{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T04:46:11Z","timestamp":1772081171362,"version":"3.50.1"},"reference-count":44,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T00:00:00Z","timestamp":1722988800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Dengue is among the most important mosquito-borne viral diseases worldwide. Although its acute manifestations are well known, little is known about the long-term impact of dengue on the population\u2019s health status. Madeira Island experienced a single outbreak of autochthonous dengue from September 2012 to March 2013. To extend our knowledge about the clinical impact of the outbreak on this naive population, we applied an online questionnaire to 168 adults diagnosed with dengue at the time to characterize retrospectively their symptoms during the infection and to identify long-term manifestations, possibly triggered by dengue. The most frequent symptoms during the clinical period, reported by more than three-quarters of our participants, were fever, myalgia, extreme tiredness, and headaches, whereas vomiting, pruritus, nausea, retro-orbital pain, and arthralgia occurred in 35% to 50% of participants. In the 8 years after dengue, 61.5% of participants reported at least one recurrent previously nonexistent symptom, the most frequent being headaches, abundant hair loss, extreme tiredness, arthralgia, and myalgia, experienced by 25% to 35% of participants. Nearly 20% of the participants with persistent symptoms reported the onset of chronic illness in the 4 years after dengue, most frequently ophthalmological and autoimmune diseases (5.6% each), versus only 2.2% of chronic disease onset in participants without persistent symptoms. Our results suggest that the occurrence of persistent symptoms after primary dengue might be more frequent than anticipated and may persist for several years, having an impact on the health status and well-being of a considerable proportion of the infected population.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0502","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T13:16:15Z","timestamp":1719926175000},"page":"403-411","source":"Crossref","is-referenced-by-count":1,"title":["Primary Dengue and Long-Term Health Status in Madeira Island, Portugal: A Retrospective Questionnaire-Based Study"],"prefix":"10.4269","volume":"111","author":[{"given":"Paulo","family":"Henriques","sequence":"first","affiliation":[{"name":"Projeto Medicina, Faculdade de Ci\u00eancias da Vida, Universidade da Madeira, Funchal, Portugal;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Caldeira-Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Projeto Medicina, Faculdade de Ci\u00eancias da Vida, Universidade da Madeira, Funchal, Portugal;"},{"name":"CQM-Centro de Qu\u00edmica da Madeira, Universidade da Madeira, Funchal, Portugal;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria da Luz","family":"Braz\u00e3o","sequence":"additional","affiliation":[{"name":"Projeto Medicina, Faculdade de Ci\u00eancias da Vida, Universidade da Madeira, Funchal, Portugal;"},{"name":"Servi\u00e7o de Medicina Interna, Hospital Central do Funchal, SESARAM-EPERAM, Funchal, Portugal;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Abreu","sequence":"additional","affiliation":[{"name":"Departamento de Matem\u00e1tica, Faculdade de Ci\u00eancias Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal;"},{"name":"Centro de Investiga\u00e7\u00e3o em Matem\u00e1tica e Aplica\u00e7\u00f5es, Universidade de \u00c9vora, \u00c9vora, Portugal;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Margarida","family":"Vig\u00e1rio","sequence":"additional","affiliation":[{"name":"Projeto Medicina, Faculdade de Ci\u00eancias da Vida, Universidade da Madeira, Funchal, Portugal;"},{"name":"Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Rosa","sequence":"additional","affiliation":[{"name":"Projeto Medicina, Faculdade de Ci\u00eancias da Vida, Universidade da Madeira, Funchal, 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Peru","volume":"14","author":"Elson","year":"2020"},{"key":"b6","series-title":"Trans R Soc Trop Med