Document Detail

The reappearance of dengue-3 and a subsequent dengue-4 and dengue-1 epidemic in Puerto Rico in 1998.
MedLine Citation:
PMID:  12452489     Owner:  NLM     Status:  MEDLINE    
In January 1998, dengue-3 (DEN)-3 (group III genotype) was detected in Puerto Rico after an absence of 20 years. Public health officials intensified education efforts to promote community participation in dengue control. Virologic surveillance revealed an unexpected paradox: DEN-4 and DEN-1 produced a large epidemic overlaying the DEN-3 epidemic. In 1998 there were 17,000 reported cases of dengue (4.8/1,000 persons), and among all virus isolations (n = 960), DEN-4 (419, 43.6%), DEN-1 (337, 35.1%), and DEN-2 (143, 14.9%) were detected much more frequently than DEN-3 (61, 6%). Age group-specific attack rates were highest for persons 10-19 years old, followed by infants less than a year of age. Nineteen fatal cases (median = 37 years old, range = 8 months to 90 years) had a positive laboratory diagnosis of dengue. Among DEN-3 cases no fatalities were documented, 50 were hospitalized, and 10 of 48 (21%) fulfilled the criteria for dengue hemorrhagic fever (four had primary infections and six had secondary infections). During 1999, DEN-3 became the predominant serotype isolated (182 of 310 isolations, 59%). The reappearance of DEN-3 and its subsequent circulation from 1999 to 2001 produced no changes in dengue incidence that could have been detected in the absence of virologic surveillance.
José G Rigau-Pérez; Aurimar Ayala-López; Enid J García-Rivera; Sharon M Hudson; Vance Vorndam; Paul Reiter; Marta P Cano; Gary G Clark
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of tropical medicine and hygiene     Volume:  67     ISSN:  0002-9637     ISO Abbreviation:  Am. J. Trop. Med. Hyg.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-11-27     Completed Date:  2002-12-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370507     Medline TA:  Am J Trop Med Hyg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  355-62     Citation Subset:  AIM; IM    
Dengue Branch, Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico 00920-3860, USA.
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MeSH Terms
Aged, 80 and over
Child, Preschool
Dengue / diagnosis,  epidemiology*,  virology
Dengue Virus / classification,  immunology,  isolation & purification*
Disease Outbreaks*
Enzyme-Linked Immunosorbent Assay
Middle Aged
Puerto Rico / epidemiology

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