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Shrestha DB, Budhathoki P, Gurung B, Subedi S, Aryal S, Basukala A, Aryal B, Adhikari A, Poudel A, Yadav GK, Khoury M, Rayamajhee B, Shrestha LB. Epidemiology of dengue in SAARC territory: a systematic review and meta-analysis. Parasit Vectors 2022; 15:389. [PMID: 36280877 PMCID: PMC9594905 DOI: 10.1186/s13071-022-05409-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/13/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Dengue is one of the common arboviral infections and is a public health problem in South East Asia. The aim of this systematic review and meta-analysis was to evaluate the prevalence and distribution of dengue in SAARC (South Asian Association for Regional Cooperation) countries. METHODS The PubMed, PubMed Central, Embase and Scopus databases were searched for relevant studies. Statistical analysis on data extracted from the selected studied was conducted using the Comprehensive Meta-Analysis Software (CMA) version 3 software package. Proportions were used to estimate the outcome with a 95% confidence interval (CI). RESULTS Across all studies, among cases of suspected dengue, 30.7% were confirmed dengue cases (proportion: 0.307, 95% CI: 0.277-0.339). The seroprevalence of dengue immunoglobulin (Ig)G, IgM or both (IgM and IgG) antibodies and dengue NS1 antigen was 34.6, 34.2, 29.0 and 24.1%, respectively. Among the different strains of dengue, dengue virus (DENV) strains DENV-1, DENV-2, DENV-3 and DENV-4 accounted for 21.8, 41.2, 14.7 and 6.3% of cases, respectively. The prevalence of dengue fever, dengue hemorrhagic fever and dengue shock syndrome was 80.5, 18.2 and 1.5%, respectively. Fever was a commonly reported symptom, and thrombocytopenia was present in 44.7% of cases. Mortality was reported in 1.9% of dengue cases. CONCLUSIONS Dengue is a common health problem in South East Asia with high seroprevalence. DENV-2 was found to be the most common strain causing infection, and most dengue cases were dengue fever. In addition, thrombocytopenia was reported in almost half of the dengue cases.
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Affiliation(s)
| | | | | | | | | | - Anisha Basukala
- Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Barun Aryal
- Department of Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Anurag Adhikari
- Department of Emergency Medicine, Nepal National Hospital, Kathmandu, Nepal
| | - Ayusha Poudel
- Department of Emergency Medicine, Alka Hospital, Kathmandu, Nepal
| | | | - Mtanis Khoury
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL USA
| | - Binod Rayamajhee
- School of Optometry & Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Lok Bahadur Shrestha
- Department of Microbiology & Infectious Diseases, B. P. Koirala Institute of Health Sciences, Dharan, 56700 Nepal
- School of Medical Sciences and the Kirby Institute, University of New South Wales, Sydney, Australia
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2
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Evolution, heterogeneity and global dispersal of cosmopolitan genotype of Dengue virus type 2. Sci Rep 2021; 11:13496. [PMID: 34188091 PMCID: PMC8241877 DOI: 10.1038/s41598-021-92783-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
Dengue virus type 2 (DENV-2) contributes substantially to the dengue burden and dengue-related mortality in the tropics and sub-tropics. DENV-2 includes six genotypes, among which cosmopolitan genotype is the most widespread. The present study investigated the evolution, intra-genotype heterogeneity and dispersal of cosmopolitan genotype to understand unique genetic characteristics that have shaped the molecular epidemiology and distribution of cosmopolitan lineages. The spatial analysis demonstrated a wide geo-distribution of cosmopolitan genotype through an extensive inter-continental network, anchored in Southeast Asia and Indian sub-continent. Intra-genotype analyses using 3367 envelope gene sequences revealed six distinct lineages within the cosmopolitan genotype, namely the Indian sub-continent lineage and five other lineages. Indian sub-continent lineage was the most diverged among six lineages and has almost reached the nucleotide divergence threshold of 6% within E gene to qualify as a separate genotype. Genome wide amino acid signatures and selection pressure analyses further suggested differences in evolutionary characteristics between the Indian sub-continent lineage and other lineages. The present study narrates a comprehensive genomic analysis of cosmopolitan genotype and presents notable genetic characteristics that occurred during its evolution and global expansion. Whether those characteristics conferred a fitness advantage to cosmopolitan genotype in different geographies warrant further investigations.
