ArticlePLoS neglected tropical diseases2016
Enhanced Surveillance for Fatal Dengue-Like Acute Febrile Illness in Puerto Rico, 2010-2012.
Article in PLoS neglected tropical diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Economic burden of dengue in Puerto Rico, 2010-2023.Infectious diseases of poverty · 2026Article
- Utility of sentinel surveillance as an early warning system for emerging pathogens in a low-resource setting: Correlations of dengue, chikungunya, Zika, and COVID-19 trends between sentinel and passive surveillance systems in Puerto Rico, 2012-2023.PLOS global public health · 2026Article
- Coinfection with Respiratory Pathogens and Dengue Disease Severity in Puerto Rico, 2012-2024.The American journal of tropical medicine and hygiene · 2025Article
- Article
- Machine learning for predicting severe dengue in Puerto Rico.Infectious diseases of poverty · 2025Article
- Perceptions of dengue risk and acceptability of a dengue vaccine in residents of Puerto Rico.Human vaccines & immunotherapeutics · 2024Article
- Metatranscriptomic insights into the dengue patient blood microbiome: Enhanced microbial diversity and metabolic activity in severe patients.PLoS neglected tropical diseases · 2024Article
- Review
- Diagnostic Accuracy of the Abbott BinaxNOW COVID-19 Antigen Card Test, Puerto Rico.Influenza and other respiratory viruses · 2024Article
- Seroprevalence, distribution, and risk factors for human leptospirosis in the United States Virgin Islands.PLoS neglected tropical diseases · 2022Article
- Clinical Characteristics, Histopathology, and Tissue Immunolocalization of Chikungunya Virus Antigen in Fatal Cases.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Viral etiology and seasonal trends of pediatric acute febrile illness in southern Puerto Rico; a seven-year review.PloS one · 2021Article
- Recent influenza activity in tropical Puerto Rico has become synchronized with mainland US.Influenza and other respiratory viruses · 2020Article
- Dengue Fever and Severe Dengue in Barbados, 2008-2016.Tropical medicine and infectious disease · 2020Article
- Lessons Learned from Dengue Surveillance and Research, Puerto Rico, 1899-2013.Emerging infectious diseases · 2019Article
- Article
- Clinical Indicators of Fatal Dengue in Two Endemic Areas of Colombia: A Hospital-Based Case-Control Study.The American journal of tropical medicine and hygiene · 2019Article
- Implementation and Evaluation of Guillain-Barré Syndrome Surveillance in Puerto Rico during the 2016 Zika Virus Epidemic.Puerto Rico health sciences journal · 2018Article
- Estimating dengue under-reporting in Puerto Rico using a multiplier model.PLoS neglected tropical diseases · 2018Article
- Postmortem Findings in Patient with Guillain-Barré Syndrome and Zika Virus Infection.Emerging infectious diseases · 2018Article
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Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDengue is a leading cause of morbidity throughout the tropics; however, accurate population-based estimates of mortality rates are not available. METHODS/PRINCIPAL
findingsWe established the Enhanced Fatal Acute Febrile Illness Surveillance System (EFASS) to estimate dengue mortality rates in Puerto Rico. Healthcare professionals submitted serum and tissue specimens from patients who died from a dengue-like acute febrile illness, and death certificates were reviewed to identify additional cases. Specimens were tested for markers of dengue virus (DENV) infection by molecular, immunologic, and immunohistochemical methods, and were also tested for West Nile virus, Leptospira spp., and other pathogens based on histopathologic findings. Medical records were reviewed and clinical data abstracted. A total of 311 deaths were identified, of which 58 (19%) were DENV laboratory-positive. Dengue mortality rates were 1.05 per 100,000 population in 2010, 0.16 in 2011 and 0.36 in 2012. Dengue mortality was highest among adults 19-64 years and seniors ≥65 years (1.17 and 1.66 deaths per 100,000, respectively). Other pathogens identified included 34 Leptospira spp. cases and one case of Burkholderia pseudomallei and Neisseria meningitidis. CONCLUSIONS/SIGNIFICANCE: EFASS showed that dengue mortality rates among adults were higher than reported for influenza, and identified a leptospirosis outbreak and index cases of melioidosis and meningitis.
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