Clinical expression of dengue in beneficiaries of the Instituto Mexicano del Seguro Social in Veracruz, Mexico

Objective: To describe and compare the clinical behavior of Dengue Fever (DF) and Hemorrhagic Dengue Fever (HDF) in beneficiaries of the Instituto Mexicano del Seguro Social (IMSS). Methods: Transversal study in beneficiaries from Veracruz, selected among those who sought attention at two medical attention units, with probable dengue diagnosis. Surveys were performed to know personal and epidemiological data, as well as a clinical follow up. Blood samples were taken for RT-PCR viral identification and antibodies against Dengue. In the same way, platelet, hemoglobin, and hematocrit tests were performed for their determination. The SPSS 12.0 software was used for the process and analysis of the information, and simple frequencies, proportions, and means were estimated. Results: 109 patients were studied, classified as 72 DF and 37 as HDF. 40 isolations were performed, and the circulation of the four types of dengue virus was identified, although most of the isolations corresponded to serotype 2 (Asian-American genotype). In one patient, a simultaneous infection of dengue viruses 1 and 2 was identified. A group of patients did not present hemorrhages, capillary fragility, or liquid permeation, but with important thrombocytopenia and hemoconcentration, all infected with den-1 and den-2. Conclusions: The presence of cases with atipical behavior of the diseases were identified. The characteristics and immunologic experience of the populations, as well as the simultaneous circulation of various dengue viruses and their changing structure could be related with the current clinical behavior of Dengue in Mexico. It is important to continue the research to confirm these asseverations.