31411 - DENGUE EPIDEMIOLOGY PART II SCOTT B HALSTEAD MD...

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DENGUE: EPIDEMIOLOGY PART II SCOTT B HALSTEAD, MD Director, Research PEDIATRIC DENGUE VACCINE INITIATIVE
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EPIDEMIOLOGY Risk factors for severe disease. Sequential dengue infection (includes antigenic structure of virus) Race Age Host genetic factors Nutritional status Sex
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Race Caucasian & Asian vs African. At least 5:1 1,2 1. Guzman MG et al. AJTMH 42:179-184, 1990. 2. Halstead SB et al AJTMH 65:180, 2001
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BLACKS ARE RELATIVELY RESISTANT TO SEVERE DENGUE ILLNESS A human resistance gene seems to explain the observation that while all dengue virus types circulate in Africa no DHF/DSS cases or outbreaks of DF have been reported.
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RACE - SANTIAGO DE CUBA OUTBREAK, 1997 Race DHF % Deaths % Open Pop % White 130 47.7 3 25.0 30.1 Mixed 60 35.5 6 50.0 42.8 Black 27 16.0 2 16.7 26.8 Asian 3 1.8 1 8.3 0.27 Totals 169 12
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0 10 20 30 40 50 60 70 80 90 100 Percent 6 7 8 9 10 11 12 13 Age (years) HETEROTYPIC DENGUE 4 DENGUE 3 DENGUE 2 DEN 1 DENGUE NEUTRALIZING ANTIBODIES BY AGE IN 210 CHILDREN RESIDENT IN PORT AU PRINCE, HAITI, 1996. N =(46) (40) (36) (41) (27) (13) (10) (4)
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AGE
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DHF - EFFECT OF AGE, 1981 Cuba Outbreak GUZMAN MG et al. Int J Infect Dis 6:18, 2002
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CAPILLARY FRAGILITY Gamble J et al. Biochem Soc Med Res Soc 98:211-6, 2000.
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Susceptibility Resistance HLA 1 : HLA-A*0207 HLA-A*0203 HLA-B*51 HLA-B*52 HLA A24 HLA A33 Vit D 2 : t allele/352 FcRγII 3 : DCSIGN 4 : CD 209 promoter TNFα 5 : 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
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31411 - DENGUE EPIDEMIOLOGY PART II SCOTT B HALSTEAD MD...

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