More precise estimates of the burden of neurological events after infection are needed due to the rising frequency of acute dengue virus (DENV) infection worldwide. However, population-based estimates are inadequate. To assess the risk and excess burden of neurological events in a cohort of people with DENV infection during the acute postinfectious period in comparison to population-based comparators without DENV infection, this study was carried out.
This research conducted in Singapore included a cohort of all adults (aged ≥18) infected with DENV between January 1, 2017, and December 31, 2023 using national registries. The index date (time 0 [T0]) was used as the date of notification for this cohort. Additionally, a cohort of uninfected population-based comparators was created, for whom T0 was randomly assigned to match the T0 distribution in DENV-infected cases.
The people who contracted SARS-CoV-2 within 30 days of T0, as well as those who passed away prior to T0 and uninfected comparators who had no prior medical contact, were also excluded because the time coincided with the COVID-19 pandemic. The period of data analysis was January 1, 2017, through March 30, 2024.
A total of 1616 865 uninfected comparators (mean [SD] age, 54.8 [18.3] years; 730 702 [45.2%] male) were compared to 65 207 confirmed DENV-infected patients (mean [SD] age, 48.4 [17.8] years; 34 876 [53.5%] male). The odds of any new-incident neurological event (adjusted odds ratio [aOR], 9.69; 95% CI, 6.59-14.90), movement disorders (aOR, 7.10; 95% CI, 2.49-29.18), memory loss (aOR, 3.19; 95% CI, 1.36-8.69), and other neurological events (aOR, 14.32; 95% CI, 8.61-26.04).
With fewer than one excess incident for every 100 patients, the overall excess burden was low. Only those 60 years of age or older and those infected during DENV serotype 3 transmission exhibited higher risks of memory loss (aOR, 2.99; 95% CI, 1.30-7.87) and mobility abnormalities (aOR, 6.38; 95% CI, 2.23-25.96) when compared to uninfected persons.
Overall, although the EB was minor, acute DENV infection was linked to substantially increased probabilities of any composite new-incident neurological event, memory loss, movement abnormalities, and other neurological events (e.g., weariness or malaise) compared to uninfected population-based comparators.
Reference:
Wee, L. E., Tan, W. Z., Chow, J. Y., Lim, J. T., Chiew, C., Chia, P. Y., Dickens, B., Ng, L. C., Ong, B., Leo, Y. S., Lye, D. C., & Tan, K. B. (2025). Neurological events associated with acute dengue infection. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.4608
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