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Dengue and other febrile illness among children in the Philippines


Kazunori Oishi,
Cynthia A. Mapua,
Celia  C. Carlos,
Mariko Saito,
Shingo Inoue,
Kouichi Morita,
Filipinas F. Natividad

Related Institution

International Research Center for Infectious Diseases - Research Institute for Microbial Diseases, Osaka University

Department of Internal Medicine - Institute of tropical Medicine Nagasaki University

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Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
St. Luke's Journal of Medicine
Publication Date

Publication Type
Publication Sub Type
Journal Article, Original
Dengue Bulletin
Publication Date


In view of the increasing trend of DHF in the Philippines, a prospective study was undertaken to define the clinical and haematological differences between DF/DHF and other febrile illnesses (OFI) between 1999 and 2001. A total of 503 paediatric patients, who had acute febrile illness without an apparent focus of infection and who were admitted to St. Luke's Medical Center in Metro Manila, Philippines, were enrolled in this study. Of these, 359 cases (71.4%) were diagnosed with a dengue virus infection and 144 cases (28.6%) were OFI, respectively. Most of the cases with dengue virus infection were associated with DENV-1 and DENV-2. One third of the patients with dengue virus infections were DHF,
and most of these were without shock. A low incidence of dengue shock syndrome and a low fatality rate among paediatric patients with dengue virus infection was found. The white blood cell counts were significantly lower in DF or DHF than in OFI. The platelet count was also significantly lower in DHF than in DF or OFI. On the other hand, the haematocrit was significantly higher in DHF than in OFI. Coagulation abnormalities associated with a majority of DHF patients were thrombocytopaenia and an increased fibrinolysis, but not disseminated intravascular coagulation. We present here clinical and laboratory data on paediatric patients with acute febrile illness lacking an apparent focus of infection that can be used for an early diagnosis and appropriate clinical management of patients with dengue virus infections in Metro Manila, Philippines.


1. Hammon, W. M., Rudnick, A. , Sather, G. E.. "Viruses associated with epidemic hemorrhagic fevers of the Philippines and Thailand." Science 131, 1102-3, April 1960
2. Venzon, El , Rudnick, A. , Marchette, N. J., Fabie, A. E., Dukellis, E. . "The greater Manila dengue hemorrhagic fever epidemic of 1966" Journal of Philippine Medical Association 48, 297-313, 1972
3. Dizon, J. J.. "The occurrence of dengue hemorrhagic fever in the Philippines" Asian Journal of Infectious Disease 2, 15-17, 1978
4. Hayes, C. G., Manoloto, C. R., Gonzales, A. , Ranoa, C. P.. "Dengue infections in the Philippines: clinical and virological findings on 517 hospitalized patients" American Journal of Tropical Medicine and Hygiene 39(1): 110-6, July 1988
5. La Russa, V. F., Innis, B. L.. "Mechanism of dengue virus-induced bone marrow suppression" Baillieres Clinical Haematology 8(1): 249-70, March 1995
6. Saito, M. , Oishi, K. , Inoue, S. , Dimaano, E. M., Alera, M. T., Robles, A. M., Estrella, B. D. jr, Kumatori, A. , Moji, K. , Alonzo, M. T., Buerano, C. C., Matias, R. R., Morita, K. , Natividad, F. F., Nagatake, T. . "Association of increased platelet-associated immunoglobulins with thrombocytopenia and the severity of disease on secondary dengue virus infection." Clinical Experimental Immunology 138(2): 299-303, November 2004
7. Vaughn, D. W., Green, S. , Kalayanarooj, S. , Innis, B. L., Nimmannitya, S. , Suntayakorn, S. , Rothman, A. L., Ennis, F. A., Nisalak, A. . "Dengue in the early febrile phase: viremia and antibody responses" Journal of Infectious Diseases 176(2): 322-30, August 1997
8. George, R. , Lum, L.C. S., Gubler, D. J., Kuno, G. . Dengue and Dengue Hemorrhagic fever.. New York: CAB International, 1997. 89-113.
9. Carlos , C. C., Oishi, K. , Cinco, M. T., Mapua, C. A., Inoue, S. , Cruz, D. J., Pancho, M. A., Tanig, C. Z., Matias, R. R., Morita, K. , Natividad, F. F., Igarashi, A. , Nagatake, T. . "Comparison of clinical features and hematologic abnormalities between dengue fever and dengue hemorrhagic fever among children in the Philippines" American Journal of Tropical Medicine and Hygiene 73(2): 435-40, August 2005
10. World, Health Organization. Dengue hemorrhagic fever: diagnosis, treatment, prevention, and control. 2nd Ed. Geneva: World Health Organization, 1997.
11. Nishiyama, T. , Matsukawa, T. , Hanaoka, K. . "Is protease inhibitor a choice for the treatment of pre- or mild disseminated intravascular coagulation?" Critical Care Medicine 28(5): 1419-22, May 2000
12. Gubler, D. J.. "Dengue and Dengue Hemorrhagic fever" Clinical Microbiology Reviews 11(3): 480-96, July 1998
13. Vaughn, D. W., Green, S. , Kalayanarooj, S. , Innis, B. L., Nimmannitya, S. , Suntayakorn, S. , Endy, T. P., Raengsakulrach, B. , Rothman, A. L., Ennis, F. A., Nisalak, A. . "Dengue viremia titer, antibody response pattern and virus serotype correlate with disease severity" Journal of Infectious Disease 181(1): 2-9, January 2000
14. Guzman, M. G., Kouri, G. . "Dengue: an update" Lancet Infectious Diseases 2(1): 33-42, January 2002
15. Kalayanarooj, S. , Vaughn, D. W., Nimmannitya, S. , Green, S. , Suntayakorn, S. , Kunentrasai, N. , Viramitrachai, W. , Ratanachu-eke, S. , Kiatpolpoj, S. , Innis, B. L., Rothman, A. L., Nisalak, A. , Ennis, F. A.. "Early clinical and laboratory indicators of acute dengue illness" Journal of Infectious Diseases 176(2): 313-21, August 1997
16. Nguyen, T. H., Lei, H. Y., Nguyen, T. L., Lin, Y. S., Huang, K. J., Le, B. L., Lin, C. F., Yeh, T. M., Do, Q. H., Vu, T. Q., Chen, L. C., Huang, J. H., Lam, T. M., Liu, C. C., Halstead, S. B.. "Dengue hemorrhagic fever in infants: a study of clinical and cytokine profiles" Journal of Infectious Diseases 189(2): 221-32, January 2004
17. Mitrakul, C. , Poshyachinda, M. , Futrakul, P. , Sangkawibha, N. , Ahandrik, S. . "Hemostatic and platelet kinetic studies in dengue hemorrhagic fever" American Journal of Tropical Medicine and Hygiene 26(5pt1): 975-84, September 1977
18. Wills, B. A., Oragui, E. E., Stephens, A. C., Daramola, O. A., Dung, N. M., Loan, H. T., Chau, N. V., Chambers, M. , Stepniewska, K. , Farrar, J. J., Levin, M. . "Coagulation" abnormalities in dengue hemorrhagic fever: serial investigations in 167 Vietnamese children with Dengue shock syndrome 35(3): 277-85, August 2002
19. Rigau-Perez, J. G., Clark, G. G., Gubler, D. J., Reiter, P. , Sanders, E. J., Vorndam, A. V.. "Dengue and Dengue Hemorrhagic fever" Lancet 352(9132): 971-7, September 1998


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