High case-fatality rate of adults with dengue hemorrhagic fever during an outbreak in non-endemic Taiwan: Risk factors for dengue-infected elders

In 2002, a dengue outbreak occurred in Taiwan with 5336 confirmed cases, 242 DHF and 21 death, the case fatality rate reached 8.7% (21/242). The demographic data of these age-specific dengue patients showed that dengue virus infection caused symptom primarily occurred in adults. A comparative analysis of clinical and laboratory data for DF, DHF/DSS and fatal DSS found that high fatality from dengue infection was associated with the following patient conditions: (1) age above 55 years, (2) underlying diseases with hypertension, chronic renal insufficiency, or diabetes, (3) abnormal thrombocytopenia, APTT and PT prolongation, low hematocrit (<30%) and leukocytosis, (4) abnormal elevation of AST, ALT and BUN. In a non-endemic area like Taiwan, dengue should be considered as an adult infectious disease and the dengue-infected elders will have higher morbidity or mortality.