Clinical Profiles of Dengue Fever Patients, During an Outbreak
,
Abstract
Background: Dengue fever (DF) has become a major public health concern globally. It is an infection caused by a virus of the family Flaviviridae, with five serotypes (DENV 1–5). Recent years have seen an increase in the prevalence of the disease in Pakistan. The current study was carried out to evaluate the clinical features, laboratory findings and demographic information of the patients reported during the dengue outbreak in Multan of Pakistan in 2015.
Methods: The hospital documentation-based data of confirmed DF cases were collected for the 6 months period from a Tertiary Care Hospital in Multan, Pakistan. The patients were labeled as confirmed on the basis of NS1 and IgM positivity by ELISA. The data collected were analyzed using SPSS.
Results: Overall, 361 patients were investigated (78.67% males and 21.33% females), with maximum infection rate in the age group of 18–35yr (50.41%). Mean hospital stay was 2.64d (SD 1.2), while mean fever duration was 5.27 (SD 1.57). Outbreak occurred during the months from Jul–Dec, while maximum patients were reported in Oct (287). No mortality was reported, and all patients recovered.
Conclusion: Better management practices and timely reporting can reduce the risk factors associated with the disease.
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2. Nathan MB, Dayal-Drager R, Guzman M (2009) Epidemiology, burden of dis-ease and transmission. Dengue guide-lines for diagnosis, treatment, preven-tion and con¬trol. New edition. Geneva, Switzerland. WHO. 1–21. Available at: www.who.int/neglected_diseases/en
3. Thavara U, Tawatsin A, Chansang C, Kong-ngamsuk W, Paosriwong S, Boon-Long J, Rongsriyam Y, Komal¬amisra N (2001) Larval occurrence, oviposition behavior and biting activity of poten-tial mosquito vectors of den¬gue on Samui Island, Thailand. J Vec¬tor Ecol. 26(2): 172–180.
4. Chen LH, Wilson ME (2010) Dengue and chikungunya infections in travelers. Curr Opin Infect Dis. 23(5): 438–444.
5. Gubler DJ (1998) Dengue and dengue hem¬orrhagic fever. Clin Microbiol Rev. 11 (3): 480–496.
6. Mustafa MS, Rasotgi V, Jain S, Gupta V (2015) Discovery of fifth serotype of dengue virus (DENV-5): A new public health dilemma in dengue control. Med J Armed Forces India. 71(1): 67–70.
7. Mackenzie JS, Gubler DJ, Petersen LR (2004) Emerging flaviviruses: the spread and resurgence of Japanese en-cephali¬tis, West Nile and dengue vi-ruses. Nat Med. 10(12): 98–109.
8. Halstead SB (1988) Pathogenesis of den¬gue: challenges to molecular biology. Science. 239(4839): 476–481.
9. Henchal EA, Putnak JR (1990) The den-gue viruses. Clin Microbiol Rev. 3(4): 376–396.
10. Lee MS, Hwang KP, Chen TC, Lu PL, Chen TP (2006) Clinical characteris-tics of dengue and dengue hemorrhag-ic fe¬ver in a medical center of south-ern Tai¬wan during the 2002 epidemic. J Microbiol Immunol Infect. 39(2): 121–129.
11. Sharp TW, Wallace MR, Hayes CG, Sanchez JL, DeFraites RF, Arthur RR, Thornton SA, Batchelor RA, Rozmajzl PJ, Hanson RK, et al. (1995) Dengue fever in US Troops during operation restore hope, Somalia, 1992–1993. Am J Trop Med Hyg. 53(1): 89–94.
12. Brady OJ, Gething PW, Bhatt S, Messi-na
JP, Brownstein JS, Hoen AG, Moyes CL, Farlow AW, Scott TW, Hay SI (2012) Refining the global spatial limits of den¬gue virus transmission by evi¬dence-based consensus. PLoS Negl Trop Dis. 6(8): e1760
13. Plummer RS, Kulkarni RP, Sethi A (2016) Dengue fever: the fundamen-tals. J Pakistan Assoc Dermatologists. 19(3): 127–130.
