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Dengue Hemorrhagic Fever Could Occur Locally in U.S.

Circulating dengue fever as well as mosquito vectors suggest hemorrhagic fever could occur in south Texas

FRIDAY, Aug. 10 (HealthDay News) -- Physicians should be aware of the early signs of dengue hemorrhagic fever, particularly due to an increase in cases in Latin American and Mexico as well as sporadic dengue fever outbreaks in south Texas that could allow local occurrences of the more severe form of the disease, according to a report in the Aug. 10 issue of the Morbidity and Mortality Weekly Report.

Dengue hemorrhagic fever, the more severe and potentially life-threatening form of the disease, is characterized by bleeding, thrombocytopenia and vascular permeability, which can lead to shock.

The report describes an outbreak in the summer of 2005, which apparently spread from the northern Mexican state of Tamaulipas to Brownsville and Matamoros on the Texas-Mexico border. A survey of residents in Brownsville, Texas found that 38 percent had antibodies to dengue fever, including 25 percent of those who had never traveled outside the United States.

The risk of dengue hemorrhagic fever is higher in patients who have a second bout of the disease caused by a different serotype. There are four closely related serotypes, and infection confers lifelong immunity only to the serotype that caused the infection.

"Entomologic, serologic and virologic conditions are now such that locally acquired dengue hemorrhagic fever can occur in south Texas," the report states. "Early recognition and diagnosis of dengue hemorrhagic fever and careful fluid management can reduce the case fatality rate in cases with shock to less than 1 percent."

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