CHARACTERISTICS OF DENGUE FEVER IN A LARGE PUBLIC HOSPITAL, JEDDAH, SAUDI ARABIA

Authors

  • Muhammad Ayyub
  • Adel M Khazindar
  • Eman H Lubbad
  • Shahid Barlas
  • Adnaan Y Alfi
  • Sawsan Al- Ukayli

Abstract

Background: This study aims to determine demographic, clinical and laboratory profile alongwith disease outcome of all confirmed cases of dengue fever (DF) and dengue hemorrhagic fever(DHF) admitted in King Abdulaziz Hospital & Oncology Center, Jeddah, Saudi Arabia. We alsowant to highlight the significance of implementing a well targeted community based diseaseprevention program. Methods: All patients admitted from May 2004 till April 2005 with asuspected diagnosis of DF and DHF were followed. All cases confirmed by a positive serology(IgM alone or IgM and IgG) to dengue fever were studied in detail to determine age, gender,ethnicity, monthly distribution, clinical and laboratory profile. Results: A total of 80 patients wereadmitted with a suspected diagnosis of DF. Among these, 39 (48.75%) patients were confirmed bypositive serology to have the disease. Male to female ratio was 3.3:1. Their ages ranged from 2 to60 years with a mean of 27.6 + 11.2. Twelve patients were Saudis, while the rest were non-Saudiscoming from different countries in Asia, Africa and Middle East. Maximum number of patients(48.72%) was seen in the summer months of June, July and August. Commonest presentation wasfever (100%), headache (48.72%), myalgias (66.7%) and vomiting (25.64%). Rash, hemorrhagicmanifestations and positive tourniquet test were relatively uncommon. Only two patients fulfilledWHO criteria of DHF. Main hematological abnormalities were thrombocytopenia (79.49%) andleucopenia (48.72%). Significant elevation of PTT was observed in 25.64% of patients. Abnormalliver function tests with high transaminases were seen in about 66.7% of patients, whereas 33.33%of patients had significantly elevated creatine kinase. All patients improved clinically withimprovement of chemical and hematological parameters. None of the patients died in this series.Conclusion: DF continues to be a significant health problem in Western region of Saudi Arabia.Large number of pilgrims coming from disease endemic areas all over the world facilitates thecontinued introduction of dengue virus with different strains. Fortunately there has been no seriousoutbreak of dengue fever in recent years. A sharp vigilance is required by concerned authorities toprevent and minimize any future outbreak. It is extremely important to implement and maintain aneffective, sustainable and community based disease prevention program.Key Words: Dengue fever, Dengue hemorrhagic Fever, Headache, Rash, Thrombocytopenia

References

Gubler DJ. Dengue and dengue hemorrhagic fever. Clin

Microbiol Rev. 1998 Jul;11(3):480-96.

Gubler DJ. The global emergence/resurgence of arboviral

diseases as public health problems. Arch Med Res. 2002 JulAug;33(4):330-42.

Pinheiro FP, Corber SJ. Global situation of dengue and dengue

haemorrhagic fever, and its emergence in the Americas. World

Health Stat Q. 1997;50(3-4):161-9.

Gubler DJ. The global pandemic of dengue/dengue

haemorrhagic fever: current status and prospects for the future.

Ann Acad Med Singapore. 1998 Mar;27(2):227-34.

Fakeeh M, Zaki AM. Virologic and serologic surveillance for

dengue fever in Jeddah, Saudi Arabia, 1994-1999. Am J Trop

Med Hyg. 2001 Dec;65(6):764-7.

World Health Organization. Dengue Hemorrhagic Fever:

Diagnosis, Treatment, Prevention and Control. 2nd edition.

Geneva, World Health Organization, 1997.

Statistical package for Social Sciences – Personal Computers

(SPSS-PC). Version 7.5 SPSS Co. (444 N. Michigan Avenue,

Chicago, Illinois, USA) 1988.

Bielefeldt-Ohmann H. Pathogenesis of dengue virus diseases:

missing pieces in the jigsaw. Trends Microbiol. 1997

Oct;5(10):409-13.

Halstead SB. Pathogenesis of dengue: challenges to molecular

biology. Science. 1988 Jan 29;239(4839):476-81.

Gubler DJ. Dengue and dengue hemorrhagic fever: its history

and resurgence as a global public health problem. Gubler DJ,

Kuno G, eds. Dengue and dengue hemorrhagic fever.

Wallingford, UK: CAB International, 1-20.

Jimenez-Lucho VE, Fisher EJ, Saravolatz LD. Dengue with

hemorrhagic manifestations: an imported case from the

Middle East. Am J Trop Med Hyg. 1984 Jul;33(4):650-3.

J Ayub Med Coll Abbottabad 2006;18(2)

Aggarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK. An

epidemic of dengue hemorrhagic fever and dengue shock

syndrome in children in Delhi. Indian Pediatr. 1998

Aug;35(8):727-32.

Pancharoen C, Thisyakorn U. Dengue virus infection during

infancy. Trans R Soc Trop Med Hyg. 2001 MayJun;95(3):307-8.

Witayathawornwong P. Dengue hemorrhagic fever in infancy

at Petchabun Hospital, Thailand. Southeast Asian J Trop Med

Public Health. 2001 Sep;32(3):481-7.

Kabra SK, Jain Y, Singhal T, Ratageri VH. Dengue

hemorrhagic fever: clinical manifestations and management.

Indian J Pediatr. 1999 Jan-Feb;66(1):93-101.

Wali JP, Biswas A, Aggarwal P, Wig N, Handa R. Validity of

tourniquet test in dengue haemorrhagic fever. J Assoc

Physicians India. 1999 Feb;47(2):203-4.

Gomber S, Ramachandran VG, Kumar S, Agarwal KN, Gupta

P, Gupta P, Dewan DK. Hematological observations as

diagnostic markers in dengue hemorrhagic fever--a

reappraisal. Indian Pediatr. 2001 May;38(5):477-81.

Lin SF, Liu HW, Chang CS, Yen JH, Chen TP. Hematological

aspects of dengue fever. Gaoxiong Yi Xue Ke Xue Za Zhi.

Jan;5(1):12-6.

Lin CF, Lei HY, Liu CC, Liu HS, Yeh TM, Wang ST, Yang

TI, Sheu FC, Kuo CF, Lin YS. Generation of IgM anti-platelet

autoantibody in dengue patients. J Med Virol. 2001

Feb;63(2):143-9.

Pancharoen C, Rungsarannont A, Thisyakorn U. Hepatic

dysfunction in dengue patients with various severity. J Med

Assoc Thai. 2002 Jun;85 Suppl 1:S298-301.

Gubler DJ. Arboviruses as imported disease agents: the need

for increased awareness. Arch Virol Suppl. 1996;11:21-32.

Gubler DJ, Clark GG. Community involvement in the control

of Aedes aegypti. Acta Trop. 1996 Apr;61(2):169-79

Issue

Vol. 18 No. 2 (2006): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.