Showing papers by "Gustavo Kourí published in 1987"

Why dengue haemorrhagic fever in Cuba? I. Individual risk factors for dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS)

Abstract: During the dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) epidemic in Cuba in 1981, we identified some individual risk factors for the development of the severe clinical picture or for the fatal outcome of the disease. The percentage of secondary infection in 3 groups of patients with DHF/DSS was between 95 and 98·3 and it is concluded that secondary infection is an important, but not the only, condition for the development of DHF/DSS. An analysis of these 3 groups of patients and a fourth group of fatal cases showed that chronic diseases such as bronchial asthma, diabetes mellitus and sickle cell anaemia were additional risk factors contributing significantly to the development of DHF/DSS. The study also revealed that race was an individual risk factor, since DHF/DSS was more prevalent in white than in black persons.

Why dengue haemorrhagic fever in Cuba? 2. An integral analysis

Abstract: The epidemiological factors present in Cuba in 1981, when the dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) epidemic occurred, were exceptional when compared to those of other countries in the region. Evidence is presented which demonstrates that virulence of the circulating strain is an important element in the analysis of an epidemic. Although the two current hypotheses to explain the occurrence of DHF/DSS epidemics are valid in well defined but different epidemiological situations, neither Halstead's hypothesis of secondary-type infection or Rosen's hypothesis of the role played by the virulence of the circulating strain can explain all cases. An integrated, multifactorial and unifying hypothesis is presented, which could be applied in different epidemiological situations. It is based mainly on an in-depth analysis of the literature and of the Cuban experience.