title: Four Cases of Autochthonous Dengue Infection in Japan and 46 Imported Cases: Characteristics of Japanese Dengue.
abstract: OBJECTIVE
  A dengue outbreak occurred in Japan 2014. We investigated the characteristics of dengue infection among Japanese.
  
  
  METHODS
  We investigated the medical charts retrospectively. Patients The study participants are patients who came to our clinic between 2008 and 2014.
  
  
  RESULTS
  We investigated 4 domestic cases and 46 imported cases of Japanese with laboratory confirmation of dengue. Major symptoms were fever (100%), rash (86%), fatigue (84%), headache (81%), joint pain (66%), muscle pain (49%), and bleeding (6%). A late rash that appeared near the time of fever resolution was observed in 37 cases (74%). A total of 38/43 (88%) cases had low WBC count (<3,500 /μL) during the febrile period, 42/48 (88%) cases had a low platelet (PLT) count (<130×10(3)/μL), and 44/50 (88%) cases had a C-reactive protein (CRP) <2.0 mg/dL.
  
  
  CONCLUSIONS
  Patients with a high fever, late rash, fever-associated leukopenia, low PLT count, low CRP, and elevated aminotransferases are generally suspected of having a dengue infection.
authors.affiliation: Division of Infectious Diseases, Yokohama Municipal Citizen's Hospital, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Yohei
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Amano
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakaharai
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yaita
authors.forename: Tokio
authors.initials: T
authors.lastname: Hoshina
authors.forename: Hanako
authors.initials: H
authors.lastname: Kurai
authors.forename: Shuzo
authors.initials: S
authors.lastname: Usuku
authors.forename: Natsuo
authors.initials: N
authors.lastname: Tachikawa
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D002675:Child, Preschool; D003715:Dengue / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D004196:Disease Outbreaks; D005076:Exanthema / Q000453:epidemiology / Q000209:etiology*; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology*; D006261:Headache / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D063806:Myalgia / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein