Tai AYC

McGuinness, Sarah

Robosa R

Turner D

Huang GKL

Leder K

Korman TM

Thevarajan I

Stewardson AJ

Padiglione AA

Johnson DF

2017-04-17

To describe the epidemiology, clinical and laboratory features and outcomes of dengue in returned Australian travellers, applying the revised WHO dengue classification (2009) to this population. Retrospective case series analysis of confirmed dengue cases hospitalised at one of four Australian tertiary hospitals, January 2012 - May 2015. Clinical features, laboratory findings and outcomes of patients with dengue; dengue classification according to 2009 WHO guidelines. 208 hospitalised patients (median age, 32 years; range, 4-76 years) were included in the study. Dengue was most frequently acquired in Indonesia (94 patients, 45%) and Thailand (40, 19%). The most common clinical features were fever (98% of patients) and headache (76%). 84 patients (40%) met the WHO criteria for dengue with warning signs, and one the criteria for severe dengue; the most common warning signs were mucosal bleeding (44 patients, 21%) and abdominal pain (43, 21%). Leukopenia (176 patients, 85%), thrombocytopenia (133, 64%), and elevated liver enzyme levels (154, 76%) were the most common laboratory findings. 46 patients (22%) had serological evidence of previous exposure to dengue virus. WHO guidelines were documented as a management benchmark in ten cases (5%); 46 patients (22%) received non-steroidal anti-inflammatory drugs (NSAIDs). A significant proportion of returning Australian travellers hospitalised for dengue have unrecognised warning signs of severe disease. Many received NSAIDs, which can increase the risk of haemorrhage in dengue. As travel to Asia from Australia continues to increase, it is vital for averting serious outcomes that clinicians can recognise and manage dengue.

Austin Health, Melbourne, VIC alakaytai@gmail.com..

Royal Darwin Hospital, Darwin, NT..

Monash Infectious Diseases, Monash Health and Monash University, Melbourne, VIC..

Victorian Infectious Disease Service, Royal Melbourne Hospital, Melbourne, VIC..

Royal Darwin Hospital, Darwin, NT..

Victorian Infectious Disease Service, Royal Melbourne Hospital, Melbourne, VIC..

Monash Infectious Diseases, Monash Health and Monash University, Melbourne, VIC..

Victorian Infectious Disease Service, Royal Melbourne Hospital, Melbourne, VIC..

Austin Health, Melbourne, VIC..

Monash Infectious Diseases, Monash Health and Monash University, Melbourne, VIC..

Austin Health, Melbourne, VIC..

Med J Aust . 2017 Apr 17;206(7):295-300. doi: 10.5694/mja16.01056.

https://pubmed.ncbi.nlm.nih.gov/28403751/?otool=iaurydwlib

https://hdl.handle.net/10137/5247

Abdominal Pain

Adolescent

Adult

Aged

Anti-Inflammatory Agents, Non-Steroidal

Australia

Child

Child, Preschool

Dengue

Dengue Virus

Disease Management

Female

Fever

Headache

Hemorrhage

Hospitalization

Humans

Indonesia

Leukopenia

Male

Middle Aged

Retrospective Studies

Tertiary Care Centers

Thailand

Thrombocytopenia

Young Adult

Travel

Management of dengue in Australian travellers: a retrospective multicentre analysis.

Journal Article

Publication