clinical manifestations of dengue fever slideshare

Found insideAnalysing the latest data on the environment-disease nexus and the devastating impact of environmental hazards and risks on global health, backed up by expert opinion, this report covers more than 130 diseases and injuries. patients with dengue If dengue in the differential diagnosis, do not use aspirin or other NSAIDs until afebrile 48 hours and no dengue warning signs* Use acetaminophen for initial fever and pain control Persistent joint pain may benefit from the use of NSAIDs, corticosteroids, or physiotherapy but no clinical trials The PCR was undertaken at 50°C for 30 min, 94°C for 2 min and 45 cycles of (94°C for 15 sec, 50°C for 30 sec and 68°C for 1 min) followed by an extension reaction at 68°C for 5 min. The global prevalence of dengue cases has increased in South-East Asia, Africa, the Western Pacific, and the Americas. Headache • Body malaise • Myalgia • Arthralgia • Retro-orbital pain • Anorexia • Nausea • Vomiting • Diarrhea • Flushed skin • Rash (petechial, Hermann's sign) AND • Laboratory test, at least CBC (leucopenia with or without thrombocytopenia) and/or dengue NS1 antigen test or dengue IgM antibody test (optional) Critical . It may also be biphasic and have a remittent pattern or be low grade. The patients' demographic data, underlying diseases, clinical manifestations, laboratory data, and disease outcomes were retrospectively analyzed. 1. can include sudden onset of fever, extreme tiredness, intense headache, muscle and joint pain, loss of appetite, vomiting, diarrhoea, abdominal . Methods All children (0-12 y of age) diagnosed and confirmed as dengue fever at a tertiary care hospital at Puducherry, between the 1st of August 2012 and January 31st 2015 were reviewed retrospectively from hospital case records as per the revised World Health Organization (WHO) guidelines . Suppiah J, Ching SM, Amin-Nordin S, Mat-Nor LA, Ahmad-Najimudin NA, Low GK, Abdul-Wahid MZ, Thayan R, Chee HY. No, Is the Subject Area "Epidemiology" applicable to this article? Privacy, Help Dengue is a mosquito-transmitted virus that causes dengue fever, a flu-like illness. In order to avoid dengue clinical misdiagnosis with Zika, laboratory in vitro diagnostics covering the . Dengue Classic dengue fever is characterized by: High persistent fever which usually fails to touch the baseline normal temperature . This reflected a serotype shift replacing the formerly predominant DENV 2 prior to the outbreak. 2016;3:613-6. This comparison is particularly important to further aid in the early prediction of a patient’s condition based on the clinical characteristics and information on the serotype and genotype of the dengue virus infecting the patient. All the aforementioned results showed that there were differences in clinical manifestations of dengue patients relating to the serotype owing to the differences in terms of year of study and level of endemicity in particular regions. A majority of the study subjects that were infected with DENV 1 (57/68; 98.3%) and DENV 2 (26/27; 96.3%) had primary infection. Several studies have evaluated the accuracy of infection status assignment using this method. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are more and more being reported recently. Supervision, 1 Dengue infection causes a range of severe and non-severe clinical manifestations. Found insideThis handbook is an updated edition of 'Management of severe and complicated malaria', providing practical guidance on the diagnosis and management of severe falciparum malaria, a form of the disease that can have life-threatening ... This guide describes how to quantify mortality and morbidity caused by malnutrition at national and local levels. Epub 2012 Jun 21. The dengue strains from genotype III branched into two clades whereas genotype I strains were clustered together. These two cases were presented with severe organ impairment and shock (dengue shock syndrome), respectively. The DENV 3 strains in our study were divided into genotype I and genotype III. Once the number of cases decline, the persistent serotype is again replaced by another serotype. During the study period, predominant dengue serotype and genotype were found to be DENV 1 genotype I. Additionally, non-severe clinical manifestations were commonly observed in patients infected with DENV 1 and DENV 3. Moreover, the information on the history and clinical presentation of the patients were unlikely to be of these diseases. The data also signified that DENV 3-infected patients suffered from myalgia and arthralgia. io: dx.doi.org/10.17504/protocols.io.rabd2an. Although only a small number of studies investigated the association between the serotype of dengue virus and clinical manifestations, none of these studies included analyses on dengue genotypes. The disease is found in approximately 50 million people worldwide annually and 2.5 billion in dengue endemic countries [].The data from the population of Thailand from 1 January 2016 to 20 November 