Dengue and Dengue Haemorrhagic Fever in Children During the 2000 Outbreak in Chittagong, Bangladesh

An outbreak of dengue/dengue haemorrhagic fever occurred during 2000 in Chittagong, Bangladesh. A total of 72 children admitted to the Paediatrics ward of the Chittagong Medical College Hospital were evaluated. Sixty-four (89.0%) children came from the Chittagong metropolitan area and the rest 8 (11.0%) from the rural area. The clinical diagnosis of dengue fever (DF) was made in 26 children (36.0%), dengue haemorrhagic fever (DHF) in 36 (50.0%), and dengue shock syndrome (DSS) in 10 children (14.0%) according to WHO case definition. The mean age was 8.4 + 3.0 years. The distinct features of the present study were: rural occurrence of the disease, which affected malnourished children and more of the students; a higher prevalence of haemorrhagic manifestations and hepatomegaly; jaundice, cough, splenomegaly and encephalopathy; and high PCV in a half and low platelet in one -fourth of the DF patients. The recorded case fatality was 5 (7.0%). It was found that respiratory difficulty, pleural effusion, splenomegaly, tachycardia, low blood pressure, narrow pulse pressure, prolonged capillary refill time, shock, convulsion, coma and platelet count of 100,000/cmm or less were significantly associated with a 5 -25 times higher risk of death. Country-specific control measures, case definition, and case management are desirable.