14. Deshwal R, Qureshi MI, Singh R (2015) Clinical and laboratory profile of den-gue fever. J Assoc Physicians India. 63 (12): 30–32.
15. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, Sonnenburg FV, Key¬stone JS, Pandey P, Cetron MS (2006) Spectrum of disease and rela-tion to place of exposure among ill re-turned travelers N Engl J Med. 354(2): 119–130.
16. Jahan F (2011) Dengue fever (DF) in Pa-kistan. Asia Pac Fam Med. 10(1): 1–4.
17. Akram DS, Igarashi A, Takasu T (1998) Dengue virus infection among chil-dren with undifferentiated fever in Ka-rachi. Indian J Pediatr. 65(5): 735–740.
18. Paul RE, Patel AY, Mirza S, Fisher-Hoch SP, Luby SP (1998) Expansion of epidem-ic dengue viral infections to Pakistan. Int J Infect Dis. 2(4): 197–201.
19. Khanani MR, Arif A, Shaikh R (2011) Den-gue in Pakistan: Journey from a dis-ease free to a hyper endemic nation. J Dow Univ Heal Sci. 5(3): 81–84.
20. Rasheed SB, Butlin RK, Boots M (2013) A review of dengue as an emerging disease in Pakistan. Public Health. 127 (1): 11–17.
21. Contributors W (2018) Multan. Wikipedia, The Free Encyclopedia. [cited 2018 Apr 15]. Available at: https://en.wikipedia.org/w/index.php?title=Multan&oldid=836194785
22. Faisal M, Tayyab B, Mohammad A (2012) Dengue GCP guidelines. Lahore. Avail¬able at: http://www.sims.edu.pk/Dengue/DengueGCPGUIDELINES.pdf
23. Khan J, Khan I, Amin I (2016) A com-prehensive entomological, serological and molecular study of 2013 dengue outbreak of Swat, Khyber Pakh¬tunkhwa, Pakistan. PLoS One. 11(2): e0147416.
24. Kale AV, Haseeb M, Sandeep Reddy C, Khan S, Golwalkar A, Badaam KM (2014) Clinical Pro¬file and Outcome of Dengue Fever from a Tertiary Care Cen¬tre at Au¬rangabad Maharashtra In-dia: An Observational Study. IOSR-JDMS. 13(9): 14–19.
25. Malavige GN, Velathanthiri VG, Wijew-ickrama ES, Fernando S, Jayaratne SD, Aaskov J, Seneviratne SL (2006) Pat¬terns of disease among adults hos-pital¬ized with dengue infections. J Assoc Phy¬sicians India. 99(5): 299–305.
26. Bandyopadhyay B, Bhattacharyya I, Ad-hikary S, Konar J, Dawar N, Sarkar J, Mondal S, Singh Chauhan M, Bhattachar¬ya N, Chakravarty A, Biswas A (2013) A comprehensive study on the 2012 den-gue fever out¬break in Kolkata, India. ISRN Virol. 2013: 207580.
27. Jayarajah U, de Silva PK, Jayawardana P, Dissanayake U, Kulatunga A, Fer¬nan¬do H, Perera L, Kannangara V, Udayanga-ni C, Peiris R, Faizer S (2018) Pattern of dengue virus infec¬tions in adult pa-tients from Sri Lanka. Trans R Soc Trop Med Hyg. 112(3): 144–153.
28. Thaher MA, Ahmad SR, Chandrasekhar A (2016) Clinical presentation and out¬come of dengue cases in a tertiary-care hospital, Hyderabad. Int J Med Sci Public Heal. 5(10): 2009–2012.
29. Khan J, Khan A (2015) Incidence of den¬gue in 2013: dengue outbreak in District Swat, Khyber Pakhtunkhwa, Pakistan. Inter J Fauna Biolo Stud. 2(1): 1–7.