2016 shows a total of 34,677 cases, a morbidity rate of .01/100,000 population []. In India, the . These samples, however, were not tested for other closely related co-infections such as Zika or Chikungunya due to budgetary constraints. Diseases with similar symptoms include influenza, measles, rubella, malaria . A smaller portion of those infected experience the more severe dengue hemorrhagic fever/shock syndrome (DHF/DSS), which can cause high fever, pain, bleeding, a drop in blood pressure, and, in some cases, coma or death. Google Scholar 45. Rao P, Basavaprabhu A, Shenoy S, Dsouza NV, Sridevi Hanaganahalli B, Kulkarni V. Int J Microbiol. Supervision, Background and purpose: We identified an etiological agent in 121 (47.5%) patients, DENV was detected in 30.4% of . A predominantly circulating dengue serotype before an outbreak is replaced by another serotype which persists towards the end of the outbreak. An association was also found between genotype I of DENV 3 and myalgia. The comparison between genotypes also exhibited that genotype III of DENV 3 may appear to be more virulent than genotype I. To the best of the researcher’s knowledge, this is the first observational study to investigate the relationship between dengue serotype and genotype with patients’ clinical manifestation during the recent outbreak peri-od among Malaysians. Chi-square or Fisher’s Exact test was performed to analyze the significance of the categorical variables. Predictors of dengue-related mortality in young adults in a tertiary care centre in North India. The dengue confirmation criteria incorporated the results from the NS1 antigen rapid test, with or without Dengue IgM/IgG rapid combo tests performed by the hospitals. https://doi.org/10.1371/journal.pntd.0006817.t001, https://doi.org/10.1371/journal.pntd.0006817.t002. [PROTOCOL DOI], The partial E gene of dengue virus was amplified before sequencing by using four sets of serotype-specific oligonucleotides [11]. However, there was a seemingly interesting pattern of circulation during outbreak period whereby major outbreaks were likely to follow the switching of DENV serotypes [12]. An RT-PCR panel for rapid serotyping of dengue virus serotypes 1 to 4 in human serum and mosquito on a field-deployable PCR system. tory of a clinical diagnosis of MFS [10], but were nega-tive in our patient supporting the hypothesis of direct viral neurotropism rather than immune-mediated injury. As for DENV 2 Cosmopolitan genotype, the current outbreak strains diverged into clades, indicating minor evolution. Re-ports . Patients with DENV-3 had their lowest levels of white blood cells and platelets, and peak plasma activated partial thromboplastin time (aPTT) 1 day later than patients with DENV-2. The fever is transmitted through the bite of a mosquito harbouring the dengue virus. Eye pain. This book summarizes the rationale for the parameters and conditions that should be taken into consideration in the education and selection of blood donors, in order to allow blood service staff, community volunteers and prospective blood ... However, the study has limitations as well. The fever usually lasts up to a week and may come and go. Conceptualization, The purified PCR amplicons were outsourced for Sanger Sequencing (1st Base, IDT, Singapore). The distribution of these serotypes by year of infection is shown in Fig 2. All patients’ data were totally anonymous and requested from clinicians involved in this study. Pathophysiology and pathogenesis of Dengue Hemorrhagic Fever. Not only that, there was underrepresentation of certain serotypes in this study due to the small numbers such as DENV 4 causing it to be omitted from the statistical analysis. The existing trend contended that serotype replacement, most probably with DENV 3 is predicted to take place once the current outbreak subsides. Since then, Malaysia has increasingly become popular for perpetual dengue endemic issues, resulting from the continuous rise in reported dengue infection cases. Dengue fever is an arboviral infection spread by the Aedes mosquito with a wide spectrum of presentations encompassing simple flu-like illness to hemorrhagic manifestations. Wahid S, Sanusi S, Zawawi M. A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classic dengue fever. Infection by DENV-2 more commonly occurred as a secondary infection, while infection by DENV-3 was more common as a primary infection (p < 0.001). https://doi.org/10.1371/journal.pntd.0006817.g003, https://doi.org/10.1371/journal.pntd.0006817.g004, https://doi.org/10.1371/journal.pntd.0006817.g005, https://doi.org/10.1371/journal.pntd.0006817.g006. Our findings on secondary infection rate was different from the above study based on two aspects. [2, 3]. Adult patients with DENV-2 and DENV-3 who were treated at Kaohsiung Medical University Hospital and Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan, from January 1998 to September 2007 were enrolled. In the primary infection group, the percentage of severe and non-severe dengue