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Fortuitously, the only dengue viruses ever to
infect the Cuban population ages 3 – 40 years, were DENV 1 in 1977-9 and
DENV 2 in 1981. Epidemiological studies showed that rates of infection for
these viruses were the same in all age and ethnicity categories (Guzman MG
et al AJTMH 42:179-184, 1990) and thus, age-specific DHF/DSS attack rates
per 10,000 secondary dengue infections measure intrinsic age-specific
susceptibility to dengue vascular permeability. Note that case fatality
rates in the elderly exceed reported DHF/DSS attack rates.
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