DENGUE

Selected abstracts:

1.                  Bandyopadhyay S, Lum LC, Kroeger A. Classifying dengue: a review of the difficulties in using the WHO case classification for dengue haemorrhagic fever. Trop Med Int Health. 2006 Aug;11(8):1238-55.

  Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

BACKGROUND: The current World Health Organisation (WHO) classification of dengue includes two distinct entities: dengue fever (DF) and dengue haemorrhagic fever (DHF)/dengue shock syndrome; it is largely based on pediatric cases in Southeast Asia. Dengue has extended to different tropical areas and older age groups. Variations from the original description of dengue manifestations are being reported. OBJECTIVES: To analyse the experience of clinicians in using the dengue case classification and identify challenges in applying the criteria in routine clinical practice. METHOD: Systematic literature review of post-1975 English-language publications on dengue classification. RESUTLS: Thirty-seven papers were reviewed. Several studies had strictly applied all four WHO criteria in DHF cases; however, most clinicians reported difficulties in meeting all four criteria and used a modified classification. The positive tourniquet test representing the minimum requirement of a haemorrhagic manifestation did not distinguish between DHF and DF. In cases of DHF thrombocytopenia was observed in 8.6-96%, plasma leakage in 6-95% and haemorrhagic manifestations in 22-93%. The low sensitivity of classifying DHF could be due to failure to repeat the tests or physical examinations at the appropriate time, early intravenous fluid therapy, and lack of adequate resources in an epidemic situation and perhaps a considerable overlap of clinical manifestations in the different dengue entities. CONCLUSION: A prospective multi-centre study across dengue endemic regions, age groups and the health care system is required which describes the clinical presentation of dengue including simple laboratory parameters in order to review and if necessary modify the current dengue classification

2.                  Seneviratne SL, Malavige GN, de Silva HJ.  Pathogenesis of liver involvement during dengue viral infections. Trans R Soc Trop Med Hyg. 2006 Jul;100(7):608-14.                                                                                                                       Department of Clinical Immunology, Level 7, John Radcliffe Hospital, Oxford OX3 9DU, UK.
The dengue virus can infect many cell types and cause diverse clinical and pathological effects. We describe clinical and experimental observations that suggest that liver involvement occurs during dengue infections, and we outline the possible role played by host immune responses in this process.

Pathogenesis:

15011.  Shrivastava R, Srivastava S, Upreti RK, Chaturvedi UC. Effects of dengue virus infection on peripheral blood cells of mice exposed to hexavalent chromium with drinking water. Indian J med Res 2005, 122(2), 111-19

15012.  Lin CF, Wan SW, Cheng HJ, Lei HY, Lin YS. Autoimmune pathogenesis in dengue virus infection. Viral Immunol. 2006 Summer;19(2):127-32. Review.

Vaccines:

15013.  Fink J, Gu F, Vasudevan SG.  Role of T cells, cytokines and antibody in dengue fever and dengue haemorrhagic fever. Rev Med Virol. 2006 Jul-Aug;16(4):263-75. Review. 

15014.  Raviprakash K, Apt D, Brinkman A, Skinner C, Yang S, Dawes G, Ewing D, Wu SJ, Bass S, Punnonen J, Porter K. A chimeric tetravalent dengue DNA vaccine elicits neutralizing antibody to all four virus serotypes in rhesus macaques. Virology. 2006 Sep 15;353(1):166-73.

15015.  Thomas S, Redfern JB, Lidbury BA, Mahalingam S. Antibody-dependent enhancement and vaccine development. Expert Rev Vaccines. 2006 Aug;5(4):409-12. Review.

Therapy:

15016.  Panpanich R, Sornchai P, Kanjanaratanakorn K. Corticosteroids for treating dengue shock syndrome. Cochrane Database Syst Rev. 2006 Jul 19;3:CD003488. Review

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