Fatal Hemorrhagic Disease and Shock Associated with Primary Dengue Infection on a Pacific Island *

Abstract

An epidemic of dengue type 2 which occurred on Niue Island during the first half of 1972 involved approximately 90% of the population of 4,600 persons and affected all age groups equally. Serologic data indicated that this was the first occurrence of any dengue virus on the island for at least 25 years. Many persons had minor hemorrhages associated with febrile illnesses during the outbreak and a few had severe hemorrhages or shock. Twelve deaths occurred which may have been caused by dengue. The clinical features of the fatal illnesses among children were very similar to those described previously for dengue hemorrhagic fever or dengue shock syndrome. It is concluded that at least some deaths among children were caused by dengue virus and were, consequently, the result of primary infection with that virus.