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Characteristics of Mild Dengue Virus Infection in Thai Children
ARMED FORCES RESEARCH INST OF MEDICAL SCIENCES BANGKOK (THAILAND)
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A four-year longitudinal cohort and geographic cluster study in rural Thailand was conducted to characterize the clinical spectrum of dengue virus DENV infection. Symptomatic DENV infections in the cohort were detected by active school absence based surveillance that triggered cluster investigations around ill cohort children. Data from 189 cohort children with symptomatic DENV infection and 126 contact children in the clusters with DENV infection were analyzed. Of infected contacts, only 19 were asymptomatic 81 were symptomatic, but only 65.9 reported fever. Symptom-based case definitions were unreliable for diagnosis. Symptomatic infections in contacts were milder with lower DENV RNA levels than the cohort. Infections in contacts with fever history were more likely to have detectable DENV RNA than infections without fever history. Mild infections identified by cluster investigations account for a major proportion of allDENV infections. These findings are relevant for disease burden assessments, transmission modeling, and determination of vaccine impact.
APPROVED FOR PUBLIC RELEASE