During the 1950s, the South-East Asian Treaty Organization (SEATO), in response to a cholera outbreak occurring throughout Asia, created a number of laboratories comprised of host-country and US scientists in Thailand, Malaysia, Bangladesh and Pakistan. The Thailand laboratory named the SEATO General Medical Research Project located in Bangkok, later re-named the Armed Forces Research Institute of Medical Sciences (AFRIMS) in 1977, formed a still ongoing 50-year relationship of Thai-US collaborators in the study of tropical infectious diseases. The discovery that Bangkok was experiencing an outbreak of a new clinical manifestation of dengue infection, dengue haemorrhagic fever by both Thai and US scientists, allowed the ongoing study of dengue in Thailand that spanned over a half of a century producing many of the seminal concepts of dengue virus transmission and disease severity. Early studies on DHF in Thailand established this as a unique clinical syndrome of DENV infection. Careful clinical studies of hospitalized children in Bangkok, Thailand demonstrated the clinical severity of DHF in producing thrombocytopenia, leucopenia, coagulopathy and plasma leakage. Studies on DHF pathogenesis in the 1960s revealed its unique features in being largely a phenomenon of secondary DENV infections or in primary infection of infants, a function of declining maternal DENV antibody. Classic studies in Thai children first established the role of enhancing antibody in the peripheral blood mononuclear cells of children in producing severe dengue illness and DHF. Prospective studies in hospitalized Thai children and in long-term cohort studies demonstrated the importance of dengue viral load and the T-cell response in determining dengue severity, the diversity of all four dengue serotypes circulating spatially and temporally in a well-defined geographic area and the role of subclinical dengue infection and its contribution to the overall burden of dengue illness.

from Endy et al. in Frontiers in Dengue Virus Research

Labels: cholera, Dengue haemorrhagic fever, DHF