An epidemic of dengue haemorrhagic fever dengue shock syndrome in tropical India

An epidemic of dengue haemorrhagic fever/dengue shock syndrome occurred in Chennai, South India in 1989 during and following the rainy season. Sixty-nine infants and children admitted to the Institute of Child Health and Hospital for Children with a brief febrile illness associated with skin and mucous membrane bleeds and/or shock were studied. Forty-nine had antibodies to dengue viruses. The specific serotype of the virus responsible could not be identified owing to cross-reacting antibodies. Primary infection occurred in 11 cases, secondary infection in 17 cases, antibodiy titres were indicative of 'probable' dengue infection in 16 and were uninterpretable in five. In 11 cases, serology could not be done. The pattern of disease in these 60 cases was similar, with a high mortality. Haemoconcentration was not a feature in the majority and the Hess rest was negative in all those tested. Nine cases with a similar but milder illness rested negative for dengue.