biostudies-literatureAggarwal CDepartment of Biotechnology, Ministry of Science and Technology (DBT)NIAID NIH HHSU.S. Department of Health & Human Services | NIH | National Institute of Allergy and Infectious DiseasesU.S. Department of Health & Human Services | NIH | National Institute of Allergy and Infectious Diseases (NIAID)DBT/Wellcome Trust India AllianceWellcome TrustDepartment of Biotechnology, Ministry of Science and Technology670-674https://www.ebi.ac.uk/biostudies/studies/S-EPMC7617637biostudies-literatureUnknown30(3)Dengue is a global epidemic causing over 100 million cases annually. The clinical symptoms range from mild fever to severe hemorrhage and shock, including some fatalities. The current paradigm is that these severe dengue cases occur mostly during secondary infections due to antibody-dependent enhancement after infection with a different dengue virus serotype. India has the highest dengue burden worldwide, but little is known about disease severity and its association with primary and secondary dengue infections. To address this issue, we examined 619 children with febrile dengue-confirmed infection from three hospitals in different regions of India. We classified primary and secondary infections based on IgM:IgG ratios using a dengue-specific enzyme-linked immunosorbent assay according to Nature medicineSevere disease during both primary and secondary dengue virus infections in pediatric populations.PMC7617637BT/PR30260/MED/15/194/2018IA/S/14/1/501291IA/E/18/1/504307AI0900231UO1A/115654U19 AI090023Gottimukkala KRajan AShah PSaini KKaur MChawla YMAhmed RShet AKumar SAnsari AAhmed HGunisetty SSingla MMaheshwari DMammen SPanda HSreekanth GPNayak KSingh PYu TReddy ESPriyamvada LKabra SKSharma PRai RCBhaumik SKVerghese VPWrammert JChandele AVivek RDixit KAlagarasu KAntia RMedigeshi GRBhatnagar PAbraham AMAggarwal CAhamed SFDavis CWLodha RBajpai PMurali-Krishna KfalseSevere disease during both primary and secondary dengue virus infections in pediatric populations.Dengue is a global epidemic causing over 100 million cases annually. The clinical symptoms range from mild fever to severe hemorrhage and shock, including some fatalities. The current paradigm is that these severe dengue cases occur mostly during secondary infections due to antibody-dependent enhancement after infection with a different dengue virus serotype. India has the highest dengue burden worldwide, but little is known about disease severity and its association with primary and secondary dengue infections. To address this issue, we examined 619 children with febrile dengue-confirmed infection from three hospitals in different regions of India. We classified primary and secondary infections based on IgM:IgG ratios using a dengue-specific enzyme-linked immunosorbent assay according to 2024-01-01T00:00:00Z2024 Mar2025-07-08T03:12:51.211Z2025-07-08T03:12:51.211ZS-EPMC76176373832121910.1038/s41591-024-02798-x