30. Mohan DK, Shiddappa DM, Dhananjaya M (2013) A study of clinical profile of dengue fever in a tertiary care teach-ing hospital. Sch J App Med Sci. 1(4): 280–282.
31. Sarkar A, Taraphdar D, Chatterjee S (2012) Molecular typing of dengue vi¬rus cir-culating in Kolkata, India in 2010. J Trop Med. 2012: 960329.
32. García-Rivera EJ, Rigau-Pérez JG (2003) Dengue severity in the elderly in Puer-to Rico. Rev Panam Salud Pub¬lica. 13 (6): 362–368.
33. Narayanan M, Aravind MA, Thilotham-mal N, Prema R, Sargunam CR, Rama-murty N (2002) Dengue fever ep-idemic in Chennai-a study of clinical profile and outcome. Indian Pediatr. 39(11): 1027–1033.
34. Keating J (2001) An investigation into the cyclical incidence of dengue fever. Soc Sci Med. 53(12): 1587–1597.
35. Wang C, Jiang B, Fan J, Wang F, Liu Q (2014) A study of the dengue epidemic and meteorological factors in Guang-zhou, China, by using a zero-inflated Poisson regression model. Asia Pac J Public Health. 26(1): 48–57.
36. Sang S, Yin W, Bi P, Zhang H, Wang C, Liu X, Chen B, Yang W, Liu Q (2014) Predicting local dengue transmission in Guangzhou, China, through the influence of imported cases, mosquito density and climate variability. PloS One. 9(7): e102755.
37. Wang SM, Sekaran SD (2010) Early diagnosis of Dengue infection using a commercial Dengue Duo rapid test kit for the detection of NS1, IGM, and IGG. Am J Trop Med Hyg. 83(3): 690–695.
38. Tewari K, Tewari VV, Mehta R (2018) Clinical and hematological profile of patients with dengue fever at a tertiary care hospital–an observational study. Mediterr J Hematol Infect Dis. 10(1): e2018021.
39. Ratageri VH, Shepur TA, Wari PK, Chavan SC, Mujahid IB, Yergolkar PN (2005) Clinical profile and outcome of dengue fever cases. Indian J Pediatr. 72(8): 705–706.
40. Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR (2011) Clinical profile of dengue infection at a teaching hospital in North India. J Infect Dev Ctries. 6 (7): 551–554.
2. Nathan MB, Dayal-Drager R, Guzman M (2009) Epidemiology, burden of dis-ease and transmission. Dengue guide-lines for diagnosis, treatment, preven-tion and con¬trol. New edition. Geneva, Switzerland. WHO. 1–21. Available at: www.who.int/neglected_diseases/en
3. Thavara U, Tawatsin A, Chansang C, Kong-ngamsuk W, Paosriwong S, Boon-Long J, Rongsriyam Y, Komal¬amisra N (2001) Larval occurrence, oviposition behavior and biting activity of poten-tial mosquito vectors of den¬gue on Samui Island, Thailand. J Vec¬tor Ecol. 26(2): 172–180.
4. Chen LH, Wilson ME (2010) Dengue and chikungunya infections in travelers. Curr Opin Infect Dis. 23(5): 438–444.
5. Gubler DJ (1998) Dengue and dengue hem¬orrhagic fever. Clin Microbiol Rev. 11 (3): 480–496.
6. Mustafa MS, Rasotgi V, Jain S, Gupta V (2015) Discovery of fifth serotype of dengue virus (DENV-5): A new public health dilemma in dengue control. Med J Armed Forces India. 71(1): 67–70.
7. Mackenzie JS, Gubler DJ, Petersen LR (2004) Emerging flaviviruses: the spread and resurgence of Japanese en-cephali¬tis, West Nile and dengue vi-ruses. Nat Med. 10(12): 98–109.
