The analysis of imported cases of dengue fever in Saint-Petersburg

Abstract

Aim of work Analysis of epidemiological, clinical and laboratory features of dengue fever in St. Petersburg in 2012-2015. Materials and methods. There were analyzed medical records of 43 patients hospitalized with dengue fever in S.P. Botkin Clinical Infectious Diseases Hospital. In all cases the diagnosis of dengue fever was confirmed by ELISA. Results. At the prehospital stage the correct diagnosis ofdengue fever was established only in 1/5 ofpatients (n = 9). Among other patients 39.5% were hospitalized with the diagnosis of acute respiratory viral infection (n = 17), 9.3% (n = 4) - with pneumonia, 4.7% (n = 2) - with enterocolitis and the rest - with infectious mononucleosis, measles, rubella, sore throat, pseudotuberculosis and acute hepatitis. At admission the sound diagnosis of dengue fever was made only in quarter ofpatients (n = 11), in other 63% of cases there was made the diagnosis of acute respiratory viral infection, gastroenterocolitis and rubella in 4-7%, and viral hepatitis in 2,3% of a cases. On the threshold of the disease 76.7% (n=33) patients visited Thailand and Vietnam, 11.6% (n=5) - India, 4.7% (n=2) - Cuba. The clinical picture of the diseases was characterized by follows signs: fever (39.1 ± 0,60C° for 6.4 ± 16 days), in some cases - two-wave fever was registered, oropharyngeal hyperemia was seen in 69.8%, myalgia and arthralgia in 41.9% of cases, small-spotted or mottled-papular rash was observed in half of the patients, 7% ofpatients had a hemorrhagic component of a rush. Polylymphoadenopathy was registered in 48.8%, hepatomegaly in 46.5% and splenomegaly in 18.6% of patients. Laboratory data showed leukopenia - in 67%, (3.5 ± 1,3•109/l), thrombocytopenia - in 70% (140 ± 58,3•109/l), increased ALT activity (72,2 ± 62,9 U/l; max - 247 U/l) and AST (73.3 ± 55.5 U/l; max - 225 U/l) in the half of the cases. Conclusion. The course of dengue fever on the territory of St. Petersburg in 2012 - 2015 was characterized by typical clinical and laboratory symptoms, but the lack of epidemiological alertfor imported infections becomes an obstacle for timely diagnosis of the disease and gives trouble to make the choice of the right tactics of treatment.

Keywords

dengue fever / clinical picture / laboratory diagnosis

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