title: Dengue Hemorrhagic Fever in a Japanese Traveler with Pre-existing Japanese Encephalitis Virus Antibody.
abstract: An adult Japanese man who had just returned from Thailand developed dengue hemorrhagic fever (DHF). A primary infection of dengue virus (DENV) was confirmed, specifically DENV serotype 2 (DENV-2), on the basis of the detection of the virus genome, a significant increase in the neutralizing antibody and the isolation of DENV-2. DHF is often observed following a secondary infection from another serotype of dengue virus, particularly in children, but this case was a primary infection of DENV. Japan is a non-endemic country for dengue disease. In fact, only Japanese encephalitis (JE) is known to be a member of the endemic flavivirus family. In this study, IgG antibody against Japanese encephalitis virus (JEV) was detected. JEV belongs to the family of dengue virus and prevails in Japan, particularly Kyushu. Among many risk factors for the occurrence of DHF, a plausible candidate could be a cross-reactive antibody-dependent enhancement (ADE) mechanism caused by JEV antibody. This indicates that most Japanese travelers who living in dengue non-endemic areas, particularly Kyushu, should be aware of the occurrence of DHF.
authors.affiliation: Department of Internal and Respirology Medicine, Asakura Medical Association Hospital , Japan.
authors.forename: Rumi
authors.initials: R
authors.lastname: Sato
authors.affiliation: Department of Infection Control and Prevention, Kurume University School of Medicine , Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hamada
authors.affiliation: Department of Infection Control and Prevention, Kurume University School of Medicine , Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Kashiwagi
authors.affiliation: Department of Infection Control and Prevention, Kurume University School of Medicine , Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Imamura
authors.affiliation: Department of Infection Control and Prevention, Kurume University School of Medicine , Japan.
authors.forename: Koyu
authors.initials: K
authors.lastname: Hara
authors.affiliation: Department of Internal and Respirology Medicine, Asakura Medical Association Hospital , Japan.
authors.forename: Munetsugu
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: Department of Internal and Respirology Medicine, Asakura Medical Association Hospital , Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kamimura
authors.affiliation: Laboratory of Neuroviruses, Department of Virology 1, National Institute of Infectious Diseases , Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Takasaki
authors.affiliation: Department of Infection Control and Prevention, Kurume University School of Medicine , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Internal and Respirology Medicine, Asakura Medical Association Hospital , Japan.
authors.forename: Takeharu
authors.initials: T
authors.lastname: Koga
keywords: Japanese encephalitis virus antibody; antibody-dependent enhancement (ADE); cross-reactive antibody; dengue hemorrhagic fever; imported infection; petechiae; thrombocytopenia