• Indian pediatrics · Aug 1998

    An epidemic of dengue hemorrhagic fever and dengue shock syndrome in children in Delhi.

    • A Aggarwal, J Chandra, S Aneja, A K Patwari, and A K Dutta.
    • Department of Pediatrics, Kalawati Saran Children's Hospital, New Delhi, India.
    • Indian Pediatr. 1998 Aug 1; 35 (8): 727-32.

    ObjectiveTo study clinical profiles and outcome of children of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) during 1996 Delhi epidemic.DesignRetrospective study.SettingHospital based study.MethodsChildren hospitalized from September to November 1996 were studied. All patients were diagnosed, managed and monitored according to a standard protocol.ResultsOne hundred and thirty four children (80 (60%) males and 54 (40%) females) were studied. Sixty (45%) children were less than 6 years of age of which 12 presented during infancy. There were 92 (67%) cases of DHF and 42 (33%) cases of DSS. Common symptoms were fever (93%), abdominal pain (49%) and vomiting (68%). The commonest hemorrhagic manifestation was hematemesis (39%) followed by epistaxis (36%) and skin bleeds (33%). Hepatomegaly was observed in 97 (72%) cases and splenomegaly in 25 (19%). Serology was positive (IgM hemaglutination antibody titres > 1: 160) for dengue type 2 in 31 (80%) of 39 patients in whom sera was tested during the acute phase of illness. Mortality was 6%. Hematocrit > 40% was observed in only 25 (18%) patients and hence the management protocol was based on clinical signs and symptoms and not on hematocrit.ConclusionsA management protocol of DHF/DSS in which fluid therapy is not based on haematocrit values needs to be formulated.

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