The 2001 dengue epidemic in Chennai

Dengue is emerging as a serious public health problem in Tamil Nadu. The present surveillance system is unlikely to generate proper information on the epidemiology of the disease, which is essential for planning and development of relevant control/preventive measures against dengue. Objective: Between November 2001 and January 2002, a descriptive study was undertaken on children with clinical dengue attending Kanchi Kamakoti Child Trust Hospital (KKCTH, a major private referral pediatric hospital in Tamil Nadu, India) to define the magnitude of dengue burden, the natural history of this disease in terms of clinical presentation, and outcome of the infections in hospitalized children (<15) with clinical dengue. Methods: The sera collected from patients analyzed for dengue specific IgM and IgG antibodies by IgM, IgG antibody capture enzyme linked immunosorbent assay (ELISA) using alternatively two commercial kits. World Health Organization clinical case definition was adopted to categorize the dengue confirmed children. Results: Dengue was diagnosed in 74.5% (143) of the 192 hospitalized children with clinical dengue. A considerable proportion (20%) of the total dengue infections were constituted by infants less than 1 yr of age. DF [dengue fever], DHF [dengue hemorrhagic fever] and DSS [dengue shock syndrome] were diagnosed in 65%, 11.2% and 23.8% of 143 dengue confirmed patients respectively. Though severe dengue (DSS + DHF) was present in 35% of the patients, the mortality rate was low during the study period due to timely diagnosis and clinical management of the patients. Conclusion: In developing countries like India, building of laboratory capacity for diagnosis and combat-mode ready preparedness for the management of dengue cases in emergency situation may reduce dengue-related mortality. This can be achieved in a wider scale through an integrated approach through the community, professionals and the public health departments.