ABSTRACT
During the 1981 epidemic of dengue type 2 in Cuba a study was done of 124 children from 0 to 14 years of age who had dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), degress III and IV. Almost all these children (98 percent) had neutralizing antibodies against the dengue type 1 and 2 viruses, indicating that they had already been previously infected with the type 1 virus. Neither sex was predominant among the patients. The frequency of the serious form of the disease was significantly greater among white children (p0.01) than among black or mulatto. Subjects between the ages of 4 and 11 were most apt to suffer serious clinical manifestations of the disease. In most of the cases the shock occurred four or five days after the appearance of the signs and symptoms, often preceded by abdominal pain. The most frequent clinical manifestations were fever, vomiting, and hepatomegaly. In 68.5 percent of the children there were hemorrhagic manifestations, mainly petechia and hematemesis. It was noted that and unusually high percentage of the children in the study had a personal or family background of asthma. In general, the results confirm that infection with the dengue type 1 virus shortly before infection with the type 2 virus is closely related to the appearance of DHF/DSS. In addition, the high percentage of children with a background of asthma supports the theory that this and other forms