Factors associated with JEV seropositivity among those experiencing dengue (DENV) infection.

*<p>Refers to first-detected DENV infections in the cohort that occurred during the active surveillance period each year (June 1 – November 1) and had neutralizing antibody data available.</p>**<p>Statistical tests considered the association between variables of interest and the presence or absence of JEV NAbs in the pre-infection sample. p-values were obtained using the Pearson chi-square test for categorical variables, with α = 0.05 as the level of significance. ‘Missing’ categories were not included in statistical comparisons.</p

Duration of DENV illness (days) by JEV NAb status.

*<p>Duration of illness was calculated as the number of days elapsed from first day of febrile illness to the last day that a child reported any fever, muscle or joint pain, headache, nauseas, vomiting, diarrhea, or any signs of bleeding or hemorrhage.</p>**<p>P-values were calculated using 2-way analysis of variance testing (ANOVA), with α = 0.05 as the level of significance.</p

Cohort characteristics associated with symptomatic DENV illness.

*<p>Refers to first-detected DENV infections in the cohort that occurred during the active surveillance period each year (June 1–November 1) and had neutralizing antibody data available</p>**<p>Statistical tests considered the association between variables of interest and the occurrence of symptomatic versus asymptomatic infection. p-values were obtained using the Pearson chi-square test for categorical variables, with α = 0.05 as the level of significance. ‘Missing’ categories were not included in statistical comparisons.</p

Clinical severity of dengue infections by strata of preexisting DENV and JEV immunity.

<p>The proportions of dengue (DENV) infections resulting in symptomatic illness (1a), hospitalized illness (1b), and dengue hemorrhagic fever (1c) are shown. Data are stratified by preexisting DENV immunity (naïve [DENV -], monotypic [DENV 1+], multitypic older and younger than 10 years of age [DENV >1+]) and preexisting Japanese encephalitis virus (JEV) neutralizing antibodies (NAbs) (positive [+] or negative [-]). The JEV NAb positive groups are indicated by hash lines for each stratum of DENV immunity. Odds ratios (ORs) estimate the odds of being experiencing the disease severity of interest (dengue hemorrhagic fever [DHF], hospitalized illness [Hosp], or symptomatic illness [Sx]) in the presence of JEV NAbs over the odds of experiencing the disease severity of interest in the absence of JEV NAbs. Values in parentheses indicate the 95% confidence intervals for the ORs. Error bars indicate the 95% confidence intervals for proportions.</p

Unadjusted associations of DENV illness severity and JEV antibody status.

*<p>Non-hospitalized infections incorporate both non-hospitalized DF and asymptomatic seroconversions.</p>**<p>Non-DHF infections incorporate both non-hospitalized and hospitalized DF and asymptomatic seroconversions.</p>†<p>P-values were calculated using the Mantel-Haenzel chi-square statistic.</p

Clinical characteristics of study participants.

<p>Fever day and laboratory findings were from the day of study entry. Values represent mean (SE), or number of cases.</p><p>^<i>a</i> Different from non-dengue cases (<i>P</i> < .05)</p><p>^<i>b</i> different from DF (<i>P</i> < .05).</p><p>Clinical characteristics of study participants.</p

Frequencies of abnormal TDI during the course of the illness.

<p>Percentages of DF (dotted lines) and DHF cases (solid lines) with low septal and lateral S wave (A, B) and septal and lateral Ea wave (C, D) and high E/Ea ratios (E) determined based on published age-specific normal values (21). * different from DF (<i>P</i> < .05).</p

Tissue Doppler image of LV functions by fever day.

<p>Left ventricular lateral (A) and septal S wave (B), LV mean performance index (MPI) (C), lateral (D) and septal (E) annulus movement during early diastole, lateral (F) and septal (G) annulus movement during late diastole, and lateral (H) and medial (I) E/Ea ratios of dengue fever (dotted line) and dengue hemorrhagic fever (solid line) cases over the course of the illness. Fever day 0 denotes day of defervescence. * different from DF (<i>P</i> < .05). The numbers of cases were: fever-day -3 (DF 4, DHF 5), fever-day-2 (DF 13, DHF 9), fever-day-1(DF 43, DHF 26), fever-day-0(DF 104, DHF 56), fever-day+1(DF 119, DHF 62), fever-day+2(DF 70, DHF 60), fever-day+3(DF 13, DHF 38).</p

Comparison between cardiac function at fever day +1 and early convalescence.

<p>^a<i>P</i> value comparing values at fever day +1 and early convalescence (Student’s paired t-test).</p><p>Comparison between cardiac function at fever day +1 and early convalescence.</p

Plasma troponin-T levels in individual DF (white circles) or DHF cases (black circles) during the course of the illness.

<p>The horizontal line indicates a cut-off for an abnormal value at 30 pg/ml.</p