The following is a summary of “Predominance of Severe Plasma Leakage in Pediatric Patients With Severe Dengue in Puerto Rico” published in the December 2022 issue of Infectious Disease by Paz-Bailey et al.

For a study, researchers sought to determine the clinical and laboratory results among dengue patients in Puerto Rico who had mild, moderate, or severe cases to see if there were any age-related differences in clinical symptoms.

In 2012 to 2014, they enrolled patients who had a fever or a history of fever within 7 days after their initial visit to the emergency room. reverse transcriptase-polymerase chain reaction (RT-PCR) and an IgM enzyme-linked immunosorbent assay (ELISA) were used to detect the presence of dengue virus (DENV) in serum samples. At presentation, during hospitalization, or during follow-up, severe dengue was defined as plasma leakage or shock, severe bleeding, or organ involvement.

Over 281 (26%) of the 1,089 dengue cases diagnosed were considered severe. Patients with severe dengue were more likely to be hospitalized (87% vs. 30%, P< .001) and to be 10–19 years old (55% vs. 40%, P <.001) than those with nonsevere dengue. Children aged 0–9 (59%) or 10–19 years (86%) experienced severe plasma leakage or shock more frequently than adults (49%) (P< .01). When compared to 0-9-year-olds (45%) and adults (52%), 10-19-year-olds (24%) had a lower prevalence of severe bleeding (P< .01).

The most frequent manifestation in children was severe plasma leakage, underlining significant differences from adults. Dengue vaccination may help protect kids in Puerto Rico from developing severe dengue.