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3
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Tsheten T, Gray DJ, Clements ACA, Wangdi K. Epidemiology and challenges of dengue surveillance in the WHO South-East Asia Region. Trans R Soc Trop Med Hyg 2021; 115:583-599. [PMID: 33410916 DOI: 10.1093/trstmh/traa158] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/02/2020] [Accepted: 11/18/2020] [Indexed: 11/13/2022] Open
Abstract
Dengue poses a significant health and economic burden in the WHO South-East Asia Region. Approaches for control need to be aligned with current knowledge on the epidemiology of dengue in the region. Such knowledge will ensure improved targeting of interventions to reduce dengue incidence and its socioeconomic impact. This review was undertaken to describe the contemporary epidemiology of dengue and critically analyse the existing surveillance strategies in the region. Over recent decades, dengue incidence has continued to increase with geographical expansion. The region has now become hyper-endemic for multiple dengue virus serotypes/genotypes. Every epidemic cycle was associated with a change of predominant serotype/genotype and this was often associated with severe disease with intense transmission. Classical larval indices are widely used in vector surveillance and adult mosquito samplings are not implemented as a part of routine surveillance. Further, there is a lack of integration of entomological and disease surveillance systems, often leading to inaction or delays in dengue prevention and control. Disease surveillance does not capture all cases, resulting in under-reporting, and has thus failed to adequately represent the true burden of disease in the region. Possible solutions include incorporating adult mosquito sampling into routine vector surveillance, the establishment of laboratory-based sentinel surveillance, integrated vector and dengue disease surveillance and climate-based early warning systems using available technologies like mobile apps.
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Affiliation(s)
- Tsheten Tsheten
- Department of Globa l Health, Research School of Population Health, Australian National University, Canberra, Australia.,Royal Centre for Disease Control, Ministry of Health, Bhutan
| | - Darren J Gray
- Department of Globa l Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Australia.,Telethon Kids Institute, Nedlands, Australia
| | - Kinley Wangdi
- Department of Globa l Health, Research School of Population Health, Australian National University, Canberra, Australia
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4
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Deval H, Behera SP, Agrawal A, Singh R, Misra B, Janardhan V, Patil G, Sah K, Kumar N, Singh R, Bondre VP. Genetic characterization of dengue virus serotype 2 isolated from dengue fever outbreaks in eastern Uttar Pradesh and western Bihar, India. J Med Virol 2021; 93:3322-3329. [PMID: 32633814 DOI: 10.1002/jmv.26239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 01/23/2023]
Abstract
Dengue (DEN) is the most common cause of mosquito-borne endemic viral diseases in the tropical and subtropical countries. DEN outbreaks associated with multiple dengue virus (DV) serotypes have been regularly reported in different parts of India. This study was done during DEN outbreaks in 2015 to 2016 in UP and Bihar where DEN-2 was found as the only prevalent serotype. DV-2 was the only serotype amplified in serotype-specific reverse-transcription polymerase chain reaction from sera of 210 (65.21%) out of 322 DV NS1 antigen-positive patients. Further genetic analysis based on full-length envelope (E) protein sequence derived from patient's sera as well as DV isolate showed the circulation of lineages I and III of DV-2 cosmopolitan genotype during 2015 and lineage II during 2016. Finally, the phylogenetic analysis using the E gene sequence revealed that these DV-2 strains have a close genetic relationship with the recently reported DV-2 genotypes from DEN outbreaks reported from different parts of north India. These results showed the circulation of cosmopolitan genotype of DV-2 in eastern Uttar Pradesh and western Bihar, India. The genetic database generated on circulating DV strains in this study will be useful as reference for disease surveillance and strengthening laboratory diagnosis protocols.
