Dengue Fever: Inpatients clinical and laboratory characteristics during the 1st European Epidemics of the 21st century and literature review

Abstract

Introduction and objective: Dengue Fever has been historically described
in the literature at least since the 18th century. In the last few years viral
transmission has intensified all over the world with an increasing incidence
on dengue hemorrhagic fever due to a growing urban development, population growth, increased mobility and climatic changes. Aedes aegypti mosquito is the transmission vector. Most dengue infections are subclinical. There are 3 stages of disease: febrile, critical and the recovery phase.
The most frequent signs and symptoms are: fever, facial flushing, musculoskeletal pain, retro orbital pain, photophobia and headache. Hemorrhagic diathesis can also happen. Thrombocytopenia, leucopenia and liver
impairment (increase on liver enzymes and delayed INR) are reported in
most cases of dengue. The authors present cases of dengue requiring
hospitalization during the first European epidemics of the 21st century. The
aim of this study is to evaluate the demographic features, how the clinical condition has been evolving and manifesting itself, and its laboratory findings.
Material and methods: a retrospective study of dengue cases diagnosed
from the 1st September 2012 to the 31st December 2012 and requiring
hospitalization, through the assessment of their clinical files. Results: 67
patients were admitted for hospitalization, forty three women and twenty four men. The mean age was 44 years. The symptoms leading most patients to seek medical help were: muscle pain (31 patients / 42.3%),
nausea (18 patients / 26.9%), headache (17 patients / 25.4%), abdominal pain (7 patients / 10.4%), exanthema (5 patients / 7.5%), diarrhea (3 patients / 4.5%) and arthralgia (3 patients / 4.5%). Hepatic dysfunction
was frequent, being present in 88% of the patients. Thrombocytopenia
and leucopenia were present in 86.5% and 80.6% patients. The average
length of time in hospital was 5 days. All patients received support care.
There were no major complications. Conclusion: The characteristics of our
population were similar to the other published series, although in Madeira
Island only the serotype 1 virus was reported. The inexistence of other
serotypes may explain the fact that there were no secondary infections
and serious cases (hemorrhagic fever). Supportive care is the main form of
treatment. A new epidemics with a different serotype probably will cause
secondary infections, and Madeira Island must be prepared to face them
in the best possible way.