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American Journal of Epidemiology, Vol 152, Issue 9 793-799, Copyright © 2000 by Oxford University Press

Epidemiologic studies on Dengue in Santiago de Cuba, 1997 [In Process Citation]

MG Guzman, G Kouri, L Valdes, J Bravo, M Alvarez, S Vazques, I Delgado and SB Halstead
Institute of Tropical Medicine Pedro Kouri, Havana, Cuba.

A small, isolated outbreak of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) due to dengue virus type 2 (DEN-2) was documented in Santiago de Cuba on the island of Cuba beginning in January 1997. There were 205 DHF/DSS cases, all in persons older than age 15 years. All but three had evidence of a prior dengue infection, with the only known opportunity being the islandwide dengue virus type 1 (DEN-1) epidemic of 1977-1979. Virtually complete clinical and laboratory surveillance of overt disease was achieved. From December 1997 to January 1998, a random, age-stratified serum sample was obtained from 1,151 persons in 40 residential clusters in Santiago. Sera were tested for DEN-1 and DEN- 2 neutralizing antibodies. The prevalence of DEN-2 antibodies in children age 15 years and under, born after the 1981 DEN-2 epidemic, was taken as the 1997 DEN-2 infection rate. This was adjusted slightly to accommodate observed cases, resulting in an estimated infection rate of 4.3%. Dengue fever and DHF/DSS attack rates were calculated from estimated total primary and secondary DEN-2 infections. Only 3% of 13,116 primary infections were overt. The DHF/DSS attack rate for adults of all ages was 420 per 10,000 secondary DEN-2 infections.
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Related articles in Am. J. Epidemiol.:

Invited Commentary: Dengue Lessons from Cuba
David W. Vaughn
Am. J. Epidemiol. 2000 152: 800-803. [Abstract] [FREE Full Text]  

Dr. Guzmán et al. Respond to Dr. Vaughn
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Am. J. Epidemiol. 2000 152: 804. [Abstract] [FREE Full Text]  



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