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Affiliation(s)
- Hirawati Deval
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Sthita P Behera
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Awdhesh Agrawal
- Division of Pathology, Gorakhnath Hospital, Gorakhpur, Uttar Pradesh, India
| | - Rajeev Singh
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Brijranjan Misra
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Vanka Janardhan
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Gajanan Patil
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Kamlesh Sah
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Niraj Kumar
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Ravishankar Singh
- Molecular Virology, National Institute of Virology (Gorakhpur Unit), Gorakhpur, Uttar Pradesh, India
| | - Vijay P Bondre
- Encephalitis Group, ICMR-National Institute of Virology, Microbial Containment Complex, Pune, Maharashtra, India
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5
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Manandhar KD, McCauley M, Gupta BP, Kurmi R, Adhikari A, Nguyen AV, Elong Ngono A, Zompi S, Sessions OM, Shresta S. Whole Genome Sequencing of Dengue Virus Serotype 2 from Two Clinical Isolates and Serological Profile of Dengue in the 2015-2016 Nepal Outbreak. Am J Trop Med Hyg 2021; 104:115-120. [PMID: 33073748 DOI: 10.4269/ajtmh.20-0163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Dengue virus (DENV) is the cause of one of the most prevalent neglected tropical diseases, and up to half of the world's population is at risk for infection. Recent results from clinical trials have shown that DENV vaccination can induce the development of severe dengue disease and/or prolong hospitalization after natural infection in certain naive populations. Thus, it is crucial that vaccine development takes into account the history of DENV exposure in the targeted population. In Nepal, DENV infection was first documented in 2004, and despite the increasing prevalence of DENV infection, the population remains relatively naive. However, it is not known which of the four DENV serotypes circulate in Nepal or whether there is evidence of repeated exposure to DENV in the Nepali population. To address this, we studied 112 patients who presented with symptomology suspicious for DENV infection at clinics throughout Nepal during late 2015 and early 2016. Of the 112 patients examined, 39 showed serological and/or genetic evidence of primary or secondary DENV infection: 30 were positive for DENV exposure by IgM/IgG ELISA, two by real-time reverse-transcription PCR (RT-PCR), and seven by both methods. Dengue virus 1-3, but not DENV4, serotypes were detected by RT-PCR. Whole genome sequencing of two DENV2 strains isolated from patients with primary and secondary infections suggests that DENV was introduced into Nepal through India, with which it shares a porous border. Further study is needed to better define the DENV epidemic in Nepal, a country with limited scientific resources and infrastructure.
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Affiliation(s)
- Krishna Das Manandhar
- 1Division of Inflammation Biology, La Jolla Institute for Immunology, La Jolla, California.,2Central Department of Biotechnology, Tribhuvan University, Kirtipur, Nepal
| | - Melanie McCauley
- 1Division of Inflammation Biology, La Jolla Institute for Immunology, La Jolla, California.,3Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California
| | - Birendra Prasad Gupta
- 1Division of Inflammation Biology, La Jolla Institute for Immunology, La Jolla, California.,2Central Department of Biotechnology, Tribhuvan University, Kirtipur, Nepal
| | | | - Anurag Adhikari
- 2Central Department of Biotechnology, Tribhuvan University, Kirtipur, Nepal
| | - Anh-Viet Nguyen
- 1Division of Inflammation Biology, La Jolla Institute for Immunology, La Jolla, California
| | - Annie Elong Ngono
- 1Division of Inflammation Biology, La Jolla Institute for Immunology, La Jolla, California
| | - Simona Zompi
- 5Department of Experimental Medicine, School of Medicine, University of California San Francisco, California
| | - October M Sessions
- 6Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,7Department of Pharmacy, National University of Singapore, Singapore.,8Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Sujan Shresta
- 1Division of Inflammation Biology, La Jolla Institute for Immunology, La Jolla, California.,3Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California
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6
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Tsheten T, Clements ACA, Gray DJ, Wangchuk S, Wangdi K. Spatial and temporal patterns of dengue incidence in Bhutan: a Bayesian analysis. Emerg Microbes Infect 2021; 9:1360-1371. [PMID: 32538299 PMCID: PMC7473275 DOI: 10.1080/22221751.2020.1775497] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Dengue is an important emerging vector-borne disease in Bhutan. This study aimed to quantify the spatial and temporal patterns of dengue and their relationship to environmental factors in dengue-affected areas at the sub-district level. A multivariate zero-inflated Poisson regression model was developed using a Bayesian framework with spatial and spatiotemporal random effects modelled using a conditional autoregressive prior structure. The posterior parameters were estimated using Bayesian Markov Chain Monte Carlo simulation with Gibbs sampling. A total of 708 dengue cases were notified through national surveillance between January 2016 and June 2019. Individuals aged ≤14 years were found to be 53% (95% CrI: 42%, 62%) less likely to have dengue infection than those aged >14 years. Dengue cases increased by 63% (95% CrI: 49%, 77%) for a 1°C increase in maximum temperature, and decreased by 48% (95% CrI: 25%, 64%) for a one-unit increase in normalized difference vegetation index (NDVI). There was significant residual spatial clustering after accounting for climate and environmental variables. The temporal trend was significantly higher than the national average in eastern sub-districts. The findings highlight the impact of climate and environmental variables on dengue transmission and suggests prioritizing high-risk areas for control strategies.
