Epidemic dengue hemorrhagic fever in rural Indonesia. II. Clinical studies
Eram, S.; Setyabudi, Y.; Sadono, T.I.; Sutrisno, D.S.; Gubler, D.J.; Sulianti Saroso, J.
American Journal of Tropical Medicine and Hygiene 28(4): 711-716
1979
ISSN/ISBN: 0002-9637 PMID: 464192 Document Number: 150827
Clinical observations were made on 95 serologically or virologically confirmed dengue fever cases during an epidemic in a rural area of Indonesia in Dec. 1976. The age distribution was similar to that observed in patients with dengue hemorrhagic fever in Jakarta, a highly endemic urban area. The observed disease ranged in severity from undifferentiated fever to shock and death. The majority of patients had acute onset of fever with nausea, vomiting, headache and abdominal pain. Hepatomegaly was observed in only 19% of the patients. A positive tourniquet test was the most frequently observed hemorrhagic manifestation, but epistaxis was observed in 20% and hematemesis in 6% of the patients. Dengue shock syndrome was observed in 37% of the patients. There were 4 deaths, 3 of which were confirmed as due to dengue infection by virus isolation. One or two of the fatal cases with virus isolation were primary infections, based on the results of hemagglutination-inhibition tests using all 4 dengue antigens.