Critical Dengue in 27% of Cases: ESPID 2024 Highlights Urgent Need for DENV2-Targeted Strategies

The largest dengue outbreak ever recorded in the Americas (2023-2024) has provided crucial insights into predictors of severe disease, according to data presented at ESPID 2024. Researchers from Hospital Universitario del Valle (HUV) in Colombia conducted a prospective cohort study of 600 patients with virologically confirmed dengue to identify factors associated with critical dengue-defined as severe dengue or dengue with warning signs progressing to a severe course (e.g., vascular leakage, hemodynamic compromise, organ dysfunction).

Overall, 27% of patients developed critical dengue, most of whom were children and adolescents (median age: 13 years). Infection with serotype DENV2 emerged as a significant risk factor, especially in those with prior dengue exposure (OR 2.51; interaction P = 0.04). Additional independent predictors included living outside city limits and clinical presentation with bleeding or edema. The study also found a predominance of DENV2 (32%) and DENV3 (15%) among sequenced samples, highlighting the genetic diversity fueling this epidemic. Investigators stressed the importance of Vaccines targeting DENV2 and early recognition of high-risk patients to reduce morbidity and mortality in future outbreaks...Read more

ESPID (OP059)

How feasible is early serotyping in low-resource settings to predict severity?