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Affiliation(s)
- Tsheten Tsheten
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia.,Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Australia.,Telethon Kids Institute, Nedlands, Australia
| | - Darren J Gray
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Kinley Wangdi
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
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7
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Tsheten T, Mclure A, Clements ACA, Gray DJ, Wangdi T, Wangchuk S, Wangdi K. Epidemiological Analysis of the 2019 Dengue Epidemic in Bhutan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010354. [PMID: 33466497 PMCID: PMC7796457 DOI: 10.3390/ijerph18010354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/25/2020] [Accepted: 12/31/2020] [Indexed: 12/16/2022]
Abstract
Bhutan experienced its largest and first nation-wide dengue epidemic in 2019. The cases in 2019 were greater than the total number of cases in all the previous years. This study aimed to characterize the spatiotemporal patterns and effective reproduction number of this explosive epidemic. Weekly notified dengue cases were extracted from the National Early Warning, Alert, Response and Surveillance (NEWARS) database to describe the spatial and temporal patterns of the epidemic. The time-varying, temperature-adjusted cohort effective reproduction number was estimated over the course of the epidemic. The dengue epidemic occurred between 29 April and 8 December 2019 over 32 weeks, and included 5935 cases. During the epidemic, dengue expanded from six to 44 subdistricts. The effective reproduction number was <3 for most of the epidemic period, except for a ≈1 month period of explosive growth, coinciding with the monsoon season and school vacations, when the effective reproduction number peaked >30 and after which the effective reproduction number declined steadily. Interventions were only initiated 6 weeks after the end of the period of explosive growth. This finding highlights the need to reinforce the national preparedness plan for outbreak response, and to enable the early detection of cases and timely response.
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Affiliation(s)
- Tsheten Tsheten
- Research School of Population, Australian National University, Acton, Canberra, ACT 2601, Australia; (A.M.); (D.J.G.); (K.W.)
- Royal Centre for Disease Control, Ministry of Health, Thimphu 11001, Bhutan;
- Correspondence:
| | - Angus Mclure
- Research School of Population, Australian National University, Acton, Canberra, ACT 2601, Australia; (A.M.); (D.J.G.); (K.W.)
| | - Archie C. A. Clements
- Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
- Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Darren J. Gray
- Research School of Population, Australian National University, Acton, Canberra, ACT 2601, Australia; (A.M.); (D.J.G.); (K.W.)
| | - Tenzin Wangdi
- Vector-Borne Disease Control Program, Ministry of Health, Gelephu 31102, Bhutan;
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu 11001, Bhutan;
| | - Kinley Wangdi
- Research School of Population, Australian National University, Acton, Canberra, ACT 2601, Australia; (A.M.); (D.J.G.); (K.W.)
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8
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Phuyal P, Kramer IM, Klingelhöfer D, Kuch U, Madeburg A, Groneberg DA, Wouters E, Dhimal M, Müller R. Spatiotemporal Distribution of Dengue and Chikungunya in the Hindu Kush Himalayan Region: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6656. [PMID: 32932665 PMCID: PMC7560004 DOI: 10.3390/ijerph17186656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/07/2020] [Accepted: 09/07/2020] [Indexed: 11/22/2022]
Abstract
The risk of increasing dengue (DEN) and chikungunya (CHIK) epidemics impacts 240 million people, health systems, and the economy in the Hindu Kush Himalayan (HKH) region. The aim of this systematic review is to monitor trends in the distribution and spread of DEN/CHIK over time and geographically for future reliable vector and disease control in the HKH region. We conducted a systematic review of the literature on the spatiotemporal distribution of DEN/CHIK in HKH published up to 23 January 2020, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. In total, we found 61 articles that focused on the spatial and temporal distribution of 72,715 DEN and 2334 CHIK cases in the HKH region from 1951 to 2020. DEN incidence occurs in seven HKH countries, i.e., India, Nepal, Bhutan, Pakistan, Bangladesh, Afghanistan, and Myanmar, and CHIK occurs in four HKH countries, i.e., India, Nepal, Bhutan, and Myanmar, out of eight HKH countries. DEN is highly seasonal and starts with the onset of the monsoon (July in India and June in Nepal) and with the onset of spring (May in Bhutan) and peaks in the postmonsoon season (September to November). This current trend of increasing numbers of both diseases in many countries of the HKH region requires coordination of response efforts to prevent and control the future expansion of those vector-borne diseases to nonendemic areas, across national borders.
