Altogether, the present results highlight the inadequacy of the 1997 WHO classification of dengue clinical forms [19] [21], that considers DF and DHF grades I/II as two separate disease phenotypes, and support the recently proposed classification [90].
The hemagglutination inhibition (HI) test [10], based on antibody titering of paired serum specimens and recommended by the World Health Organization (WHO) [7], is the method that has most frequently been used for serologic classification of dengue infections.
We report here the results of a prospective study comparing the whole blood genome-wide expression profiles of 48 matched Cambodian children recruited during the huge 2007 dengue outbreak who presented with classical dengue fever (DF), dengue hemorrhagic fever grades I/II (DHF) or dengue shock syndrome (DSS), according to the 1997 WHO classification of dengue severity [29].
Indeed, DSS occurs by the end of the acute infection in only a fraction of dengue-infected patients and current severity criteria, based on the 1997 World Health Organization (WHO) classification of dengue severity, fail to predict a significant proportion of patients who progress to life-threatening DSS [19] [21].
In this kit the IgG-based classification of dengue infection is based on the use of a constant cut-off value to discriminate between the two types of infection, regardless of disease stage (as measured here by the number of days from the onset of symptoms).
With this resurgence, the classification of dengue cases for hospitalization and clinical management has gained importance.
These findings raise the question if the current WHO classification system is appropriate for the classification of dengue disease severity.
Splitting stopped at nodes with a minimum classification of dengue, maximum classification of influenza, or a small number of patients in the node.
12– 14 Consequently, the classification of dengue became fragmented and epidemiologic comparisons within and between countries became almost impossible.
All cases were classified as severe dengue, while only 70% eventually fulfilled all 4 criteria for the 1997 World Health Organization classification of dengue hemorrhagic fever.
