Guzmán M G, Vázquez S, Martínez E, Alvarez M, Rodríguez R, Kourí G, de los Reyes J, Acevedo F
Instituto de Medicina Tropical Pedro Kouri, La Habana, Cuba.
Bol Oficina Sanit Panam. 1996 Aug;121(2):102-10.
The principal aim of this work was to report the reintroduction of dengue virus serotype 3 in the Americas after an absence of 17 years. In addition, it describes the most common symptoms associated with classical dengue and hemorrhagic dengue and presents data on the distribution of the epidemic in the various comprehensive local health care systems of Nicaragua. The study group consisted of 39 patients hospitalized in Managua and León for dengue with hemorrhagic manifestations and hemorrhagic dengue. Of these patients, 34 were classified as probable or confirmed cases of dengue. The most frequent symptoms were fever, headache, vomiting, and muscle and joint pains. The tourniquet test was positive and thrombocytopenia was confirmed in 56% and 44% of the patients, respectively. Epistaxis (67%) was the most common hemorrhagic sign. Of the 356 serum samples received through the dengue surveillance systems in October 1994, IgM antibodies were detected in 43%. The virus was isolated from 5 of 24 samples tested (serotype 3 from 3 and serotype 1 from 2). The reintroduction of serotype 3 of dengue into the Region was demonstrated, along with its ability to produce epidemics of hemorrhagic dengue. The countries are warned that if they do not quickly take the measures described in the guidelines for the prevention and control of dengue and dengue hemorrhagic fever, new epidemics may occur in the Americas, given the large number of persons susceptible to this serotype and the high density of the mosquito vector in most of the countries of the Region.
这项工作的主要目的是报告登革热病毒3型在缺席17年后重新在美洲出现的情况。此外，它描述了与经典登革热和出血性登革热相关的最常见症状，并呈现了尼加拉瓜各个综合地方卫生保健系统中疫情分布的数据。研究组由在马那瓜和莱昂因登革热伴出血表现及出血性登革热住院的39名患者组成。在这些患者中，34例被归类为登革热疑似或确诊病例。最常见的症状是发热、头痛、呕吐以及肌肉和关节疼痛。束臂试验呈阳性，分别有56%和44%的患者确诊血小板减少。鼻出血（67%）是最常见的出血体征。在1994年10月通过登革热监测系统收到的356份血清样本中，43%检测到IgM抗体。在检测的24份样本中有5份分离出病毒（3份为3型，2份为1型）。证实了登革热3型重新传入该地区，以及其引发出血性登革热疫情的能力。警告各国，如果它们不迅速采取登革热和登革出血热预防与控制指南中所述的措施，鉴于该地区大多数国家有大量人群对这种血清型易感且蚊媒密度高，美洲可能会出现新的疫情。
