Live attenuated vaccines against all 4 serotypes are currently under development. Convalescence may be prolonged, with weakness and mental depression. Survival is related directly to early hospitalization and aggressive supportive care. Pediatric deaths associated with dengue viral infection most commonly occur in infants younger than 1 year. Delayed capillary refill may be the first sign of intravascular volume depletion.
Hypotension usually is a late sign in children.
This child's capillary refill at 6 seconds was delayed well beyond a normal duration of 2 seconds. Signs of early coagulopathy may be as subtle as a guaiac test positive for occult blood in the stool. This test should be performed on all patients in whom dengue virus infection is suspected. Challenges to molecular biology. A treatise of infectious processes.