ressElmer Articles © The authors | Journal compilation © J Clin Med Res and Elmer Press ™ | www.jocmr.org Simple Prognostic Criteria Can Definitively Identify Patients Who Develop Severe Versus Non-Severe Dengue Disease, or Have Other Febrile Illness

Background: Severe dengue disease (SDD) (DHF/DSS: dengue hemorrhagic fever/dengue shock syndrome) results from either primary or secondary dengue virus (DENV) infections, which oc-cur 4- 6 days after the onset of fever. As yet, there are no defini-tive clinical or hematological criteria that can specifically identify SDD patients during the early acute febrile-phase of disease (day 0- 3: < 72 hours). This study was performed during a SDD (DHF/ DSS) epidemic to: 1) identify the DENV serotypes that caused SDD during primary or secondary DENV infections; 2) identify simple clinical and hematological criteria that could significantly discriminate between patients who subsequently developed SDD versus non-SDD (N-SDD), or had a non-DENV fever of unknown origin (FUO) during day 0- 3 of fever; 3) assess whether DENV serotype co-infections resulted in SDD. Methods: First serum samples, with clinical and hematological criteria, were collected from 100 patients during the early acute fe-brile-phase (day 0- 3: < 72 hours), assessed for DENV or FUO in-fections by IgM- and IgG-capture ELISAs on paired serum samples and by DENV isolations, and subsequently graded as SDD, N-SDD or FUO patients. Results: In this study: 1) Thirty-three patients had DENV infec-tions, predominantly secondary DENV-2 infections, including eac