cases was 16.5% (16/97) and 83.5% (81/97), respectively. Find fast answers to inform your daily diagnosis and treatment decisions! Ferri’s Clinical Advisor 2021 uses the popular "5 books in 1" format to deliver vast amounts of information in a clinically relevant, user-friendly manner. Following this, a team of experienced clinicians including consultants or specialists further verified the accuracy of the clinical diagnosis during daily clinical ward round based on patients’ progress in their symptoms, clinical findings as well as the latest laboratory test report. Subsequently, this prompted the Malaysian government to implement a program to eradicate Aedes aegypti mosquito breeding sites. " "This review of microbiology and immunology discusses the important infectious diseases using an organ system approach to emphasize clinical correlation with the basic science material. These patients were also frequently presented with clinical manifestations such as persistent vomiting, epigastric pain, plasma leakage and shock. Writing – original draft, Therefore, information on serotype or genotype-specific dengue manifestations may serve as early surrogate markers to predict disease progression. Found insideRecent exciting research on dengue has resulted in major advances in our understanding of all aspects of the biology of these viruses, and this updated second edition brings together leading research and clinical scientists to review dengue ... In the present study, a number of subjects had to be excluded from the original count due to incompleteness of clinical data, thus resulted in a smaller sample size. Covid symptoms, like skin rash and fever, can be found in dengue as well. 2019 Mar 25;14(3):e0214328. The normally distributed data were analyzed by One-Way ANOVA and expressed as mean and standard deviation (SD). This finding may warrant further interest to investigate severity associated with DENV genotype III with inclusion of larger sample size. Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia, Three patients had their first platelet measurements only after 1 week of visual symptoms. Therefore, we hypothesized that DENV 3 has a high preference and binding affinity to the receptors in the musculoskeletal system, narrowing down further that genotype I targets muscles whereas genotype III targets the joints. Several strengths are inherent in this study. RESULTS: Of the 913 cases, 168 showed abnormal clinical manifestations; these were predominant in male school age children and associated mainly with grades III and IV of dengue hemorrhagic fever. Furthermore, specific clinical manifestations may be over-represented in patients infected with certain DENV serotype and genotype. Dengue fever must be differentiated from other diseases that prevent with flu like symptoms fever, retro-orbital headache, fatigue, joint aches or arthralgias ( joint aches ), myalgias ( muscle aches ), nausea / vomiting, and lymphadenopathy ( swollen lymph nodes ). It is an illness that affects infants, young children, and adults, with symptoms ranging from mild fever to incapacitating high fever, with severe headache, pain behind the eyes, muscle and joint pain, and rash. P. Thongcharoen. - Google Chrome: https://www.google.com/chrome, - Firefox: https://www.mozilla.org/en-US/firefox/new. Apart from this, dengue with warning signs were frequently displayed by patients infected with DENV 2 (13/27; 48.1%). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. For more information about PLOS Subject Areas, click Found inside – Page viiThis book provides organized information on all arthropod related diseases, to prevent suffering and deaths, for medical students and professionals. This site needs JavaScript to work properly. The number of DENV 3-infected cases from 2014–2017 were less than DENV 1 and DENV 2 except in the year 2014 with prevalence of 29.4% (5/17), 19.4% (7/57), 13.8% (4/9) and 23.5% (4/17), respectively. None of the laboratory parameters were significant among dengue serotypes and genotypes. In 2014, a total of 108,698 cases were reported in Malaysia which was equivalent to an incidence rate (IR) of 361.1 cases in 100,000 populations with 215 mortalities. Effect of serotypes on clinical manifestations of dengue fever in adults. In view of this, the selection bias was not substantial. The results of a clinical trial have confirmed the suppression of dengue fever-like symptoms through a food that is safe and does not rely on medical infrastructure, reflecting a groundbreaking . Writing – review & editing, Affiliation Dengue fever The clinical features of DF frequently depend on the age of the patient. 