DENGUE: EPIDEMIOLOGY PART II. SCOTT B HALSTEAD, MD. Director, Research PEDIATRIC DENGUE VACCINE INITIATIVE. EPIDEMIOLOGY. Risk factors for severe disease. Sequential dengue infection (includes antigenic structure of virus) Race Age Host genetic factors Nutritional status Sex. Race.
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SCOTT B HALSTEAD, MD
PEDIATRIC DENGUE VACCINE INITIATIVE
At least 5:11,2
IN PORT AU PRINCE, HAITI, 1996.
N =(46) (40) (36) (41) (27) (13) (10) (4)
GUZMAN MG et al. Int J Infect Dis 6:18, 2002
CAPILLARY FRAGILITY RESIDENT
Gamble J et al. Biochem Soc Med Res Soc 98:211-6, 2000.
HLA1: HLA-A*0207 HLA-A*0203
HLA A24 HLA A33
Vit D2: t allele/352
DCSIGN4: CD 209 promoter
TNFα5: TNF 308
1. Loke H et al. JID 184:1369-73, 2001
2. Stephens HA et al. Tissue Antigens 60:309-318, 2002.
3. Loke H et al. AJTMH 67:102-6, 2001
4. Sakuntabthai A et al. Nat Genetics 37:507-13, 2005
5. Fernandez-Mestre MT et al. Tissue Ag 64:468-72, 2004
Well nourished children:
highly susceptible to severe disease
Malnourished: protected against severe disease (protein-calorie malnutrition grade 2 and 3)
1. Thisyakorn U et al. CID 16:295-297, 1993
DSS in a 6 month-old infants with hepatomegaly. Vietnam DHF/DSS in children
CENTRAL ROLE OF MACROPHAGES IN SUPPORTING DENGUE INFECTIONS IN HUMANS
Dengue viruses are adapted to grow in dendritic cells, DHF/DSS in children
monocytes and macrophages.
Complexed with antibodies dengue viruses enter FcR-bearing cells with great efficiency.
DEN 3 DHF/DSS in children
LIBRATY DH et al JID 185:1213, 2002
Schematic distribution of dengue 2 viruses DHF/DSS in children
in blood and tissues of 31 rhesus monkeys.
DENGUE VIRUSES, BANGKOK 1973 - 2001 severity and size.