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The first bout of dengue can be as life-threatening as the subsequent ones, according to a study which challenges the widely held belief that the viral disease is severe only in secondary infections. The research, published recently in the journal Nature Medicine, analysed severe dengue cases in a group of children in India, showing that more than half could be attributed to primary rather than secondary infection. Over the past two decades, dengue infections have greatly increased in India and the country has one of the largest number of cases globally. Dengue patients fall into two categories -- those experiencing the infection for the first time, known as primary infections and those who get re-infected after a previous exposure, known as secondary infections. The prevailing belief has been that only secondary infections pose significant risks, leading much of the research into vaccine development and treatment to focus on this group. An international team led by researchers at