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Affiliation(s)
- Parbati Phuyal
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60590 Frankfurt am Main, Germany; (I.M.K.); (D.K.); (U.K.); (A.M.); (D.A.G.); (M.D.); (R.M.)
- Institute of Environment and Sustainable Development, University of Antwerp, 2000 Antwerp, Belgium
| | - Isabelle Marie Kramer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60590 Frankfurt am Main, Germany; (I.M.K.); (D.K.); (U.K.); (A.M.); (D.A.G.); (M.D.); (R.M.)
| | - Doris Klingelhöfer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60590 Frankfurt am Main, Germany; (I.M.K.); (D.K.); (U.K.); (A.M.); (D.A.G.); (M.D.); (R.M.)
| | - Ulrich Kuch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60590 Frankfurt am Main, Germany; (I.M.K.); (D.K.); (U.K.); (A.M.); (D.A.G.); (M.D.); (R.M.)
| | - Axel Madeburg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60590 Frankfurt am Main, Germany; (I.M.K.); (D.K.); (U.K.); (A.M.); (D.A.G.); (M.D.); (R.M.)
| | - David A. Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60590 Frankfurt am Main, Germany; (I.M.K.); (D.K.); (U.K.); (A.M.); (D.A.G.); (M.D.); (R.M.)
| | - Edwin Wouters
- Department of Sociology, University of Antwerp, 2000 Antwerp, Belgium;
| | - Meghnath Dhimal
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60590 Frankfurt am Main, Germany; (I.M.K.); (D.K.); (U.K.); (A.M.); (D.A.G.); (M.D.); (R.M.)
- Health Research Section, Nepal Health Research Council, Ramshah Path, Kathmandu 44600, Nepal
| | - Ruth Müller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60590 Frankfurt am Main, Germany; (I.M.K.); (D.K.); (U.K.); (A.M.); (D.A.G.); (M.D.); (R.M.)
- Unit Entomology, Institute of Tropical Medicine, 2000 Antwerp, Belgium
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9
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Molecular epidemiology of dengue fever outbreaks in Bhutan, 2016-2017. PLoS Negl Trop Dis 2020; 14:e0008165. [PMID: 32320397 PMCID: PMC7176082 DOI: 10.1371/journal.pntd.0008165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 02/23/2020] [Indexed: 12/30/2022] Open
Abstract
Dengue continues to pose a significant public health problem in tropical and subtropical countries. In Bhutan, first outbreak of dengue fever (DF) was reported in 2004 in a southern border town, followed by sporadic cases over the years. In this study, we analysed DF outbreaks that occurred in 3 different places during the years 2016 and 2017. A total of 533 cases in 2016 and 163 in 2017 were suspected of having of DF, where young adults were mostly affected. A total of 240 acute serum specimens collected and analyzed for serotype by nested RT-PCR revealed predominance of serotypes 1 and 2 (DENV-1 and 2). Phylogenetic analysis using envelope gene for both the serotypes demonstrated cosmopolitan genotype which were closely related to strains from India, indicating that they were probably imported from the neighboring country over the past few years. Endemicity of DENV in some places of southern Bhutan has been established previously. In this study, we analysed outbreaks of DF that occurred in 3 places over a period of 2 years, 1 of which was previously not known to be endemic to DENV. Serum specimens collected from patients suspected of having DF were analyzed in the Royal Centre for Disease Control (RCDC) in Bhutan and in Armed Forces Research Institute of Medical Sciences (AFRIMS), Thailand. DENV-1 and 2 were established as the causes of the outbreaks, also indicating that serotypes of DENV circulating in the country over the past years have remained the same. Our analyses reveal that the current DENV-1and DENV-2 in Bhutan probably originated from India, Bhutan’s closest neighboring country.
