Effect of age on outcome of secondary dengue 2 infections

• Published in: International journal of infectious diseases Vol. 6; no. 2; pp. 118 - 124
• Main Authors: Guzmán, María G., Kouri, Gustavo, Bravo, Jose, Valdes, Luis, Susana, Vazquez, Halstead, Scott B.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.06.2002; Elsevier
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Aging - physiology; Arboviroses; Biological and medical sciences; Child; Child, Preschool; Cuba - epidemiology; Dengue fevers; Disease Susceptibility; Hospitalization; Human viral diseases; Humans; Infectious diseases; Medical sciences; Middle Aged; Risk; Seroepidemiologic Studies; Severe Dengue - epidemiology; Severe Dengue - immunology; Severe Dengue - mortality; Sex Factors; Tropical medicine; Tropical viral diseases; Viral diseases; Central America; Cuba; America; West Indies; Dengue 2; Human; Hemorrhagic fever; Prognosis; Dengue hemorrhagic fever; Dengue; Mortality; Hospitalization; Infection; Viral disease; Arbovirus disease; Risk factor; Child; Age
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/S1201-9712(02)90072-X

Objective: Dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is a growing global health problem. It is not known how age affects the outcome of secondary dengue infections. In an island setting, a large DHF/DSS outbreak in Cuba occurred in 1981. Involved were individuals, 3–40 year old, whose only lifetime dengue exposure was to DEN-1 in 1977 and DEN-2 in 1981. In this report we calculate age-specific DHF/DSS hospitalization and death rates based on secondary DEN 2 infections. Methods: Published and unpublished hospital and seroepidemiologic data from the 1981 DHF/DSS outbreak were used for the analysis. Results: Children, aged 3 and 4 years, with secondary DEN-2 infections were found to have a high death rate (25.4/10 000 secondary DEN-2 infections). The death rate fell with increasing age, being 15.9-fold lower in the 10–14-year age group. The death rate for children aged 3–14 years was 14.5-fold higher than in young adults aged 15–39 years. The death rate rose somewhat in adults aged 50 years and older. DHF/DSS hospitalization rates showed the same trend as death rates. Conclusions: Age is an important variable in the outcome of secondary DEN-2 infections. DHF/DSS case fatality and hospitalization rates are highest in young infants and the elderly. The risk that a child will die during a secondary DEN-2 infection is nearly 15-fold higher than the risk in adults.