Vertical Transmission of Dengue: Review of a Case Series

Introduction: Dengue is the most common mosquito borne disease in humans. Vertical transmission of the dengue virus has been described sporadically, and this means of transmission must be kept in mind for newborns, especially during epidemics. Objective: We present a series of cases of newborns with dengue fever seen at the neonatology Department of the Hospital de Clinicas in San Lorenzo, Paraguay. Methodology: A descriptive study of a series of cases. A total of 10 newborns born to mothers with dengue fever in the peripartum thereafter developed the disease. Auxiliary laboratory testing include series of blood and NS1 antigen tests, which in some cases showed specific IgM. Results: From 2011 to 2013, 10 cases of vertical transmission of dengue were recorded, 70% in male patients, and 70% in full-term pregnancies of appropriate birth weight, while 60% were hospitalized at the time of diagnosis, and the remaining 40% re hospitalized. Of the total, 100% were febrile and 30% showed skin manifestations. Onset of symptoms occurred. at an average of 6.6 days. Average hospital stay was 11.7 days. Expansion by parenteral hydration was required for 6 patients. Capillary extravasation was seen in 50% of cases. Leukopenia was seen in 80%, average hematocrit ratio was 57.4% (80% of newborns with hemoconcentration); moderate to severe thrombocytopenia in 90%, with lowest points occurring in days 4 to 6 of disease. NS1. antigen was positive in 90% and IgM serum positive in 40%. All the newborns (100%) were discharged. Conclusion: This information suggests that it would be prudent to monitor newborns in a hospital setting until day 7 of life and that a management protocol for dengue in pregnancy and in newborns based on current experience should be drafted.