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. 2014 Mar;90(3):449-56.
doi: 10.4269/ajtmh.13-0544. Epub 2014 Jan 27.

Occurrence and correlates of symptom persistence following acute dengue fever in Peru

Eric S Halsey  1 , Maya Williams, V Alberto Laguna-Torres, Stalin Vilcarromero, Victor Ocaña, Tadeusz J Kochel, Morgan A Marks
Affiliations

Occurrence and correlates of symptom persistence following acute dengue fever in Peru

Eric S Halsey et al. Am J Trop Med Hyg. 2014 Mar.

Abstract

Dengue virus (DENV) infection causes an acute febrile illness generally considered to result in either complete recovery or death. Some reviews describe persistent symptoms after the febrile phase, although empirical data supporting this phenomenon is scarce. We evaluated symptom persistence in acute febrile DENV-infected and DENV-negative (controls) individuals from Peru. Self-reported solicited symptoms were evaluated at an acute and a follow-up visit, occurring 10-60 days after symptom onset. Rate of persistence of at least one symptom was 7.7% and 10.5% for DENV infected and control subjects, respectively (P < 0.01). The DENV-infected individuals had lower rates of persistent respiratory symptoms, gastrointestinal symptoms, headache, and fatigue, but higher rates of persistent rash compared with controls. Older age and female gender were positively associated with symptom persistence. As dengue cases continue to increase annually, even a relatively low frequency of persistent symptoms may represent a considerable worldwide morbidity burden.

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Figures

Figure 1.
Figure 1.
The six recruitment sites in Peru are denoted with black circles. The capital of Peru, Lima, is denoted with a star and was not a recruitment site.
Figure 2.
Figure 2.
The number of subjects enrolled, excluded, and included in the febrile control and dengue virus (DENV) infected groups based on laboratory diagnosis. *Cross-reactivity was defined as immunoglobulin M (IgM) serologic positivity for both DENV and a non-DENV arbovirus. †Removed from analysis.
Figure 3.
Figure 3.
The presence of at least one symptom at the acute visit (left axis) and persistent rates at three follow-up time periods (right axis).
Figure 4.
Figure 4.
The presence of specific symptom groups at the acute visit (left axis) and persistent rates at three follow-up periods (right axis). The six symptom groups and their corresponding symptoms were “respiratory” (cough, rhinorrhea, and/or expectoration), “gastrointestinal” (decreased appetite, abdominal pain, diarrhea, nausea, and/or vomiting), “headache” (headache), “fatigue” (malaise and/or asthenia), “body pain” (myalgia, bone pain, and/or joint pain), and “rash” (truncal rash, extremity rash, and/or facial rash).
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