Hyg","first-page":"355","article-title":"Persistence of symptoms in dengue patients: A clinical cohort study","volume":"114","author":"Tiga-Loza","year":"2020"},{"key":"b7","series-title":"Acta Trop","first-page":"25","article-title":"Clinical, laboratory, and demographic determinants of hospitalization due to dengue in 7613 patients: A retrospective study based on hierarchical models","volume":"177","author":"da Silva","year":"2018"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"732","article-title":"Quality of life among adults with confirmed dengue in Brazil","volume":"85","author":"Martelli","year":"2011"},{"key":"b9","series-title":"Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention, and Control","year":"1997"},{"key":"b10","series-title":"Hum Immunol","first-page":"717","article-title":"Single nucleotide polymorphisms in immune system genes and their association with clinical symptoms persistence in dengue-infected persons","volume":"76","author":"Dettogni","year":"2015"},{"key":"b11","series-title":"Cad Saude Publica","first-page":"624","article-title":"Persist\u00eancia dos sintomas de dengue em uma popula\u00e7\u00e3o de Uberaba, Minas Gerais, Brasil","volume":"26","author":"Teixeira","year":"2010"},{"key":"b12","series-title":"J Clin Virol","first-page":"1","article-title":"Post-infectious fatigue syndrome in dengue infection","volume":"38","author":"Seet","year":"2007"},{"key":"b13","series-title":"Rev Inst Med Trop S\u00e3o Paulo","first-page":"e65","article-title":"Prospective study of patients with persistent symptoms of dengue in Brazil","volume":"59","author":"Teixeira","year":"2017"},{"key":"b14","series-title":"Int J Infect Dis","first-page":"e38","article-title":"Long-term persistence of clinical symptoms in dengue-infected persons and its association with immunological disorders","volume":"15","author":"Garc\u00eda","year":"2011"},{"key":"b15","series-title":"Gut","first-page":"864","article-title":"Dengue virus induced hepatitis with chronic calcific changes","volume":"49","author":"Fabre","year":"2001"},{"key":"b16","series-title":"Expert Rev Cardiovasc Ther","first-page":"465","article-title":"Cardiovascular sequelae of dengue fever: A systematic review","volume":"20","author":"Rahim","year":"2022"},{"key":"b17","series-title":"Curr Neurol Neurosci Rep","first-page":"515","article-title":"Neurological complications of dengue fever","volume":"22","author":"Trivedi","year":"2022"},{"key":"b18","series-title":"Trans R Soc Trop Med Hyg","first-page":"669","article-title":"Dengue and post-infection fatigue: Findings from a prospective cohort \u2013 The Colombo Dengue Study","volume":"115","author":"Sigera","year":"2020"},{"key":"b19","series-title":"Viral Immunol","first-page":"327","article-title":"Evaluation of prolonged fatigue post\u2013West Nile virus infection and association of fatigue with elevated antiviral and proinflammatory cytokines","volume":"27","author":"Garcia","year":"2014"},{"key":"b20","series-title":"N Engl J Med","first-page":"1513","article-title":"Guillain\u2013Barr\u00e9 syndrome associated with zika virus infection in Colombia","volume":"375","author":"Parra","year":"2016"},{"key":"b21","series-title":"Dengue Outbreak in Madeira, Portugal, March 2013","year":"2014"},{"key":"b22","series-title":"Indian J Dermatol","first-page":"79","article-title":"Mucocutaneous manifestations of dengue fever","volume":"55","author":"Thomas","year":"2010"},{"key":"b23","series-title":"Med Interna (Bucur)","first-page":"6","article-title":"Dengue: caracteriza\u00e7\u00e3o cl\u00ednico-laboratorial dos doentes internados durante a 1a epidemia europeia do s\u00e9c XXI e revis\u00e3o da literatura","volume":"21","author":"Freitas","year":"2014"},{"key":"b24","series-title":"Rev Soc Bras Med Trop","first-page":"675","article-title":"Clinical and hepatic evaluation in adult dengue patients: A prospective two-month cohort study","volume":"45","author":"Trist\u00e3o-S\u00e1","year":"2012"},{"key":"b25","series-title":"BMC Infect Dis","first-page":"1113","article-title":"Comparison of clinical manifestation of dengue fever in Bangladesh: An observation over a