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Clinical Features and Laboratory Findings of Travelers Returning to South Australia with Dengue Virus Infection

Microbiology and Infectious Diseases, College of Medicine and Public Health, Flinders University, Adelaide SA 5042, Australia
Infectious Diseases Laboratories SA Pathology, Adelaide, SA 5000, Australia
Author to whom correspondence should be addressed.
Denotes equal contribution and joint first authorship.
Trop. Med. Infect. Dis. 2018, 3(1), 6;
Received: 11 December 2017 / Revised: 3 January 2018 / Accepted: 3 January 2018 / Published: 7 January 2018
(This article belongs to the Special Issue Epidemiology of Dengue: Past, Present and Future)
Reported cases of dengue are rising in South Australia (SA) in travellers returning from dengue-endemic regions. We have undertaken a retrospective analysis to identify the clinical and laboratory characteristics of patients returning to SA with suspected dengue virus (DENV) infection. From 488 requests, 49 (10%) were defined by serology as acute dengue, with the majority of patients (75%) testing as non-structural protein 1 (NS1) and/or IgM positive. Dengue was most commonly acquired in Indonesia (42.9%) with clinical features of fever (95%), headache (41%) and myalgia/arthralgia (56%). The presence of rash (36%) and laboratory findings of neutropenia, leukopenia, thrombocytopenia, but not elevated C-reactive protein, were distinct from findings in DENV-seronegative patients. Available dengue seropositive samples were analysed by RT-PCR, with 14/32 (43.8%) positive by a serotype non-specific DENV assay, but 28/32 positive (87.5%) when also assessed by serotype-specific RT-PCR. Serotype analysis revealed the predominance of DENV-1 and DENV-2 and the presence of DENV-3, but not DENV-4 or Zika virus (ZIKV). Thus, dengue in returned travellers in SA presents in a manner consistent with World Health Organization (WHO) definitions, with symptoms, travel history and laboratory results useful in prioritising the likelihood of dengue. This definition will assist the future management in DENV-non-endemic regions, such as SA. View Full-Text
Keywords: dengue virus; returned traveller; dengue serology; dengue RT-PCR dengue virus; returned traveller; dengue serology; dengue RT-PCR
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Quinn, E.J.; Cheong, A.H.-C.; Calvert, J.K.; Higgins, G.; Hahesy, T.; Gordon, D.L.; Carr, J.M. Clinical Features and Laboratory Findings of Travelers Returning to South Australia with Dengue Virus Infection. Trop. Med. Infect. Dis. 2018, 3, 6.

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