Fatal dengue hemorrhagic fever in adults during a dengue epidemic in Singapore

Ong, A; Sandar, M; Chen, MI; Sin, LY; (2007) Fatal dengue hemorrhagic fever in adults during a dengue epidemic in Singapore. International journal of infectious diseases, 11 (3). pp. 263-7. ISSN 1201-9712 DOI: https://doi.org/10.1016/j.ijid.2006.02.012

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BACKGROUND: Dengue fever has seen a significant re-emergence in Southeast Asia. Associated with the rise of dengue has been the increase in dengue-associated mortality. To better understand the predictors of mortality, we conducted a review of hospitalized adult dengue infections within our institution. METHODS: This was a retrospective case-control study of dengue-associated deaths at a large tertiary care hospital. RESULTS: In 2004, of 3186 cases of dengue fever (DF)/hemorrhagic dengue fever (DHF) admitted to our institution, there were 130 cases of DHF and seven dengue-associated deaths (case-fatality rate 5.4%). At least three of the seven fatal cases had serological evidence of primary dengue infection. All dengue-mortality cases had rapidly progressive clinical deterioration at an average of day 4 of fever with intensive care admission occurring on a mean of 5.6 days of fever. Adult respiratory distress syndrome, disseminated intravascular coagulopathy, and multi-organ failure were the most common causes of death despite early hospitalization, intravenous fluid, and blood-product support. CONCLUSION: Dengue is associated with severe disease, and deaths do occur despite current supportive management. Fatal DHF/dengue shock syndrome (DSS) does occur in adults and in primary dengue infection. Better early predictors of disease severity and clinical interventions are needed.

Item Type: Article
Keywords: Adult, Aged, Case-Control Studies, Dengue Hemorrhagic Fever/epidemiology/*mortality, Female, Humans, Male, Middle Aged, Retrospective Studies, Singapore/epidemiology, Adult, Aged, Case-Control Studies, Dengue Hemorrhagic Fever, epidemiology, mortality, Female, Humans, Male, Middle Aged, Retrospective Studies, Singapore, epidemiology
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 16899384
Web of Science ID: 246398800016
URI: http://researchonline.lshtm.ac.uk/id/eprint/8680


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