8. Halstead SB (1988) Pathogenesis of den¬gue: challenges to molecular biology. Science. 239(4839): 476–481.
9. Henchal EA, Putnak JR (1990) The den-gue viruses. Clin Microbiol Rev. 3(4): 376–396.
10. Lee MS, Hwang KP, Chen TC, Lu PL, Chen TP (2006) Clinical characteris-tics of dengue and dengue hemorrhag-ic fe¬ver in a medical center of south-ern Tai¬wan during the 2002 epidemic. J Microbiol Immunol Infect. 39(2): 121–129.
11. Sharp TW, Wallace MR, Hayes CG, Sanchez JL, DeFraites RF, Arthur RR, Thornton SA, Batchelor RA, Rozmajzl PJ, Hanson RK, et al. (1995) Dengue fever in US Troops during operation restore hope, Somalia, 1992–1993. Am J Trop Med Hyg. 53(1): 89–94.
12. Brady OJ, Gething PW, Bhatt S, Messi-na
JP, Brownstein JS, Hoen AG, Moyes CL, Farlow AW, Scott TW, Hay SI (2012) Refining the global spatial limits of den¬gue virus transmission by evi¬dence-based consensus. PLoS Negl Trop Dis. 6(8): e1760
13. Plummer RS, Kulkarni RP, Sethi A (2016) Dengue fever: the fundamen-tals. J Pakistan Assoc Dermatologists. 19(3): 127–130.
14. Deshwal R, Qureshi MI, Singh R (2015) Clinical and laboratory profile of den-gue fever. J Assoc Physicians India. 63 (12): 30–32.
15. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, Sonnenburg FV, Key¬stone JS, Pandey P, Cetron MS (2006) Spectrum of disease and rela-tion to place of exposure among ill re-turned travelers N Engl J Med. 354(2): 119–130.
16. Jahan F (2011) Dengue fever (DF) in Pa-kistan. Asia Pac Fam Med. 10(1): 1–4.
17. Akram DS, Igarashi A, Takasu T (1998) Dengue virus infection among chil-dren with undifferentiated fever in Ka-rachi. Indian J Pediatr. 65(5): 735–740.
18. Paul RE, Patel AY, Mirza S, Fisher-Hoch SP, Luby SP (1998) Expansion of epidem-ic dengue viral infections to Pakistan. Int J Infect Dis. 2(4): 197–201.
19. Khanani MR, Arif A, Shaikh R (2011) Den-gue in Pakistan: Journey from a dis-ease free to a hyper endemic nation. J Dow Univ Heal Sci. 5(3): 81–84.
20. Rasheed SB, Butlin RK, Boots M (2013) A review of dengue as an emerging disease in Pakistan. Public Health. 127 (1): 11–17.
21. Contributors W (2018) Multan. Wikipedia, The Free Encyclopedia. [cited 2018 Apr 15]. Available at: https://en.wikipedia.org/w/index.php?title=Multan&oldid=836194785
22. Faisal M, Tayyab B, Mohammad A (2012) Dengue GCP guidelines. Lahore. Avail¬able at: http://www.sims.edu.pk/Dengue/DengueGCPGUIDELINES.pdf
23. Khan J, Khan I, Amin I (2016) A com-prehensive entomological, serological and molecular study of 2013 dengue outbreak of Swat, Khyber Pakh¬tunkhwa, Pakistan. PLoS One. 11(2): e0147416.
24. Kale AV, Haseeb M, Sandeep Reddy C, Khan S, Golwalkar A, Badaam KM (2014) Clinical Pro¬file and Outcome of Dengue Fever from a Tertiary Care Cen¬tre at Au¬rangabad Maharashtra In-dia: An Observational Study. IOSR-JDMS. 13(9): 14–19.
25. Malavige GN, Velathanthiri VG, Wijew-ickrama ES, Fernando S, Jayaratne SD, Aaskov J, Seneviratne SL (2006) Pat¬terns of disease among adults hos-pital¬ized with dengue infections. J Assoc Phy¬sicians India. 99(5): 299–305.
