20 Years Of Progress In Dengue Hemorrhagic Fever And Other Arboviral Diseases Research

Throughout the 20 year history of U.S. Naval Medical Research Unit No. 2 Detachment (NAMRU), many viruses and viral diseases have been studied. The greatest emphasis has been in the field of arboviruses, specifically dengue virus, chikungunya virus, and Japanese B encephalitis virus. The initial focus of the work was to define the extent of the threat posed by these viruses. Studies were conducted to determine antibody prevalence, and to determine the etiologies of infectious febrile disease in hospitalized patients. Later the work advanced into more specific areas, especially the entomologic and clinical components of these viruses. Little was known of the incidence or kind of arbovirus infections in Indonesia when NAMRU was established. Previous serological studies had used the cross reactive haemagglutination assay. Green et al. in 1973 provided convincing serological evidence of infections with chikungunya virus and group B arboviruses by using the specific virus neutralization assay. These results demonstrated the need for further studies to isolate the causative agent, to describe the epidemiology, and to investigate the clinical features of the associated disease

Perbandingan Kemampuan Kriteria WHO 1997 dan Klasifikasi DENCO dalam Diagnosis dan Klasifikasi Infeksi Dengue

Latar belakang. Sejalan dengan kemajuan ilmu pengetahuan, spektrum klinis infeksi dengue semakin luas dan bervariasi yang diikuti oleh beberapa klasifikasi infeksi dengue baru. Sejauh mana Kriteria WHO-1997 dan klasifikasi baru ini mampu mendeteksi infeksi dengue pasien di RS Sumber Waras, belum pernah dinilai. Tujuan. Membandingkan kesesuaian antara hasil konfirmasi laboratorium untuk infeksi dengue dengan kriteria WHO-1997, Klasifikasi DENCO, dan modifikasi WHO-1997 di RS Sumber Waras. Selain itu dinilai kemampuan ketiga kriteria/klasifikasi dalam mengelompokkan spektrum klinis infeksi dengue. Metode. Merupakan penelitian diskriptif retrospektif dengan menggunakan data penelitian kami terdahulu (cluster study untuk dengue). Hasil. Dalam periode tahun 2004-2008, terdapat 107 subjek penelitian terdiri 98 kasus infeksi virus dengue (serologi dan/atau virology positif) dan 9 sakit namun bukan kasus infeksi virus. Data menunjukkan bahwa dari 98 kasus terbukti infeksi dengue, 96 sesuai dengan Kriteria WHO 1997, 97 sesuai Klasifikasi Denco, dan 97 sesuai Modifikasi WHO-1997 di RS Sumber Waras. Terdapat 24 subjek yang tidak dapat diklasifikasikan dengan kriteria WHO 1997 yang ternyata 19 subjek dengue dengan tanda peringatan dan 5 subjek dengue berat berdasarkan Klasifikasi DENCO, sedangkan dengan modifikasi WHO-1997 RSSW (perdarahan bukan syarat mutlak), didapat 19 subjek DBD, SSD 2 subjek, DBD ensefalopati 1 subjek, dan SSD ensefalopati 2 subjek. Kesimpulan. Kriteria WHO-1997 masih merupakan kriteria yang sesuai dalam diagnosis infeksi dengue, namun untuk dapat mengelompokan spektrum klinis infeksi dengue perlu dipertimbangkan agar manifestasi perdarahan tidak digunakan sebagai syarat mutlak

Immunoglobulin M and G in Virologically Confirmed Dengue Hemorrhagic Fever

Starting from September 1987, a one year prospective study on lgM and lgG in dengue hemorrhagic fever, was carried out at the Department of Pediatrics, Sumber War as Hospital West Jakarta. This report describes the preliminary finding of the study from September 1987 through June 1988. Virus isolation and serologic analysis (HI, lgG and lgM capture ELISA) for DHF were done by NAMRU 2 in Jakarta. The subjects were 151 virologically confirmed DHF patients consisting of 82 boys and 69 girls of 6 months - 15 years old. Serum samples were collected: (I) on the day of admission; (II) on the day of discharge and (Ill) 2 weeks after the first samples. Serum samples I, II, and Ill were collected from respectively 151, 131 and 64 subjects on respectively 3.5 ± 1.7; 8.8 ± 2.7 and 16.8 ± 2.1 days of illness. Positive lgM titer from acute sera was observed in 20% of subjects. A positive correlation between HI -lgM and HI -lgG was also observed. The percentage of positive lgM titers rose with the increase of HI titer, the percentage of positive lgG titer was lower than that of /gM but a sudden increase exceeding that of lgM was observed at the HI liter of 320 and more. This study revealed that HI titer of640 and 1280 were indicators for the primary and secondary dengue infection respectively and lgM capture ELISA can be used as a reliable predictor for DHF even more in fatal cases where only single serum is available

20 YEARS OF PROGRESS IN DENGUE HEMORRHAGIC FEVER AND OTHER ARBOVIRAL DISEASES RESEARCH

Throughout the 20 year history of U.S. Naval Medical Research Unit No. 2 Detachment (NAMRU), many viruses and viral diseases have been studied. The greatest emphasis has been in the field of arboviruses, specifically dengue virus, chikungunya virus, and Japanese B encephalitis virus. The initial focus of the work was to define the extent of the threat posed by these viruses. Studies were conducted to determine antibody prevalence, and to determine the etiologies of infectious febrile disease in hospitalized patients. Later the work advanced into more specific areas, especially the entomologic and clinical components of these viruses. Little was known of the incidence or kind of arbovirus infections in Indonesia when NAMRU was established. Previous serological studies had used the cross reactive haemagglutination assay. Green et al. in 1973 provided convincing serological evidence of infections with chikungunya virus and group B arboviruses by using the specific virus neutralization assay. These results demonstrated the need for further studies to isolate the causative agent, to describe the epidemiology, and to investigate the clinical features of the associated disease