Secondary Dengue Infection and Serotype Heterogeneity: Risk Factors for Dengue Hemorrhagic FeverComparative Analysis of Clinical Manifestations and Laboratory Parameters Across Different Dengue Virus

https://doi.org/10.66715/jsccr/2026.v3.i1.8391 | Original Research | 2026 | Volume 3 | Issue 1 | Page 83-91

1. Swapnilraj R. Prajapati (Research Scholar). Affiliation: School of Life and Basic Sciences, Jaipur National University, Jaipur, Rajasthan, India

2. Dr. Kratika Pathak (Assistant Professor), Affiliation: School of Life and Basic Sciences, Jaipur National University, Jaipur, Rajasthan, India

3. Prof. (Dr.) Preeti Srivastava,  (Professor & Head of Department), Affiliation: Department of Microbiology, JNUIMSRC, Jaipur, Rajasthan, India.

Secondary Dengue Infection and Serotype Heterogeneity: Risk Factors for Dengue Hemorrhagic.

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Corresponding Author:-

Swapnilraj R. Prajapati (Research Scholar).

Affiliation: School of Life and Basic Sciences,

Jaipur National University,

Jaipur, Rajasthan, India

Abstract

Dengue is a major mosquito-borne viral disease caused by four antigenically distinct dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4). Secondary infection with a heterologous serotype has been associated with an increased risk of severe dengue, including dengue hemorrhagic fever (DHF), through complex immunological mechanisms such as antibody-dependent enhancement. This study aims to evaluate the relationship between secondary dengue infection, serotype heterogeneity, clinical manifestations, and laboratory abnormalities associated with disease severity. Patients with laboratory-confirmed dengue infection are assessed for demographic characteristics, previous dengue exposure, infecting serotype, clinical presentation, and relevant hematological and biochemical parameters. Comparative analysis focuses on fever characteristics, bleeding manifestations, abdominal pain, vomiting, hepatomegaly, plasma leakage, thrombocytopenia, hematocrit changes, leukocyte counts, and liver enzyme abnormalities across different dengue virus serotypes. Particular attention is given to identifying clinical and laboratory predictors of progression to DHF and other severe forms of dengue. The findings are expected to demonstrate that secondary heterologous dengue infections are associated with greater hematological disturbances and an increased likelihood of severe clinical manifestations compared with primary infections. Serotype-specific variations may further influence disease presentation and severity. Understanding these associations can facilitate early risk stratification, timely clinical intervention, and improved management of patients at risk of developing dengue hemorrhagic fever.

Keywords: Dengue virus, secondary dengue infection, serotype heterogeneity, dengue hemorrhagic fever, thrombocytopenia, clinical manifestations, laboratory parameters, severe dengue.