title: Characteristics of mild dengue virus infection in Thai children.
abstract: A four-year longitudinal cohort and geographic cluster study in rural Thailand was conducted to characterize the clinical spectrum of dengue virus (DENV) infection. Symptomatic DENV infections in the cohort were detected by active school absence-based surveillance that triggered cluster investigations around ill cohort children. Data from 189 cohort children with symptomatic DENV infection and 126 contact children in the clusters with DENV infection were analyzed. Of infected contacts, only 19% were asymptomatic; 81% were symptomatic, but only 65.9% reported fever. Symptom-based case definitions were unreliable for diagnosis. Symptomatic infections in contacts were milder with lower DENV RNA levels than the cohort. Infections in contacts with fever history were more likely to have detectable DENV RNA than infections without fever history. Mild infections identified by cluster investigations account for a major proportion of all DENV infections. These findings are relevant for disease burden assessments, transmission modeling, and determination of vaccine impact.
authors.affiliation: Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; University of Massachusetts Medical School, Worcester, Massachusetts; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Entomology, University of California, Davis, Davis, California; Department of Geography, University at Buffalo, Buffalo, New York; Bureau of Epidemiology, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand; Department of Infectious Diseases, State University of New York, Syracuse, Syracuse, New York; Institute for Immunology and Informatics, University of Rhode Island, Providence, Rhode Island; Fogarty International Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: In-Kyu
authors.initials: IK
authors.lastname: Yoon
authors.forename: Anon
authors.initials: A
authors.lastname: Srikiatkhachorn
authors.forename: Laura
authors.initials: L
authors.lastname: Hermann
authors.forename: Darunee
authors.initials: D
authors.lastname: Buddhari
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Scott
authors.forename: Richard G
authors.initials: RG
authors.lastname: Jarman
authors.forename: Jared
authors.initials: J
authors.lastname: Aldstadt
authors.forename: Ananda
authors.initials: A
authors.lastname: Nisalak
authors.forename: Suwich
authors.initials: S
authors.lastname: Thammapalo
authors.forename: Piraya
authors.initials: P
authors.lastname: Bhoomiboonchoo
authors.forename: Mammen P
authors.initials: MP
authors.lastname: Mammen
authors.forename: Sharone
authors.initials: S
authors.lastname: Green
authors.forename: Robert V
authors.initials: RV
authors.lastname: Gibbons
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Endy
authors.forename: Alan L
authors.initials: AL
authors.lastname: Rothman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D015331:Cohort Studies; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D003716:Dengue Virus / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D005334:Fever; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D012367:RNA, Viral / Q000097:blood*; D012424:Rural Population; D013785:Thailand / Q000453:epidemiology
chemical_list: D012367:RNA, Viral