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The History of Dengue Research before 1950 A Forgotten History ?. Early Dengue Investigation in the Shadow of Yellow Fever Research. Reminder “Dengue”=dengue or dengue-like illness Period covered: 1890-1950. Important Events: 1897-98. 1. “Filterable agent” [=virus]
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The History of Dengue Research before 1950A Forgotten History ?
Early Dengue Investigationin the Shadow of Yellow Fever Research
Reminder“Dengue”=dengue or dengue-like illnessPeriod covered: 1890-1950
Important Events: 1897-98 1. “Filterable agent” [=virus] 2. Vector-borne transmission 3. Extrinsic incubation period 4. Controversy on etiology of YF 5. Dengue outbreaks in Texas 6. Spanish-American War
Walter Reed (Source: U.S. Army Archive)
Farewell Clara….Clara was buried in Havana, Cuba and later reburied in New Jersey at Fairmount Cemetery .
Charles Franklin Craig (Source: Am. J. Trop. Med., 1951)
Vector-Borne Transmission of Human Diseases:Historical Events before Dengue Research
Carlos Juan Finlay (Source: Univ. Virginia Claude Moore Health Science Library)
Photo Henry Rose Carter (Source: Am. J. Publ. Hlth. 15:994; 1926)
Experimental Design for Dengue Transmission Studies Source of “infectious agent” 2. Location for human experiment
Special Considerations for Human Experiment • Informed Consent • Monetary Reward
Harris Graham (Source: American University of Beirut, Lebanon)
Dengue Studies in Cubaby the Former Members of the Walter Reed Commission: Left—Aristides Agramonte; Right– Juan Guiteras (Source of photos: Wikipedia Commons)
T.L. Bancroft (Source: Courtesy of Australian Nat. Univ.)
Makoto Koizumi(Source: The 50-year history (1929-79) of parasitologic research in Japan. Japanese Society of Parasitologists, 1981)
J. Burton Cleland (Source: Courtesy: Australian National University)
James S. Simmons (Source: U.S. Army Archive)
Emilius Paulus Snijders (Source: Academic Medical Centre, University of Amsterdam, The Netherlands)
Dutch group portrait by Lizzy Ansingh (1933): From left to right-van Loghem, Kuenen, Schueffner, Swellengrebel, Snijders (Source: Univ. Museum Amsterdam)
Etiologic Investigation: Virus Isolation
Susumu Hotta (Source: Kobe University School of Medicine, Kobe, Japan)
Mrs. Mochizuki (Source: S. Hotta-- Uirusu, 51:106; 2001)
Albert B. Sabin (Courtesy: U.S. Army )
Sabin visiting Hotta at Kobe University, 1961 (Source: Kobe University, Kobe, Japan)
Cornelius Becker Philip (Source: J. Parasitol. 73:678)
Laboratory-identified DengueViruses Year Location Serotype • Nagasaki, Japan DENV-1 1943-44 Hawaii DENV-1 • New Guinea DENV-1 and DENV-2
Serologically-identified Viruses 1924-25 Philippines DENV-4 1925-26 QLD, Australia DENV-1 • South Africa DENV-1 1929-30 Philippines DENV-1 • QLD, Australia DENV-2/DENV-1 • Singapore DENV-1 1944-45 Guam DENV-2(DENV-1?) • Calcutta, India DENV-1 1942-44 Japan DENV-1(DENV-2?)
Clinical Definition of “Dengue”- a Source of Constant Controversy • Variation depending on physicians, year, location, and unknown human conditions 2. “Typical” vs “atypical” symptoms 3. Syndrome in human experiment as ‘standard” 4. Confusion with other etiologies
Atypical Clinical Symptoms or Syndromes:Extensive Hemorrhage and/or Shock with Fatal Outcome
F. E. Hare (Source: J. Aaskov, Austr. Defense Force Health 4:66;2003)
Hemorrhagic Manifestations and Fatality Diagnosis: Rumpell-Leede test (=Tourniquet test) Borbely’s vascular resistance test Study: Correlations among increased vascular permeability, thrombocytopenia, and hemorrhage
Selected Records of Fatal Cases 1895-1926 Australia 816 QLD, Australia 97 1904-05 Australia 201 Australia 93 1907-09 Vietnam 4 Okinawa, Japan 508 Taiwan 26 1943-44 Philippines 7 Taiwan 5
Fatal Non-Fatal [A] 1897 - 1902 [B] 1926 - 1931 [C] 1940 - 1944
Other “Unusual” Syndromes1. CNS syndrome2. Pulmonary syndrome
3. Ophthalmologic Dysfunctions(Source:Yuguchi, Kai-Gun-Ikai-Shi 32:627;1943)
Medical Care Antipyretics Salicylates (Aspirin-contraindicant) Immunotherapy Blood transfusion
The Importance of Human Movement by Ships andthe Critical Roles played by the Physicians on board for unraveling Dengue Transmission