Abstract
In Chennai city, India, a cross-sectional serological survey of school children for flavivirus activity by haemagglutination inhibition (*HI) test (April and September, 2001) showed in the later survey a rise in the percentage of children with monotypic antibody responses to dengue virus. Entomological surveillance indicated that a higher proportion of houses were infested by Aedes aegypti in the later survey, suggesting a forthcoming dengue outbreak in Chennai.
In the last quarter of 2001, the city experienced a dengue outbreak. Our investigations in a referral paediatric hospital have revealed that 75% of the hospitalised children (143/192) with clinical dengue were confirmed serologically as dengue and one-third of them (35%, 50/143) suffered from severe dengue. Infants less than one year of age constituted 20% of total dengue infections. The mortality was very low due to early diagnosis and timely management of the cases. A small proportion (7.8%, 15/192) of the children with typical clinical dengue were negative in serological tests.
Our findings suggest that in developing countries, development of basic indicators to foretell dengue outbreaks, building of laboratory capacity for early diagnosis of dengue and ready preparedness for clinical management of the affected in hospitals may reduce dengue-related morbidity and mortality.
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