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  • Title: Dengue hemorrhagic Fever caused by sequential dengue 1-3 virus infections over a long time interval: Havana epidemic, 2001-2002.
    Author: Alvarez M, Rodriguez-Roche R, Bernardo L, Vázquez S, Morier L, Gonzalez D, Castro O, Kouri G, Halstead SB, Guzman MG.
    Journal: Am J Trop Med Hyg; 2006 Dec; 75(6):1113-7. PubMed ID: 17172378.
    Abstract:
    A dengue epidemic caused by dengue virus 3 (DENV-3) occurred in Cuba in 2001-2002. It included cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). We report neutralizing antibody studies on sera from 54 of 78 DHF/DSS patients that provide evidence of infections occurring in the sequence DENV-1 followed by DENV-3. No sera showed infection in the sequence DENV-2 followed by DENV-3. Some sera showed a pattern of infection in the sequence DENV-1 followed by DENV-2 and then DENV-3. However definitive categorization of a tertiary infection was not possible because of broadly reactive antibodies, which could have been raised by infections in the sequence DENV-1 then DENV-3.
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