DENGUE IN THE EARLY FEBRILE PHASE - VIREMIA AND ANTIBODY-RESPONSES

A multicenter effort was begun in 1994 to characterize the pathophysio logy of dengue using a study design that minimized patient selection b ias by offering enrollment to all children with undifferentiated fever for <72 h. In the first year, 189 children were enrolled (age range, 8 months to 14 years). Thirty-two percent of these children had dengue infections (60 volunteers). The percentage of children with a seconda ry dengue infection was 93%, with only 4 (7%) having a primary dengue infection. The virus isolation rate from the plasma of children with d engue was 98%. Viremia correlated highly with temperature. All four de ngue virus serotypes were isolated at both study sites. This study dem onstrates that all four serotypes of dengue virus can cause dengue hem orrhagic fever, that all dengue patients as defined by serology experi ence viremia during the febrile phase, and that as fever subsides, so does viremia.