ABSTRACT
The co-circulation of all 4 dengue virus serotypes in the same community, common since the 1950s in Southeast Asia, has now become a frequent occurrence in many Caribbean Islands, Mexico, and Central and South America in the past 20 years. As a consequence, the frequency of concurrent infections would be expected to increase in these areas. To assess this, using state of the art technology, we screened viremic serum samples and mosquitoes inoculated with serum samples collected during epidemics involving multiple dengue virus serotypes in Indonesia, Mexico, and Puerto Rico for virus isolation. Of 292 samples tested, 16 (5.5%) were found to contain 2 or more dengue viruses by an indirect immunofluorescence test and/or the reverse transcriptase-polymerase chain reaction.
Subject(s)
Dengue Virus/classification , Disease Outbreaks , Severe Dengue/virology , Animals , Antibodies, Monoclonal , Antibodies, Viral/blood , Biological Assay , Cells, Cultured , Culicidae/virology , DNA Primers/chemistry , Dengue Virus/genetics , Dengue Virus/immunology , Dengue Virus/pathogenicity , Electrophoresis, Agar Gel , Fluorescent Antibody Technique, Direct , Humans , Indonesia/epidemiology , Mexico/epidemiology , Puerto Rico/epidemiology , RNA, Viral/chemistry , RNA, Viral/isolation & purification , Reverse Transcriptase Polymerase Chain Reaction , Serotyping , Severe Dengue/blood , Severe Dengue/epidemiologyABSTRACT
Dengue fever was detected in Yucatan in 1979. Since then, about 17,000 clinical cases have been reported, of which 1169 were confirmed by the presence of specific antibodies (IgM and IgG) and/or virologic studies; 10 of the cases were classified as dengue haemorrhagic fever and four died. The disease is endemic in the region and serotypes 1, 2 and 4 have been observed. This paper describes a patient with chronic autoimmune thrombocytopenic purpura who developed a primary dengue infection with hemorrhagic manifestations and responded to corticosteroids. We discuss the physiopathogeny of thrombocytopenia and analyze the utility of treatment with corticosteroids in patients with autoimmune disease.