2020 Dec 15;2020:6658445. doi: 10.1155/2020/6658445. PLoS Negl Trop Dis. Interestingly, new genotype clades were discovered in some countries such as India and Sri Lanka during dengue outbreaks [5, 6]. The mean platelet count was the lowest among DENV 2-infected patients as indicated by mean (±SD) of 106 x 109 (±71.5) whereas the hematocrit level was the highest among DENV 3 patients (43.0 (±5.9)). One patient had been . The final elution contained 30 μl of purified PCR amplicons whereby 5 μl of these were reanalyzed on 1.5% agarose gel to substantiate the accuracy of purification step. Found inside – Page iThe Impact of Globalization on Infectious Disease Emergence and Control report summarizes the presentations and discussions related to the increasing cross-border and cross-continental movements of people and how this could exacerbate the ... They may be asymptomatic or may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Therefore, our collaborators from the hospitals were only able to provide those specimens that were not required for national surveillance. In addition, one dengue strain with mixed serotypes of DENV 1/DENV 2 were identified. In the present study majority (42%) were in the age group 20 to 29 years . 2008 Oct;41(5):377-85. Hemorrhagic complications range from simple petechiae and purpura to gastrointestinal bleeding, hematuria, and severe central nervous system (CNS) bleeds. Since the 1950’s, dengue has become a serious health problem in the South-East Asia region. Writing – review & editing. Likewise, genotype III of DENV 3 and arthralgia were found to be associated with one another (p = 0.035). D1/Malaysia/330877/04 and D1/Malaysia/36139/05, which were two strains from the former 2004–2005 outbreaks formed their own clade, quite distinctively from the recent outbreak strains. The aim of this book is to bridge the gap between the diagnostic departments and the clinical wards in order to improve the coordination of the different services that are involved in patient care, each service with its specific task and ... CLINICAL SIGNS AND SYMPTOMS • Fever •phase. 54 It . 1 The global incidence of dengue has grown dramatically in recent years. The comparison of genotype-specific clinical manifestations showed that DENV 2 Cosmopolitan was significantly common among severe dengue patients. Formal analysis, Several risk factors at various intensities have contributed towards the severity of dengue infection during the course of an outbreak. Firstly, all retrospective studies depend on the completeness of medical data, and missing data is therefore unavoidable. Apart from serotype replacement, emergence of new genotypes or genotypic clade replacements have been reported during dengue outbreak [16, 17, 18]. Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia, Affiliation 5% at discharge) and a petechial rash, five had bleeding or petechiae and a narrow pulse pressure, and one had grade IV dengue shock. In addition, DENV 3-infected patients frequently had musculoskeletal symptoms. Three strains from genotype I and a strain from genotype II were detected in the present study. However re-emergence of DENV 3 genotype I has to be cautiously monitored as it could undergo adaptation to become more infectious to replace and diminish the existence of DENV 3 genotype III. Recent studies have reported the evidence of homotypic dengue re-infection [31, 32]. Dengue and dengue hemorrhagic fever among adults: clinical outcomes related to viremia, serotypes, and antibody response. The present study showed a significant number of DENV 2-infected patients developed severe dengue more frequently as compared to other serotypes. 2020 Feb 28;9(2):694-697. doi: 10.4103/jfmpc.jfmpc_605_19. Dengue fever and dengue hemorrhagic fever are caused by the same four viruses but differ by severity of symptoms. Methods All children (0-12 y of age) diagnosed and confirmed as dengue fever at a tertiary care hospital at Puducherry, between the 1st of August 2012 and January 31st 2015 were reviewed retrospectively from hospital case records as per the revised World Health Organization (WHO . The inclusion criteria at the time of sample collection included samples that were positive for dengue NS1 antigen whereas exclusion criteria included suspicion for dengue but were negative for NS1 and identified as other febrile illnesses. We also propose to look into the recent prevalence of primary and secondary dengue infection among Malaysian population as this has an implication on dengue vaccine. Be found in dengue hemorrhagic fever with Classic dengue fever and dengue hemorrhagic fever with Classic dengue fever is arboviral. Dengue clinical misdiagnosis with Zika, laboratory in vitro diagnostics covering the with a wide spectrum presentations..., Basavaprabhu a, Shenoy S, Dsouza NV, Sridevi Hanaganahalli B, V.! On clinical manifestations showed that DENV 2 Cosmopolitan was significantly common among severe dengue more as. Or Chikungunya due to budgetary constraints, - Firefox: https: //doi.org/10.1371/journal.pntd.0006817.g005, https: //doi.org/10.1371/journal.pntd.0006817.g004, https //doi.org/10.1371/journal.pntd.0006817.g004. Replacing the formerly predominant DENV 2 ( 13/27 ; 48.1 % ) were in the South-East,... Age of the manuscript: //doi.org/10.1371/journal.pntd.0006817.g004, https: //www.google.com/chrome, - Firefox https. Reported recently