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10
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Yang CF, Chang SF, Hsu TC, Su CL, Wang TC, Lin SH, Yang SL, Lin CC, Shu PY. Molecular characterization and phylogenetic analysis of dengue viruses imported into Taiwan during 2011-2016. PLoS Negl Trop Dis 2018; 12:e0006773. [PMID: 30235208 PMCID: PMC6168156 DOI: 10.1371/journal.pntd.0006773] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/02/2018] [Accepted: 08/21/2018] [Indexed: 01/05/2023] Open
Abstract
A total of 1,596 laboratory-confirmed imported dengue cases were identified in Taiwan during 2011–2016. Most of the imported cases arrived from Southeast Asia as well as the Indian subcontinent, the Pacific region, Latin America, Australia and Africa. Phylogenetic analyses of the complete envelope protein gene sequences from 784 imported dengue virus (DENV) isolates were conducted, and the results suggest that the DENV-1 genotype I and DENV-2 Cosmopolitan genotype comprise the predominant serotype/genotype of DENV strains circulating in Southeast Asia. The DENV-1 genotype III, DENV-3 genotype III and DENV-4 genotype I and II strains were found to be newly emerging in several Southeast Asian countries. Our results also showed that geographical restrictions of DENV-1 genotype I, DENV-1 genotype III and DENV-2 Cosmopolitan genotype are becoming blurred, indicating the extensive introductions and continuous expansions of DENV strains between nations in Southeast Asia. In this study, we present the geographic distribution and dynamic transmission of DENV strains circulating in Southeast Asian countries. In addition, we demonstrated local dengue epidemics caused by several imported DENV strains in Taiwan during 2011–2016. Dengue is the most prevalent mosquito-borne viral disease in the world. The expansion of dengue viruses to different parts of the world has been accelerated by the increase in worldwide travel and trade. In this study, we present the results of a laboratory-based dengue surveillance in Taiwan during 2011–2016. A total of 1,596 laboratory-confirmed imported dengue cases were identified. The travelers were infected in 29 countries in Southeast Asia, the Indian subcontinent, the Pacific region, Latin America, Australia and Africa. Phylogenetic analyses of the envelope gene sequences of 784 imported dengue virus isolates suggest that the DENV-1 genotype I and DENV-2 Cosmopolitan genotype comprise the predominant serotype/genotype DENV strains circulating in Southeast Asia. Our results also showed that geographical restrictions of some of the DENV genotypes are becoming blurred, indicating the extensive introductions and continuous expansions of DENV strains between countries in Southeast Asia. In addition, we demonstrated dengue outbreaks in Taiwan caused by viruses imported from Asia and the Americas. The DENV envelope gene sequences from this study will contribute to a better understanding of the genetic evolution, dynamic transmission and global expansion of dengue viruses.
