RELATIONS BETWEEN THE VIREMIA DURATION, THE VIRAL GENOTYPES AND CLINIC-PARACLINIC MANIFESTATIONS OF DENGUE HAEMORRHAGIC FEVER

Do Quang Ha*, Vu Thi Que Huong*, Vo Dinh Tham**, Eliane Chungue***, Claudine Roche***.

* Pasteur Institute HoChiMinh City ** Children Hospital No 2 - Grall,

*** Institut Territorial de Recherches Médicales Louis-Malardé, Tahiti.

Abstract

The sequential sera were taken from 65 patients hospitalized in the Dengue Haemorrhagic Fever Department, Children Hospital No.2 (Grall), from June to November 1996. Fifty-four DF/DHF cases confirmed by viral isolation, RT-PCR, and/or serological tests (HI and Mac-ELISA) were collected (17 primary infections and 37 secondary infections). Their data were recorded as follows:

– Sex ratio: 34M/20F. Age: 8 months to 15 years. Addresses: HoChiMinh City (42 cases), Other provinces (12 cases).

– Degrees of severity: DF (1 case), DHF grade I (2 cases), grade II (31 cases), grade III (18 cases) and grade IV (2 cases).

– The clinical signs observed: continuous high fever (100%), spontaneous haemorrhage (94.4%), vomiting (78%), hepatomegaly (63%), abdominal pain (51%), shock (37%).

– Means of hemogram: Leucocytes: 6543/mm³, Hct: 45%, platelets: 90,000/mm³, VGM: 80.5m³, reticulocytes: 0.2%.

– Mild and moderate augmentation of SGOT and SGPT (with mean of 102.5IU/L and 42IU/L, respectively) suggested the existence of benign and moderate hepatitis.

– Virus isolation revealed only 5 positive cases (1 DEN-1, 2 DEN-2, 2 DEN-3), while RT-PCR could detect 31 positive cases which consisted 6 DEN-1, 9 DEN-2 and 16 DEN-3. Among these 31 cases, 14 were positive (by RT-PCR) during ³ 2 consecutive days.

The clinical, biological, virological and serological data of these 31 cases detected by RT-PCR did not show the significant correlation between viremia duration and/or viral genotypes and clinical aspects, biological disorders and immunological responses.