670. Differentiating Dengue From Other Acute Febile Illnesses. A Comparative Analysis
Session: Abstracts: Virology
Friday, October 22, 2010
Background: The features of early dengue infection are not well described. Distinguishing dengue from other acute febrile illnesses (AFIs) is important for clinical and public health reasons. We undertook this prospective study to look for clinical and laboratory predictors that will help differentiate early dengue infection from AFIs in adults at initial presentation to primary care centres.

Methods: We prospectively evaluated all patients with acute fever onset of less than seventy-two hours duration in the outpatient setting. Patients with obvious upper respiratory tract symptoms were excluded. All patients completed a standardized questionnaire on demographics and symptomatology at presentation. Blood samples were collected for dengue polymerase chain reaction, isolation and serology. Nasal samples were analyzed for viral respiratory pathogens using direct immunofluorescence assay (DFA) and culture techniques. A monoclonal antibody respiratory screen against known respiratory pathogens was applied to DFA positive sample.

Results:  A total of 447 cases of laboratory confirmed dengue (n= 256) and AFI (n=191) cases were analysed. The demographics were similar in both groups except for age. Dengue cases were older ( 40 vs 34 years, p<0.01). On multivariate analysis, older age, joint pain, diarrhoea, vomiting, red eyes, leucopenia and lymphopenia on initial testing  were predictive of dengue infection.

Conclusion: The use of a combination of clinical symptoms and basic hematological values can aid in differentiating early acute dengue infections from other AFI.


Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Speakers:
Adrian Ong, MD, MPH , Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore, Singapore
Jenny Low, MD, MPH , Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore, Singapore
Eng Eong Ooi, PhD , Program in Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore, Singapore

Disclosures:

A. Ong, None

J. Low, None

E. E. Ooi, None

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