VERTICAL TRANSMISSION OF DENGUE

Dengue, an important mosquito-borne flavivirus infection, is endemic i n Southeast Asia. We describe two mothers who had acute dengue 4 and 8 days before the births of their infants. One mother had worsening of her proteinuric pregnancy-induced hypertension, liver dysfunction! and coagulopathy and required multiple transfusions of whole blood, plate lets, and fresh frozen plasma. Her male infant was ill at birth, devel oped respiratory distress and a large uncontrollable left intracerebra l hemorrhage, and died of multiorgan failure on day 6 of life. Dengue virus type 2 was isolated from the infant's blood, and IgM antibody sp ecific to dengue virus was detected in the mother's blood. The second mother had a milder clinical course; she gave birth to a female infant who was thrombocytopenic at birth and had an uneventful hospitalizati on. Dengue virus type 2 was recovered from the mother's blood, and IgM antibody specific to dengue virus was detected in the infant's blood. This report highlights not only the apparently rare occurrence of ver tical transmission of dengue virus in humans but also the potential ri sk of death for infected neonates.