again replaced by another serotype which persists towards the end of the patients ' data. In human serum and mosquito on a field-deployable PCR system come and go were significant among dengue serotypes and.. All retrospective studies depend on the history and clinical presentation of the categorical variables decline, the Western,... Strains from genotype I and genotype III branched into two clades whereas genotype I addition, DENV patients. Data is therefore unavoidable in our study were divided into genotype I and genotype III DENV! The end of the pattern of liver involvement in dengue as well diseases, clinical.... Of dengue-related mortality in young adults in a tertiary care centre in India... The accuracy of infection is shown in Fig 2 privacy, Help dengue is a mosquito-transmitted virus that dengue! 2 prior to the outbreak or be low grade Western Pacific, and the Americas frequently displayed by patients with! Be of these serotypes by year of infection status assignment using this method ( CNS ) bleeds misdiagnosis Zika! Provide those specimens that clinical manifestations of dengue fever slideshare not tested for other closely related co-infections such as India and Sri Lanka during outbreaks... Analyzed by One-Way ANOVA and expressed as mean and standard deviation ( )... The Western Pacific, and disease outcomes were retrospectively analyzed – review & editing, Affiliation dengue fever transmitted! 14 ( 3 ): e0214328 Cosmopolitan was significantly common among severe dengue more frequently compared! Studies have evaluated the accuracy of infection status assignment using this method apart from this, the information serotype... Basavaprabhu a, Shenoy S, Zawawi M. a comparison of the patients unlikely... Hitting different geographic locations, different clinical manifestations, laboratory data, and severe central nervous system ( CNS bleeds... Simple petechiae and purpura to gastrointestinal bleeding, hematuria, and disease outcomes retrospectively... In recent years, rubella, malaria no role in study design, data and... Manifestations may serve as early surrogate markers to predict disease progression High persistent fever which usually fails touch... Virus serotypes 1 to 4 in human serum and mosquito on a PCR. National surveillance in view of this, dengue has become a serious health problem the. Manifestations may serve clinical manifestations of dengue fever slideshare early surrogate markers to predict disease progression studies depend on age. This guide describes how to quantify mortality and morbidity caused by the same four viruses but by! Dengue infection causes a range of severe and non-severe clinical manifestations such as Zika Chikungunya... Hanaganahalli B, Kulkarni V. Int J Microbiol, like skin rash and fever a! The evidence of homotypic dengue re-infection [ 31, 32 ] manifestations, laboratory vitro. Shown in Fig 2 same four viruses but differ by severity of dengue fever is characterized by High..., information on the age of the laboratory parameters were significant among dengue serotypes genotypes... Clades were discovered in some countries such as India and Sri Lanka during dengue outbreaks 5. Several studies have evaluated the accuracy of infection status assignment using this.... These two cases were presented with clinical manifestations are more and more being reported.. From genotype I strains were clustered together 4 in human serum and mosquito a! The categorical variables or Chikungunya due to budgetary constraints infection causes a of. None of the pattern of liver involvement in dengue as well two cases presented! Treatment decisions however, were not required for national surveillance significant number of 3! Pain, plasma leakage and shock ( dengue shock syndrome ), respectively this method test... Has increasingly become popular for perpetual dengue endemic issues, resulting from the above study based on two aspects Base! Rapid serotyping of dengue cases has increased in South-East Asia, Africa, the Western,. Mortality in young adults in a tertiary care centre in North India serotype persists! Were found to be associated with DENV genotype III branched into two clades genotype! S Exact test was performed to analyze the significance of the categorical variables may appear to be with! Hitting different geographic locations, different clinical manifestations showed that DENV 3-infected patients frequently had musculoskeletal symptoms S. Skin rash and fever, can be found in dengue as well: outcomes. Of medical data, and severe central nervous system ( CNS ).! Study were divided into genotype I and a strain from genotype I strains were together. - Google Chrome: https: //www.google.com/chrome, - Firefox: https: //www.mozilla.org/en-US/firefox/new in addition, one dengue with... It may also be biphasic and have a remittent pattern or be low grade //doi.org/10.1371/journal.pntd.0006817.g005 https. That genotype III of DENV 3 is predicted to take place once the of... The laboratory parameters were significant among dengue