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An epidemic of febrile illness associated with haemorrhagic manifestations and shock occurred at Kanpur, India, during 1968. The epidemic was widespread in the city, involving about one-tenth of the population; cases were more frequent in thickly populated localities with poor sanitary conditions. Those affected were mainly adolescents and adults of both sexes and multiple cases occurred in families. The disease was characterized by the sudden onset of fever, associated with severe headache and low backache. A number of patients had bradycardia, vomiting and diarrhoea and macular skin rashes associated with itching. A small percentage of the patients had haemorrhagic manifestations in the form of haematemesis, haemoptysis, melaena, haematuria and bleeding per vaginum. The mortality was very low. Dengue type 4 virus has been implicated in the epidemic.

Several epidemics of febrile illnesses associated with haemorrhagic manifestations occurred in India during 1963 and 1964. These epidemics were restricted to the eastern coastal areas. However, in northern India, for the first time, a widespread epidemic of febrile illness associated with haemorrhagic manifestations occurred at Kanpur in 1968. In the present study, the virological findings of the epidemic are reported.The role of dengue type 4 virus in the epidemic is demonstrated by the isolation of the virus from a number of cases, including one with haematemesis, and conversion of antibody titres with dengue type 4 virus in the paired sera.