Dengue Hemorrhagic Fever in a Japanese Traveler with Pre-existing Japanese Encephalitis Virus Antibody

• Published in: Tropical Medicine and Health Vol. 43; no. 2; pp. 85 - 88
• Main Authors: Sato, Rumi, Hamada, Nobuyuki, Kashiwagi, Takahito, Imamura, Yoshihiro, Hara, Koyu, Nishimura, Munetsugu, Kamimura, Tomoko, Takasaki, Tomohiko, Watanabe, Hiroshi, Koga, Takeharu
• Format: Journal Article
• Language: English
• Published: Japan Japanese Society of Tropical Medicine 01.01.2015; The Japanese Society of Tropical Medicine
• Subjects: antibody-dependent enhancement (ADE); cross-reactive antibody; dengue hemorrhagic fever; Dengue virus; Flavivirus; imported infection; Japanese encephalitis virus; Japanese encephalitis virus antibody; petechiae; Short Communications; thrombocytopenia; Thailand; Japan, Kyushu; cross-reactive antibody; dengue hemorrhagic fever; petechiae; thrombocytopenia; antibody-dependent enhancement (ADE); Japanese encephalitis virus antibody; imported infection
• ISSN: 1348-8945; 1349-4147
• DOI: 10.2149/tmh.2014-34

An adult Japanese man who had just returned from Thailand developed dengue hemorrhagic fever (DHF). A primary infection of dengue virus (DENV) was confirmed, specifically DENV serotype 2 (DENV-2), on the basis of the detection of the virus genome, a significant increase in the neutralizing antibody and the isolation of DENV-2. DHF is often observed following a secondary infection from another serotype of dengue virus, particularly in children, but this case was a primary infection of DENV. Japan is a non-endemic country for dengue disease. In fact, only Japanese encephalitis (JE) is known to be a member of the endemic flavivirus family. In this study, IgG antibody against Japanese encephalitis virus (JEV) was detected. JEV belongs to the family of dengue virus and prevails in Japan, particularly Kyushu. Among many risk factors for the occurrence of DHF, a plausible candidate could be a cross-reactive antibody-dependent enhancement (ADE) mechanism caused by JEV antibody. This indicates that most Japanese travelers who living in dengue non-endemic areas, particularly Kyushu, should be aware of the occurrence of DHF.