Imported dengue: study of 44 cases observed in 9 french university hospitals between 1994 and 1997.

Imported dengue is increasingly observed in non endemic countries. We repor t a retrospective study of 44 cases of dengue fever diagnosed in nine frenc h university hospitals between 1994 and 1997. The patients were aged betwee n 13 and 67 years. Most of them were tourists and had been traveling for a few weeks, in French West Indies and French Guyana (18), South-East Asia (1 0), India (7) or Polynesia (4). Only, two contracted the disease in Africa. The onset of symptoms preceded the return or followed it within 7 days. Th e most frequent clinical presentation was a febrile and painful syndrome. C utaneous manifestations (rash or macular exanthem) were observed in 59% of cases, digestive symptoms in 50%, pharyngitis and/or cough in 25%, microade nopathy in 20%, moderate mucous haemorrhagic manifestations in 16% and neur opsychiatric manifestations in 14%. The common biological abnormalities wer e thrombocytopenia (84%), leukopenia (59%), and elevated transminases (57%) . The diagnosis, orientated by negativity of malaria smears, the knowledge of an epidemic in the visited country, or occurence of similar cases in the entourage, were argued by serological results: presence of anti-DEN IgM in 25 cases, serological conversion (anti- DEN IgG) in 7 cases or very high s eropositivity (anti-DEN IgG > 1/1280) in 12 cases. No virus isolation was o btained.