Am J Epidemiol 2002; 156:40-51.
Copyright © 2002 by the
Johns Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Epidemiology of Inapparent and Symptomatic Acute Dengue Virus Infection: A Prospective Study of Primary School Children in Kamphaeng Phet, Thailand
1 Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
2 Division of General Communicable Diseases, Department of Communicable Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
3 Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, MA.
4 Department of Virus Diseases, Division of Communicable Diseases and Immunology, Walter Reed Army Institute of Research, Silver Spring, MD.
Dengue viruses are a major cause of morbidity in tropical and subtropical regions of the world. Knowledge about the epidemiology and host determinants of inapparent and severe dengue virus infections is limited. In this paper, the authors report findings from the first 3 years of a prospective study of dengue virus transmission and disease severity conducted in a cohort of 2,119 elementary school children in northern Thailand. A total of 717,106 person-school days were observed from 1998 to 2000. The incidence of inapparent and of symptomatic dengue virus infection was 4.3% and 3.6% in 1998, 3.2% and 3.3% in 1999, and 1.4% and 0.8% in 2000, respectively. Symptomatic dengue virus infection was responsible for 3.2%, 7.1%, and 1.1% of acute-illness school absences in 1998, 1999, and 2000, respectively. The early symptom complex of acute dengue virus infection is protean and difficult to distinguish from other causes of febrile childhood illnesses. The authors’ results illustrate the spatial and temporal diversity of dengue virus infection and the burden of dengue disease in schoolchildren in Thailand. Their findings increase understanding of dengue virus transmission and disease severity in a well-defined cohort population and offer a study design in which to test the efficacy of potential dengue vaccines.
dengue virus; disease attributes; epidemiologic factors; infection
Abbreviations: Abbreviations: ANOVA, analysis of variance; CI, confidence interval; EIA, enzyme immunoassay; HAI, hemagglutination inhibition; Ig, immunoglobulin; RR, relative risk.
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