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Kharwadkar S, Herath N. Clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands: A systematic review and meta-analysis. Rev Med Virol 2024; 34:e2521. [PMID: 38340071 DOI: 10.1002/rmv.2521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
Dengue, Zika and chikungunya outbreaks pose a significant public health risk to Pacific Island communities. Differential diagnosis is challenging due to overlapping clinical features and limited availability of laboratory diagnostic facilities. There is also insufficient information regarding the complications of these arboviruses, particularly for Zika and chikungunya. We conducted a systematic review and meta-analysis to calculate pooled prevalence estimates with 95% confidence intervals (CI) for the clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands. Based on pooled prevalence estimates, clinical features that may help to differentiate between the arboviruses include headache, haemorrhage and hepatomegaly in dengue; rash, conjunctivitis and peripheral oedema in Zika; and the combination of fever and arthralgia in chikungunya infections. We estimated that the hospitalisation and mortality rates in dengue were 9.90% (95% CI 7.67-12.37) and 0.23% (95% CI 0.16-0.31), respectively. Severe forms of dengue occurred in 1.92% (95% CI 0.72-3.63) of reported cases and 23.23% (95% CI 13.58-34.53) of hospitalised patients. Complications associated with Zika virus included Guillain-Barré syndrome (GBS), estimated to occur in 14.08 (95% CI 11.71-16.66) per 10,000 reported cases, and congenital brain malformations such as microcephaly, particularly with first trimester maternal infection. For chikungunya, the hospitalisation rate was 2.57% (95% CI 1.30-4.25) and the risk of GBS was estimated at 1.70 (95% CI 1.06-2.48) per 10,000 reported cases. Whilst ongoing research is required, this systematic review enhances existing knowledge on the clinical manifestations of dengue, Zika and chikungunya infections and will assist Pacific Island clinicians during future arbovirus outbreaks.
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Affiliation(s)
- Sahil Kharwadkar
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nipun Herath
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
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Anantharaj A, Agrawal T, Shashi PK, Tripathi A, Kumar P, Khan I, Pareek M, Singh B, Pattabiraman C, Kumar S, Pandey R, Chandele A, Lodha R, Whitehead SS, Medigeshi GR. Neutralizing antibodies from prior exposure to dengue virus negatively correlate with viremia on re-infection. COMMUNICATIONS MEDICINE 2023; 3:148. [PMID: 37857747 PMCID: PMC10587183 DOI: 10.1038/s43856-023-00378-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND India is hyperendemic to dengue and over 50% of adults are seropositive. There is limited information on the association between neutralizing antibody profiles from prior exposure and viral RNA levels during subsequent infection. METHODS Samples collected from patients with febrile illness was used to assess seropositivity by indirect ELISA. Dengue virus (DENV) RNA copy numbers were estimated by quantitative RT-PCR and serotype of the infecting DENV was determined by nested PCR. Focus reduction neutralizing antibody titer (FRNT) assay was established using Indian isolates to measure the levels of neutralizing antibodies and also to assess the cross-reactivity to related flaviviruses namely Zika virus (ZIKV), Japanese encephalitis virus (JEV) and West Nile virus (WNV). RESULTS In this cross-sectional study, we show that dengue seropositivity increased from 52% in the 0-15 years group to 89% in >45 years group. Antibody levels negatively correlate with dengue RNAemia on the day of sample collection and higher RNAemia is observed in primary dengue as compared to secondary dengue. The geometric mean FRNT50 titers for DENV-2 is significantly higher as compared to the other three DENV serotypes. We observe cross-reactivity with ZIKV and significantly lower or no neutralizing antibodies against JEV and WNV. The FRNT50 values for international isolates of DENV-1, DENV-3 and DENV-4 is significantly lower as compared to Indian isolates. CONCLUSIONS Majority of the adult population in India have neutralizing antibodies to all the four DENV serotypes which correlates with reduced RNAemia during subsequent infection suggesting that antibodies can be considered as a good correlate of protection.
