Dengue and other febrile illness among children in the Philippines

In view of the increasing trend of DHF in the Philippines, a prospective study was undertaken to define the clinical and haematological differences between DF/DHF and other febrile illnesses (OFI) between 1999 and 2001. A total of 503 paediatric patients, who had acute febrile illness without an apparent focus of infection and who were admitted to St. Luke's Medical Center in Metro Manila, Philippines, were enrolled in this study. Of these, 359 cases (71.4%) were diagnosed with a dengue virus infection and 144 cases (28.6%) were OFI, respectively. Most of the cases with dengue virus infection were associated with DENV-1 and DENV-2. One third of the patients with dengue virus infections were DHF,
and most of these were without shock. A low incidence of dengue shock syndrome and a low fatality rate among paediatric patients with dengue virus infection was found. The white blood cell counts were significantly lower in DF or DHF than in OFI. The platelet count was also significantly lower in DHF than in DF or OFI. On the other hand, the haematocrit was significantly higher in DHF than in OFI. Coagulation abnormalities associated with a majority of DHF patients were thrombocytopaenia and an increased fibrinolysis, but not disseminated intravascular coagulation. We present here clinical and laboratory data on paediatric patients with acute febrile illness lacking an apparent focus of infection that can be used for an early diagnosis and appropriate clinical management of patients with dengue virus infections in Metro Manila, Philippines.