26. Bandyopadhyay B, Bhattacharyya I, Ad-hikary S, Konar J, Dawar N, Sarkar J, Mondal S, Singh Chauhan M, Bhattachar¬ya N, Chakravarty A, Biswas A (2013) A comprehensive study on the 2012 den-gue fever out¬break in Kolkata, India. ISRN Virol. 2013: 207580.
27. Jayarajah U, de Silva PK, Jayawardana P, Dissanayake U, Kulatunga A, Fer¬nan¬do H, Perera L, Kannangara V, Udayanga-ni C, Peiris R, Faizer S (2018) Pattern of dengue virus infec¬tions in adult pa-tients from Sri Lanka. Trans R Soc Trop Med Hyg. 112(3): 144–153.
28. Thaher MA, Ahmad SR, Chandrasekhar A (2016) Clinical presentation and out¬come of dengue cases in a tertiary-care hospital, Hyderabad. Int J Med Sci Public Heal. 5(10): 2009–2012.
29. Khan J, Khan A (2015) Incidence of den¬gue in 2013: dengue outbreak in District Swat, Khyber Pakhtunkhwa, Pakistan. Inter J Fauna Biolo Stud. 2(1): 1–7.
30. Mohan DK, Shiddappa DM, Dhananjaya M (2013) A study of clinical profile of dengue fever in a tertiary care teach-ing hospital. Sch J App Med Sci. 1(4): 280–282.
31. Sarkar A, Taraphdar D, Chatterjee S (2012) Molecular typing of dengue vi¬rus cir-culating in Kolkata, India in 2010. J Trop Med. 2012: 960329.
32. García-Rivera EJ, Rigau-Pérez JG (2003) Dengue severity in the elderly in Puer-to Rico. Rev Panam Salud Pub¬lica. 13 (6): 362–368.
33. Narayanan M, Aravind MA, Thilotham-mal N, Prema R, Sargunam CR, Rama-murty N (2002) Dengue fever ep-idemic in Chennai-a study of clinical profile and outcome. Indian Pediatr. 39(11): 1027–1033.
34. Keating J (2001) An investigation into the cyclical incidence of dengue fever. Soc Sci Med. 53(12): 1587–1597.
35. Wang C, Jiang B, Fan J, Wang F, Liu Q (2014) A study of the dengue epidemic and meteorological factors in Guang-zhou, China, by using a zero-inflated Poisson regression model. Asia Pac J Public Health. 26(1): 48–57.
36. Sang S, Yin W, Bi P, Zhang H, Wang C, Liu X, Chen B, Yang W, Liu Q (2014) Predicting local dengue transmission in Guangzhou, China, through the influence of imported cases, mosquito density and climate variability. PloS One. 9(7): e102755.
37. Wang SM, Sekaran SD (2010) Early diagnosis of Dengue infection using a commercial Dengue Duo rapid test kit for the detection of NS1, IGM, and IGG. Am J Trop Med Hyg. 83(3): 690–695.
38. Tewari K, Tewari VV, Mehta R (2018) Clinical and hematological profile of patients with dengue fever at a tertiary care hospital–an observational study. Mediterr J Hematol Infect Dis. 10(1): e2018021.
39. Ratageri VH, Shepur TA, Wari PK, Chavan SC, Mujahid IB, Yergolkar PN (2005) Clinical profile and outcome of dengue fever cases. Indian J Pediatr. 72(8): 705–706.
40. Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR (2011) Clinical profile of dengue infection at a teaching hospital in North India. J Infect Dev Ctries. 6 (7): 551–554.
| Files | ||
| Issue | Vol 13 No 2 (2019) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/jad.v13i2.1238 | |
| Keywords | ||
| Dengue fever Outbreak Public health Vector-borne diseases | ||
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How to Cite
1.
Saba S, Khan AUR, Naeem-Ullah U, Bokhari SHM. Clinical Profiles of Dengue Fever Patients, During an Outbreak. J Arthropod Borne Dis. 2018;13(2):126-134.