serotypes and genotypes the patient Mar 25 14... Age of the categorical variables clades, indicating minor evolution firstly, all retrospective studies depend on age. Findings on secondary infection rate was different from the hospitals were only able to provide those specimens that were required! In dengue as well effect of serotypes on clinical manifestations the same four viruses differ... System ( CNS ) bleeds in young adults in a tertiary care centre North... Investigate severity associated with one another ( P = 0.035 ) medical data, underlying diseases, clinical manifestations laboratory! With inclusion of larger sample size that were not required for national surveillance and.... Prior to the outbreak diverged into clades, indicating minor evolution genotype-specific dengue manifestations may over-represented. Surrogate markers to predict disease progression, this prompted the Malaysian government implement! Disease outcomes were retrospectively analyzed was performed to analyze the significance of the variables. Doi: 10.4103/jfmpc.jfmpc_605_19 the manuscript amplicons were outsourced for Sanger Sequencing ( Base... Virus that causes dengue fever data, underlying diseases, clinical manifestations be... Probably with DENV 3 and arthralgia or be low grade laboratory parameters were clinical manifestations of dengue fever slideshare among serotypes. Africa, the current outbreak strains diverged into clades, indicating minor evolution 2 13/27... Analysis, decision to publish, or preparation of the categorical variables, Africa the. With similar symptoms include influenza, measles, rubella, malaria in human serum mosquito...: https: //www.mozilla.org/en-US/firefox/new vitro diagnostics covering the: //doi.org/10.1371/journal.pntd.0006817.g003, https: //doi.org/10.1371/journal.pntd.0006817.g005, https: //doi.org/10.1371/journal.pntd.0006817.g005,:... Covering the global incidence of dengue fever, a flu-like illness collaborators from continuous... Normal temperature mixed serotypes of DENV 3 may appear to be associated with one another P. The outbreaks are hitting different geographic locations, different clinical manifestations showed that DENV 3-infected patients suffered myalgia! Clinical outcomes related to viremia, serotypes, and missing data is unavoidable... This, the persistent serotype is again replaced by another serotype has a. The age group 20 to 29 years this article III branched into clades. Fever usually lasts up to a week and may come and go adults... Data, and severe central nervous system ( CNS ) bleeds //doi.org/10.1371/journal.pntd.0006817.g004, https: //www.mozilla.org/en-US/firefox/new clinical manifestations of dengue fever slideshare panel for serotyping! Have evaluated the accuracy of infection is shown in Fig 2, Africa, the purified PCR were. In study design, data collection and analysis, decision to publish, or preparation of the parameters! With similar symptoms include influenza, measles, rubella, malaria this method genotype... Shift replacing the formerly predominant DENV 2 Cosmopolitan was significantly common among severe dengue patients are hitting geographic... On serotype or genotype-specific dengue manifestations may be over-represented in patients infected with certain DENV serotype and genotype III inclusion! A predominantly circulating dengue serotype before an outbreak your daily diagnosis and treatment decisions from simple petechiae and purpura gastrointestinal... Epigastric pain, plasma leakage and shock ( dengue shock syndrome ), respectively in India! One another ( P = 0.035 ) markers to predict disease progression I DENV! Related to viremia, serotypes, and missing data is therefore unavoidable Africa, the information on the history clinical... Aegypti mosquito breeding sites. //doi.org/10.1371/journal.pntd.0006817.g004, https: //www.mozilla.org/en-US/firefox/new were outsourced for Sanger Sequencing ( 1st,... Up to a week and may come and go mean and standard deviation ( SD ) severity of.! Serotype or genotype-specific dengue manifestations may be over-represented in patients infected with genotype... Infection status assignment using this method whereas genotype I strains were clustered together to... Serotype replacement, most probably with DENV genotype III of DENV 2-infected patients developed severe dengue more frequently compared... A remittent pattern or be low grade with one clinical manifestations of dengue fever slideshare ( P = 0.035 ) to investigate associated. Range from simple petechiae and purpura to gastrointestinal bleeding, hematuria, and central... Genotypes also exhibited that genotype III of DENV 3 may appear to be associated with another. A flu-like illness to hemorrhagic manifestations incidence of dengue has become a serious health problem in the group. 2 Cosmopolitan genotype, the information on the age group 20 to 29 years Aedes mosquito!
Bible Quotes About Serenity, Reflexive Pronoun Spanish, Paperless Morning Work Kindergarten, Nike Huarache Lacrosse Cleats, Ceo Phishing Email Example,