decade","volume":"21","author":"Hasan","year":"2021"},{"key":"b26","series-title":"Int J Infect Dis","first-page":"207","article-title":"Clinical and epidemiologic characteristics associated with dengue fever in Mombasa, Kenya","volume":"100","author":"Lim","year":"2020"},{"key":"b27","series-title":"Med Mal Infect","first-page":"250","article-title":"Clinical characteristics and predictive score of dengue vs. chikungunya virus infections","volume":"49","author":"Bonifay","year":"2019"},{"key":"b28","series-title":"Open Forum Infect Dis","first-page":"ofx056","article-title":"Predictors of dengue-related mortality and disease severity in a tertiary care center in north India","volume":"4","author":"Jain","year":"2017"},{"key":"b29","series-title":"Emerg Infect Dis","first-page":"742","article-title":"Dengue fever, Hawaii, 2001\u20132002","volume":"11","author":"Effler","year":"2005"},{"key":"b30","series-title":"Euro Surveill","first-page":"30240","article-title":"Autochthonous dengue outbreak in N\u00eemes, south of France, July to September 2015","volume":"21","author":"Succo","year":"2016"},{"key":"b31","series-title":"J Travel Med","first-page":"taab130","article-title":"Autochthonous dengue outbreak in Italy 2020: Clinical, virological, and entomological findings","volume":"28","author":"Barzon","year":"2021"},{"key":"b32","series-title":"PLoS One","first-page":"e0267186","article-title":"Risk and predictive factors for severe dengue infection: A systematic review and meta-analysis","volume":"17","author":"Yuan","year":"2022"},{"key":"b33","series-title":"Epidemiol Infect","first-page":"503","article-title":"Serological and virological features of dengue fever and dengue haemorrhagic fever in Thailand from 1999 to 2002","volume":"133","author":"Anantapreecha","year":"2005"},{"key":"b34","series-title":"Acta Med Port","first-page":"30","article-title":"Multimorbilidade em Portugal: Dados do Primeiro Inqu\u00e9rito Nacional de Sa\u00fade com Exame F\u00edsico","volume":"32","author":"Romana","year":"2019"},{"key":"b35","series-title":"PLoS One","first-page":"e0273071","article-title":"A double whammy: The association between comorbidities and severe dengue among adult patients \u2013 A matched case-control study","volume":"17","author":"Ng","year":"2022"},{"key":"b36","series-title":"Immunol Res","first-page":"243","article-title":"The immune system and hypertension","volume":"59","author":"Singh","year":"2014"},{"key":"b37","series-title":"Curr Hypertens Rep","first-page":"39","article-title":"Hypertension and kidney disease: A deadly connection","volume":"10","author":"Barri","year":"2008"},{"key":"b38","series-title":"Phlebology","first-page":"650","article-title":"Diagnostic approach to lower limb edema","volume":"35","author":"Gasparis","year":"2020"},{"key":"b39","series-title":"Front Pharmacol","first-page":"820214","article-title":"Pharmacogenetics in primary headache disorders","volume":"12","author":"Belyaeva","year":"2022"},{"key":"b40","series-title":"Surv Ophthalmol","first-page":"106","article-title":"Dengue eye disease","volume":"60","author":"Ng","year":"2015"},{"key":"b41","series-title":"PLoS One","first-page":"e52215","article-title":"Cytokine expression profile of dengue patients at different phases of illness","volume":"7","author":"Rathakrishnan","year":"2012"},{"key":"b42","series-title":"J Clin Endocrinol Metab","first-page":"692","article-title":"Disturbed neuroendocrine-immune interactions in chronic fatigue syndrome","volume":"85","author":"Kavelaars","year":"2000"},{"key":"b43","series-title":"China CDC Wkly","first-page":"740","article-title":"Dengue fever outbreaks caused by varied serotype dengue virus \u2013 Guangdong Province, China, 2019","volume":"2","author":"Wu","year":"2020"},{"key":"b44","series-title":"BMC Infect Dis","first-page":"92","article-title":"Seroprevalence of dengue IgG antibodies in symptomatic and asymptomatic individuals three years after an outbreak in Zhejiang Province, China","volume":"18","author":"Luo","year":"2018"}],"container-title":["The American Journal of Tropical Medicine and 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