Department of Medicine, Allama Iqbal Medical College and Jinnah Hospital, Maulana Shabbir Ahmed Usmani Road, Lahore, Punjab, Pakistan.
Int J Infect Dis. 2010 Sep;14 Suppl 3:e54-9. doi: 10.1016/j.ijid.2009.10.008. Epub 2010 Feb 19.
The objective of this study was to investigate the clinical characteristics of patients with dengue viral infection during the 2008 outbreak in Lahore in order to better understand the clinical pattern and severity of disease in Lahore.
We analyzed the clinical characteristics of 110 patients infected with dengue virus; data were collected on standardized data collection sheets at two tertiary care hospitals from September to December 2008. Dengue infection was confirmed serologically or by real-time polymerase chain reaction (RT-PCR).
Out of the total of 110 dengue infected patients, 70 were male and 40 were female. The most common symptoms included fever (100%), myalgia (68.2%), headache (55.5%), nausea (39.1%), skin rash (53.6%), mucocutaneous hemorrhagic manifestations (58.2%), and ocular pain (20%). Classic dengue fever (DF) was seen in 41.8% of the patients, 56.4% had dengue hemorrhagic fever (DHF), and only 1.8% developed dengue shock syndrome (DSS). The mean duration of fever was 6 days. Thrombocytopenia, leukopenia, and abnormal aspartate aminotransferase (AST)/alanine aminotransferase (ALT) were more frequently encountered in DHF and DSS as compared to DF. Viral RNA detection was done by RT-PCR in 17 patients. Ten patients had DEN4, five had DEN2, and two had DEN3 serotypes. The majority of the patients recovered completely without complications.
The high frequency of DHF during the 2008 outbreak and the presence of three different dengue serotypes, emphasize the need to prevent and control dengue infection. Health authorities should consider strengthening surveillance for dengue infection, given the potential for future outbreaks with increased severity. It is also suggested that primary care physicians should be educated regarding recognition of DHF and to identify patients at high risk of developing DHF and DSS.
本研究旨在调查 2008 年拉合尔登革热疫情期间登革病毒感染患者的临床特征，以便更好地了解拉合尔的疾病临床模式和严重程度。
我们分析了 2008 年 9 月至 12 月在两家三级护理医院采集的 110 例登革病毒感染患者的临床特征。登革热感染通过血清学或实时聚合酶链反应（RT-PCR）确认。
在总共 110 例登革热感染患者中，70 例为男性，40 例为女性。最常见的症状包括发热（100%）、肌痛（68.2%）、头痛（55.5%）、恶心（39.1%）、皮疹（53.6%）、黏膜皮肤出血表现（58.2%）和眼部疼痛（20%）。典型登革热（DF）占 41.8%，登革出血热（DHF）占 56.4%，仅 1.8%发展为登革休克综合征（DSS）。发热平均持续 6 天。血小板减少症、白细胞减少症和天门冬氨酸氨基转移酶（AST）/丙氨酸氨基转移酶（ALT）异常在 DHF 和 DSS 中比在 DF 中更常见。17 例患者进行了 RT-PCR 检测病毒 RNA。10 例患者为 DEN4 型，5 例为 DEN2 型，2 例为 DEN3 型。大多数患者完全康复，无并发症。
2008 年疫情中 DHF 高发，存在三种不同的登革热血清型，强调需要预防和控制登革热感染。鉴于未来可能会出现更严重的疫情，卫生当局应考虑加强对登革热感染的监测。此外，建议初级保健医生接受有关识别 DHF 的教育，并识别出有发展为 DHF 和 DSS 高风险的患者。
