Dengue Lessons from Cuba Vaughn Invited Commentary: Dengue Lessons from Cuba
نویسنده
چکیده
An 18-year interval between a dengue virus type 1 outbreak in 1977–1979 and a dengue virus type 2 outbreak in 1997 in Santiago de Cuba, Cuba, provided a unique opportunity to evaluate risk factors for dengue disease. All patients with symptomatic dengue, including 205 cases of dengue hemorrhagic fever and 12 deaths, were adults born before the dengue virus type 1 epidemic, and nearly all (98%) experienced secondary dengue virus infections. In contrast, almost all of those who seroconverted without illness (97%) experienced primary dengue virus infection. This provides epidemiologic support for the immune enhancement theory of dengue pathogenesis. The Cuban experience suggests that immune enhancement can be seen even 20 years after the primary dengue virus infection. It also supports the contention that primary infections with dengue virus type 2 (and dengue virus type 4) are largely subclinical. These observations have implications for dengue vaccine development based on live-attenuated viruses. Am J Epidemiol 2000;152:800–3.
منابع مشابه
Enhanced severity of secondary dengue-2 infections: death rates in 1981 and 1997 Cuban outbreaks.
OBJECTIVE To understand the possible effect that length of time has on disease severity with sequential dengue infections. METHODS Death and hospitalization rates for dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) per 10,000 secondary dengue-2 infections were compared in the same age group for two dengue-2 (DEN-2) epidemics in Cuba. The first DEN-2 epidemic affected all of Cuba in 1...
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