Abstract:
: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.
journal_name
Am J Epidemioljournal_title
American journal of epidemiologyauthors
Vaughn DWdoi
10.1093/aje/152.9.800subject
Has Abstractpub_date
2000-11-01 00:00:00pages
800-3issue
9eissn
0002-9262issn
1476-6256journal_volume
152pub_type
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