Effect of age on outcome of secondary dengue 2 infections

Objective: Dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is a growing global health problem. It is not known how age affects the outcome of secondary dengue infections. In an island setting, a large DHF/DSS outbreak in Cuba occurred in 1981. Involved were individuals, 3–40 year old, whose...

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Bibliographic Details
Published in:International journal of infectious diseases 2002-06, Vol.6 (2), p.118-124
Main Authors: Guzmán, María G., Kouri, Gustavo, Bravo, Jose, Valdes, Luis, Susana, Vazquez, Halstead, Scott B.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Aging - physiology
Arboviroses
Biological and medical sciences
Child
Child, Preschool
Cuba - epidemiology
Dengue fevers
Disease Susceptibility
Hospitalization
Human viral diseases
Humans
Infectious diseases
Medical sciences
Middle Aged
Risk
Seroepidemiologic Studies
Severe Dengue - epidemiology
Severe Dengue - immunology
Severe Dengue - mortality
Sex Factors
Tropical medicine
Tropical viral diseases
Viral diseases
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Summary:Objective: Dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is a growing global health problem. It is not known how age affects the outcome of secondary dengue infections. In an island setting, a large DHF/DSS outbreak in Cuba occurred in 1981. Involved were individuals, 3–40 year old, whose only lifetime dengue exposure was to DEN-1 in 1977 and DEN-2 in 1981. In this report we calculate age-specific DHF/DSS hospitalization and death rates based on secondary DEN 2 infections. Methods: Published and unpublished hospital and seroepidemiologic data from the 1981 DHF/DSS outbreak were used for the analysis. Results: Children, aged 3 and 4 years, with secondary DEN-2 infections were found to have a high death rate (25.4/10 000 secondary DEN-2 infections). The death rate fell with increasing age, being 15.9-fold lower in the 10–14-year age group. The death rate for children aged 3–14 years was 14.5-fold higher than in young adults aged 15–39 years. The death rate rose somewhat in adults aged 50 years and older. DHF/DSS hospitalization rates showed the same trend as death rates. Conclusions: Age is an important variable in the outcome of secondary DEN-2 infections. DHF/DSS case fatality and hospitalization rates are highest in young infants and the elderly. The risk that a child will die during a secondary DEN-2 infection is nearly 15-fold higher than the risk in adults.
ISSN:1201-9712
1878-3511
DOI:10.1016/S1201-9712(02)90072-X