Effect of age on outcome of secondary dengue 2 infections
Effect of age on outcome of secondary dengue 2 infections
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DOI：
10.1016/s1201-9712(02)90072-x
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发表时间：
2002-06-01
影响因子：
8.4
通讯作者：
Halstead, Scott B.
中科院分区：
文献类型：
--
作者：
Guzman, Maria G.;Kouri, Gustavo;Halstead, Scott B.
目的：登革出血热/登革休克综合征(DHF/DSS)是一个日益严重的全球性健康问题。目前尚不清楚年龄如何影响继发性登革热感染的结局。在一个岛屿环境中，1981年在古巴发生了一次大规模的DHF/DSS疫情。涉及的是3-40岁的个人，他们一生中唯一接触登革热的是1977年的登革热1号和1981年的登革热2号。在这份报告中，我们根据二次登革热感染计算了特定年龄的DHF/DSS住院率和死亡率。方法：利用1981年DHF/DSS暴发期间已发表和未发表的医院和血清流行病学资料进行分析。结果：3岁和4岁儿童继发DEN-2感染的死亡率较高(25.4/10000)。死亡率随着年龄的增长而下降，10-14岁年龄组的死亡率低15.9倍。3-14岁儿童的死亡率是15-39岁年轻人的14.5倍。在50岁及以上的成年人中，死亡率有所上升。DHF/DSS住院率与死亡率呈现相同的趋势。结论：年龄是继发性DEN-2感染预后的重要变量。婴幼儿和老年人的DHF/DSS病死率和住院率最高。儿童在二次登革热感染期间死亡的风险几乎是成人的15倍。
Objective: Dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is a growing global health problem. It is not known how age affects the outcome of secondary dengue infections. In an island setting, a large DHF/DSS outbreak in Cuba occurred in 1981. Involved were individuals, 3-40 year old, whose only lifetime dengue exposure was to DEN-1 in 1977 and DEN-2 in 1981. In this report we calculate age-specific DHF/DSS hospitalization and death rates based on secondary DEN 2 infections. Methods: Published and unpublished hospital and seroepidemiologic data from the 1981 DHF/DSS outbreak were used for the analysis. Results: Children, aged 3 and 4 years, with secondary DEN-2 infections were found to have a high death rate (25.4/10 000 secondary DEN-2 infections). The death rate fell with increasing age, being 15.9-fold lower in the 10-14-year age group. The death rate for children aged 3-14 years was 14.5-fold higher than in young adults aged 15-39 years. The death rate rose somewhat in adults aged 50 years and older. DHF/DSS hospitalization rates showed the same trend as death rates. Conclusions: Age is an important variable in the outcome of secondary DEN-2 infections. DHF/DSS case fatality and hospitalization rates are highest in young infants and the elderly. The risk that a child will die during a secondary DEN-2 infection is nearly 15-fold higher than the risk in adults.