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An epidemic of dengue on Tahiti associated with hemorrhagic manifestations.

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TLDR
During the course of an outbreak of dengue type 2 on the island of Tahiti, French Polynesia, severe hemorrhagic disease was observed in an unusual number of patients shortly after the onset of a febrile illness and 3 patients died.
Abstract
During the course of an outbreak of dengue type 2 on the island of Tahiti, French Polynesia, severe hemorrhagic disease was observed in an unusual number of patients shortly after the onset of a febrile illness. In at least 33 instances, these hemorrhages were severe enough to require hospitalization and 3 patients died. Gastrointestinal bleeding was the most common type of severe hemorrhage observed and gross hematuria was next most common. The available data suggested that most of the hemorrhagic episodes were etiologically related to dengue virus.

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Dengue, Urbanization and Globalization: The Unholy Trinity of the 21st Century

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Antibody-Dependent Enhancement of Infection and the Pathogenesis of Viral Disease

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The Emperor's New Clothes revisited, or reflections on the pathogenesis of dengue hemorrhagic fever.

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