authors.lastname: Vapalahti
authors.forename: Anu
authors.initials: A
authors.lastname: Kantele
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003715:Dengue / Q000097:blood* / Q000276:immunology / Q000821:virology; D003716:Dengue Virus / Q000276:immunology*; D005260:Female; D005387:Finland; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D013997:Time Factors; D014195:Travel; D019562:Viral Load; D017361:Viral Nonstructural Proteins / Q000097:blood*; D014766:Viremia / Q000097:blood* / Q000276:immunology / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral; D017361:Viral Nonstructural Proteins