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Affiliation(s)
- Anbalagan Anantharaj
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Tanvi Agrawal
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Pooja Kumari Shashi
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Alok Tripathi
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Parveen Kumar
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Imran Khan
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Madhu Pareek
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Balwant Singh
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | | | - Saurabh Kumar
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Rajesh Pandey
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) laboratory, Division of Immunology and Infectious Disease Biology, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
| | - Anmol Chandele
- ICGEB-Emory Vaccine Center, International Center for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Stephen S Whitehead
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Guruprasad R Medigeshi
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India.
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Xiong N, Sun Q. Identification of stage-related and severity-related biomarkers and exploration of immune landscape for Dengue by comprehensive analyses. Virol J 2022; 19:130. [PMID: 35918744 PMCID: PMC9344228 DOI: 10.1186/s12985-022-01853-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background At present, there are still no specific therapeutic drugs and appropriate vaccines for Dengue. Therefore, it is important to explore distinct clinical diagnostic indicators. Methods In this study, we combined differentially expressed genes (DEGs) analysis, weighted co-expression network analysis (WGCNA) and Receiver Operator Characteristic Curve (ROC) to screen a stable and robust biomarker with diagnosis value for Dengue patients. CIBERSORT was used to evaluate immune landscape of Dengue patients. Gene Ontology (GO) enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene set enrichment analysis (GSEA) were applied to explore potential functions of hub genes. Results CD38 and Plasma cells have excellent Area Under the Curve (AUC) in distinguishing clinical stages for Dengue patients, and activated memory CD4+ T cells and Monocytes have good AUC for this function. ZNF595 has acceptable AUC in discriminating dengue hemorrhagic fever (DHF) from dengue fever (DF) in whole acute stages. Analyzing any serotype, we can obtain consistent results. Negative inhibition of viral replication based on GO, KEGG and GSEA analysis results, up-regulated autophagy genes and the impairing immune system are potential reasons resulting in DHF. Conclusions CD38, Plasma cells, activated memory CD4+ T cells and Monocytes can be used to distinguish clinical stages for dengue patients, and ZNF595 can be used to discriminate DHF from DF, regardless of serotypes. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01853-8.
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Affiliation(s)
- Nan Xiong
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, 650118, People's Republic of China.,Kunming Medical University, Kunming, 650500, People's Republic of China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, 650118, People's Republic of China
| | - Qiangming Sun
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, 650118, People's Republic of China. .,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, 650118, People's Republic of China.
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刘 金, 李 晓, 王 海, 唐 时, 万 成. [Dengue virus E protein-based luciferase immunosorbent assay for detecting dengue virus IgG antibody]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1747-1751. [PMID: 34916204 PMCID: PMC8685698 DOI: 10.12122/j.issn.1673-4254.2021.11.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To establish a luciferase immunosorbent assay (DENV-LISA) based on dengue virus (DENV) E protein, a specific antigen of DENV, for detection of DENV IgG antibody. METHODS The fused expression plasmids of DENV1-E1 and DENV2-E2 with luciferase were constructed. The plasmids were transfected into 293T cells, and the fusion protein containing the specific antigen and luciferase was obtained for establishing DENV-LISA. The specificity and sensitivity of DENV-LISA were assessed and compared with those of commercial DENV IgG antibody detection kit (ELISA). RESULTS The established DENV-LISA had a positive detection rate of 32.4% and a specificity of 96.6%, showing a similar positive detection rate with the commercial ELISA kit (35.3%; P>0.05). DENV-LISA was capable of detecting positive samples with a 1: 6400 dilution with a high sensitivity. The test values of DENV-LISA did not differ significantly between plates or within plates in the same batch (P> 0.05), suggesting a good reproducibility of the test. CONCLUSION The luciferase immunosorbent assay based on DENV E protein has high specificity and sensitivity for detecting DENV IgG antibody, and can be used for early screening, surveillance and epidemiological investigation of DENV infection.
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Affiliation(s)
- 金月 刘
- />南方医科大学公共卫生学院,广东 广州 510515School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 晓霞 李
- />南方医科大学公共卫生学院,广东 广州 510515School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 海鹰 王
- />南方医科大学公共卫生学院,广东 广州 510515School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 时幸 唐
- />南方医科大学公共卫生学院,广东 广州 510515School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 成松 万
- />南方医科大学公共卫生学院,广东 广州 510515School of Public Health, Southern Medical University, Guangzhou 510515, China
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