Cases were categorized using serial clinical and laboratory data from the entire clinical course as dengue fever (DF), DHF, or dengue shock syndrome (DSS) using WHO 1997 classifications [9] . Dengue fever classification requires fever and at least two of the following: headache, eye pain, myalgia, arthralgia, rash, bleeding, and leukopenia. Dengue hemorrhagic fever requires all of the following: fever, platelet count #100610 9 /liter, bleeding, and plasma leakage [9] . Dengue shock syndrome is a case of DHF with either tachycardia and pulse pressure ,20 mmHg or systolic blood pressure ,90 mmHg [9] .