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An outbreak of dengue type 3 was studied in Central Java, Indonesia, in 1978. In contrast to previous dengue 3 epidemics in Central and East Java, this outbreak was less explosive, associated with mild illness, and low viremia. The dengue virus isolation rate from serologically confirmed patients was only 32% compared to 65% for an epidemic in Bantul a year earlier. Neither dengue hemagglutination-inhibition antibody titers nor day of illness on which specimens were collected accounted for this difference. These data suggest that some naturally occurring strains of dengue virus (endemic strains) are associated with low viremia and generally cause only mild illness in man.
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Gubler et al. (1981) studied this question.
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