Early Clinical and Laboratory Indicators of Acute Dengue Illness
S. Kalayanarooja, David W. Vaughnb c d e f g h, Suchitra Nimmannityab c d e f g h, S. Greenb c d e f g h, Saroj Suntayakornb c d e f g h, N. Kunentrasaib c d e f g h, W. Viramitrachaib c d e f g h, S. Ratanachu‐ekeb c d e f g h, S. Kiatpolpojb c d e f g h, Bruce L. Innisb c d e f g h, Alan L. Rothmanb c d e f g h, Ananda Nisalakb c d e f g h, Francis A. Ennisb c d e f g h i✉
- aBangkok Children's Hospital, Department of Virology, Armed Forces Research Institute of Medical Sciences, Thailand
- bArmed Forces Research Institute of Medical Sciences, Bangkok, and
- cBangkok Children's Hospital, Bangkok, Department of Virology
- dDivision Director, Divi-sion of Infectious Diseases and Immunology, University of Massachusetts ing antibody-dependent enhancement of infection [14], com-Medical Center, 55 Lake Ave. N., Worcester, MA 01655
- eDivision of Infectious Diseases and Immunology, University of
- fKamphaeng Phet Provincial Hospital, Kamphaeng Phet, Thailand
- gMassachusetts Medical Center, Worcester, Massachusetts
- hDepartment of Virus Diseases, Walter Reed Army Institute of Research, Washington, DC
- iReprints or correspondence: Dr. Francis A. Ennis, Division Director, Division of Infectious Diseases and Immunology, University of Massachusetts Medical Center, 55 Lake Ave. N., Worcester, MA 01655
- ✉Corresponding author
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Abstract
A prospective observational study was conducted to identify early indicators of acute dengue virus infection. Children with fever for <72 h without obvious cause were studied at hospitals in Bangkok and Kamphaeng Phet, Thailand, until resolution of fever. Of 172 evaluable subjects (91% of enrollees), 60 (35%) had dengue, including 32 with dengue fever (DF) and 28 with dengue hemorrhagic fever (DHF). At enrollment, children with dengue were more likely than children with other febrile illnesses (OFI) to report anorexia, nausea, and vomiting and to have a positive tourniquet test, and they had lower total white blood cell counts, absolute neutrophil and absolute monocyte counts, and higher plasma alanine and aspartate (AST) aminotransferase levels than children with OFI. Plasma AST levels were higher in children who developed DHF than in those with DF. These data identify simple clinical and laboratory parameters that help to identify children with DF or DHF.