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Revista do Instituto de Medicina Tropical de São Paulo

Print version ISSN 0036-4665

Rev. Inst. Med. trop. S. Paulo vol.35 no.5 São Paulo Sept./Oct. 1993 



Epidemic dengue 4 in the Yucatán, México, 1984


Epidemia de dengue 4 en Yucatán, México, 1984



Maria Alba Loroño PinoI; José Arturo Farfán AleI; Elsy del Pilar Rosado ParedesI; Goro KunoII; Duaue J. GublerIII

ICentro de Investigaciones Regionales, "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatán, Apartado postal 2-1297, Mérida, Yucatán, México 97240
IIDengue Branch, Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases (NOD), Centers for Disease Control and Prevention (CDC), 2 calle Casia, San Juan, Puerto Rico 00921-3200
IIIDivision of Vector-Borne Infectious Diseases, NCID, CDC, P.0. Box 2087, Fort Collins, Colorado, USA 80522-2087

Address for correspondence




An outbreak of dengue 4 occurred in the Yucatán, México in 1984. During the course of the outbreak, 538 of 5486 reported cases of dengue-like illness were studied; 200 were confirmed as dengue serologically and/or virologically. Dengue 4 virus was isolated from 34 patients and dengue 1 from one. Severe haemorrhagic symptoms were observed in 9 laboratory confirmed patients, including four deaths. Thus, the outbreak in Yucatán is the second dengue epidemic in the Americas after the Cuban epidemic in 1981 in which a number of patients suffered from haemorrhagic complications. It was notable that 5 of 9 hospitalized, severe cases were young adults and that only one met the WHO criteria of DHF, in contrast to primary pediatric nature of DHF in Southeast Asia. In this paper we describe clinical, serologic, and virologic studies conducted during the outbreak.

Keywords: Dengue 4, Outbreak; clinical signs and symptoms; Haemorrhagic cases.


Un brote de dengue 4 ocurrió en Yucatán, México en 1984. Durante el curso del brote, 538 de 5486 casos reportados como dengue clínico fueron estudiados; 200 fueron confirmados como dengue, por estudios serológicos y/o virológicos. El dengue tipo 4 fue aislado de 34 pacientes y dengue 1 de un paciente. Síntomas hemorrágicos severos fueron observados en 9 pacientes confirmados por pruebas de laboratorio, de los cuales 4 fallecieron. Así, el brote en Yucatán es la segunda epidemia de dengue en las Américas después de la epidemia en Cuba en 1981 por el número de pacientes que sufrieron de complicaciones hemorrágicas. Fué notable que 5 de 9 casos hospitalizados, fueron adultos jóvenes y que únicamete un paciente reunió los criterios de la Organización Mundial de la Salud para la Fiebre Hemorrágica por Dengue (FHD), en contraste con los casos pediátricos de FHD del Sureste de Asia. En este artículo describimos los estudios clínicos, serológicos y virológicos realizados durante el brote.



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The authors thank Dra. Annette Arjona for the medical service and all the epidemiologists and medical doctors from the federal institutions such as Secretaria de Salubridad y Asistencia, ISSSTE and IMSS and several private doctors of the city. Also, the encouragement of Dr. Jorge Zavala Velázquez, Director of the Centro de Investigaciones Regionales "Dr. Hideyo Noguchi" of the Universidad Autónoma de Yucatán, was very much appreciated.



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Address for correspondence:
Dr. José Arturo Farfán Ale
Centro de Investigaciones Regionales, Universidad Autónoma de Yucatán
Apartado postal 2-1297
Mérida, Yucatán, México 97240

Recebido para publicação 20/04/1993
Aceito para publicação em 22/06/1993
This study was supported by Grant PRONAES Nº84-01-0207 from the Programa Nacional de Educación Superior de la Secretaría de Educación Pública of México.