The epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in Kaohsiung City, Taiwan
After the previous major dengue fever (DF) outbreaks in 2014 and 2015 in Taiwan, the second-largest DF outbreak re-emerged in 2023. A total of 178 patients with laboratory-confirmed dengue virus (DENV) infection, including 92 DENV-1 and 86 DENV-2 cases, were enrolled in this study conducted during t...
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Elsevier
2025-05-01
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| Series: | Travel Medicine and Infectious Disease |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1477893925000584 |
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| author | Li-Teh Liu Shi-Ya Huang Chen-Hsuan Lin Chun-Hong Chen Ching-Yi Tsai Ping-Chang Lin Jih-Jin Tsai |
| author_facet | Li-Teh Liu Shi-Ya Huang Chen-Hsuan Lin Chun-Hong Chen Ching-Yi Tsai Ping-Chang Lin Jih-Jin Tsai |
| author_sort | Li-Teh Liu |
| collection | DOAJ |
| description | After the previous major dengue fever (DF) outbreaks in 2014 and 2015 in Taiwan, the second-largest DF outbreak re-emerged in 2023. A total of 178 patients with laboratory-confirmed dengue virus (DENV) infection, including 92 DENV-1 and 86 DENV-2 cases, were enrolled in this study conducted during the 2023 dengue outbreak in Kaohsiung City, Taiwan. This study aimed to analyze epidemiological characteristics, clinical severity, and risk factors for severe dengue (SD), as well as the diagnostic implications of the non-structural protein 1 (NS1) antigen rapid test. Patients infected with DENV-2 exhibited significantly older age, higher incidence of secondary infections, diabetes mellitus (DM), hypertension (HT), and longer hospital stays than patients infected with DENV-1. Multivariate analysis revealed that older age (age ≥65), secondary dengue infection, DM, and HT were significant independent predictors of SD. Compared with non-SD cases, SD patients were significantly more likely to be older (age ≥65), to exhibit a higher incidence of secondary infections and a greater prevalence of chronic diseases, including DM and HT. Notably, dengue-confirmed patients with negative NS1 results had a shorter duration since symptom onset (p < 0.001). Our DENV-1 and DENV-2 isolates are related to strains from neighboring Asian countries. Our findings emphasize the important factors of old age, secondary infections, and chronic diseases that contributed to dengue severity. We should meticulously manage these high-risk groups to prevent dengue progression. Screening incoming travelers for DF during the epidemic season will be an important measure to prevent the introduction of DENV into Taiwan. |
| format | Article |
| id | doaj-art-ca8b761a794344da9f81f9a48edf47fb |
| institution | DOAJ |
| issn | 1873-0442 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Travel Medicine and Infectious Disease |
| spelling | doaj-art-ca8b761a794344da9f81f9a48edf47fb2025-08-20T03:13:59ZengElsevierTravel Medicine and Infectious Disease1873-04422025-05-016510285210.1016/j.tmaid.2025.102852The epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in Kaohsiung City, TaiwanLi-Teh Liu0Shi-Ya Huang1Chen-Hsuan Lin2Chun-Hong Chen3Ching-Yi Tsai4Ping-Chang Lin5Jih-Jin Tsai6Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung Hwa University of Medical Technology, Tainan City, TaiwanSchool of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, TaiwanSchool of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, TaiwanNational Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Miaoli County, Taiwan; National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, TaiwanTropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, TaiwanTropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, TaiwanSchool of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Corresponding author. Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100, Tzyou 1st Rd, 807377, Kaohsiung City, Taiwan.After the previous major dengue fever (DF) outbreaks in 2014 and 2015 in Taiwan, the second-largest DF outbreak re-emerged in 2023. A total of 178 patients with laboratory-confirmed dengue virus (DENV) infection, including 92 DENV-1 and 86 DENV-2 cases, were enrolled in this study conducted during the 2023 dengue outbreak in Kaohsiung City, Taiwan. This study aimed to analyze epidemiological characteristics, clinical severity, and risk factors for severe dengue (SD), as well as the diagnostic implications of the non-structural protein 1 (NS1) antigen rapid test. Patients infected with DENV-2 exhibited significantly older age, higher incidence of secondary infections, diabetes mellitus (DM), hypertension (HT), and longer hospital stays than patients infected with DENV-1. Multivariate analysis revealed that older age (age ≥65), secondary dengue infection, DM, and HT were significant independent predictors of SD. Compared with non-SD cases, SD patients were significantly more likely to be older (age ≥65), to exhibit a higher incidence of secondary infections and a greater prevalence of chronic diseases, including DM and HT. Notably, dengue-confirmed patients with negative NS1 results had a shorter duration since symptom onset (p < 0.001). Our DENV-1 and DENV-2 isolates are related to strains from neighboring Asian countries. Our findings emphasize the important factors of old age, secondary infections, and chronic diseases that contributed to dengue severity. We should meticulously manage these high-risk groups to prevent dengue progression. Screening incoming travelers for DF during the epidemic season will be an important measure to prevent the introduction of DENV into Taiwan.http://www.sciencedirect.com/science/article/pii/S1477893925000584Dengue virusDengueSevere dengueSerotypeRisk factorsSecondary infection |
| spellingShingle | Li-Teh Liu Shi-Ya Huang Chen-Hsuan Lin Chun-Hong Chen Ching-Yi Tsai Ping-Chang Lin Jih-Jin Tsai The epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in Kaohsiung City, Taiwan Travel Medicine and Infectious Disease Dengue virus Dengue Severe dengue Serotype Risk factors Secondary infection |
| title | The epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in Kaohsiung City, Taiwan |
| title_full | The epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in Kaohsiung City, Taiwan |
| title_fullStr | The epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in Kaohsiung City, Taiwan |
| title_full_unstemmed | The epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in Kaohsiung City, Taiwan |
| title_short | The epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in Kaohsiung City, Taiwan |
| title_sort | epidemiology and identification of risk factors associated with severe dengue during the 2023 dengue outbreak in kaohsiung city taiwan |
| topic | Dengue virus Dengue Severe dengue Serotype Risk factors Secondary infection |
| url | http://www.sciencedirect.com/science/article/pii/S1477893925000584 |
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