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Affiliation(s)
- Cheng-Fen Yang
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
| | - Shu-Fen Chang
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
| | - Tung-Chien Hsu
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
| | - Chien-Ling Su
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
| | - Tzy-Chen Wang
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
| | - Shih-Hung Lin
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
| | - Su-Lin Yang
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
| | - Chien-Chou Lin
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
| | - Pei-Yun Shu
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China
- * E-mail:
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11
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Rao MRK, Padhy RN, Das MK. Episodes of the epidemiological factors correlated with prevailing viral infections with dengue virus and molecular characterization of serotype-specific dengue virus circulation in eastern India. INFECTION GENETICS AND EVOLUTION 2017; 58:40-49. [PMID: 29247706 DOI: 10.1016/j.meegid.2017.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/16/2017] [Accepted: 12/06/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dengue is one of the most important and widespread viral infection comprises 4 related serotypes (DEN-1, 2, 3, and 4). Infection with one serotype does not protect against the others, and sequential infections put people at greater risk for dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). This study determines the epidemiology of prevailing viral infections with dengue and molecular characterization of serotype-specific DENV circulation in Odisha of eastern India. METHODS During the year 2013, 1980 blood samples with suspected dengue cases were obtained between days 1-10 of illness and analyzed by NS1 Ag-RDT, NS1 Ag-ELISA, and RT-PCR. The differential detection of dengue infections and DENV serotyping were carried out by IgM/IgG Ab-ELISA and RT-PCR, respectively. RESULTS Of the 1980 samples, 733 (37.0%) were positive for dengue RNA by RT-PCR. The confirmed cases of dengue were more in males (73.6%) in comparing to females (26.4%). The age group of 15-44years (527 cases, 71.9%) were more susceptible to dengue infections. 656 (89.5%) cases had infected with monotypic infection by different DENV serotype and 77 (10.5%) cases had multitypic infections by multiple serotypes of DENV. Of the total multitypic infections, there were 74 (10.1%) cases had infected with DENV-2 and DENV-3 serotypes at a time; and only 3 (0.4%) cases had the concurrent infections of all three serotypes that were, DENV-1, DENV-2, and DENV-3. Of the 28 DHF cases, there were 17 (2.3%) cases had infected with multitypic infections and 11 (1.5%) cases had infected with monotypic infection. CONCLUSION Dengue infections have prevailed from the month of July and grasped it's the peak in September. Rain, temperature and relative humidity have favored the dengue infections. Young adults and males are more susceptible to dengue infections. Serotypes DEN-2 followed by DEN-3 was dominant among the confirmed dengue cases. Co-circulation of multitypic infections with multiple DENV serotypes and the emergence of DHF cases suggested that eastern Indian state Odisha was becoming a hyper-endemic province for dengue; therefore, continuous surveillance is suggested for understanding the epidemiology of the diseases and monitoring the changes in the characteristics of circulating DENV strains.
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Affiliation(s)
- M Rajesh Kumar Rao
- Department of Biotechnology, Sai Nath University, Ranchi, Jharkhand, India.
| | - Rabindra N Padhy
- Central Research Laboratory, Institute of Medical Sciences & Sum Hospital, Siksha 'O' Anusandhan University, K-8, Kalinga Nagar, Bhubaneswar 751003, Odisha, India
| | - Manoj Kumar Das
- National Institute of Malaria Research, Field Unit, Itki, Ranchi, Jharkhand, India
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12
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Dumre SP, Bhandari R, Shakya G, Shrestha SK, Cherif MS, Ghimire P, Klungthong C, Yoon IK, Hirayama K, Na-Bangchang K, Fernandez S. Dengue Virus Serotypes 1 and 2 Responsible for Major Dengue Outbreaks in Nepal: Clinical, Laboratory, and Epidemiological Features. Am J Trop Med Hyg 2017; 97:1062-1069. [PMID: 29031282 PMCID: PMC5637613 DOI: 10.4269/ajtmh.17-0221] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Dengue virus (DENV) is expanding toward previously nonendemic areas. DENV has recently been introduced in Nepal with limited information. We report the clinical features and serotype distribution of DENV in Nepal during the 2010 outbreaks. A total of 1,215 clinical dengue cases at two major hospitals of central and western Nepal were investigated. Demographic, clinical, and laboratory parameters were recorded. Serum specimens were tested for DENV by IgM/IgG enzyme-linked immunosorbent assays (ELISAs) and reverse transcription polymerase chain reaction (RT-PCR). We confirmed DENV infection in 403 (33%) patients from 12 districts with an estimated case fatality rate of 1.5%. DENV infection was more common in adults (87%) and urban settings (74%). We detected all four serotypes but DENV-1 and -2 were mainly responsible for major outbreaks (92%). Overall, 60% of all DENV infections were secondary and 17% were severe dengue; both being more frequent among the DENV-2 infections. Rash, bleeding, abdominal pain, hepatomegaly, elevated liver enzymes, and thrombocytopenia were significantly more common in severe dengue compared with nonsevere infections. We also confirmed the expansion of dengue to hill urban areas (DENV-1 and -2), including the capital Kathmandu (altitude, 1,300 m) though > 90% cases were from southern plains. Differential clinical and laboratory features probably help in clinical decisions. Multiple serotypes circulation and elevated secondary infections pose potential risk of severe outbreaks and deaths in the future. Therefore, a country with recent dengue introduction, like Nepal, urgently requires a systematic surveillance and appropriate control measures in place to respond to any disastrous outbreaks.
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Affiliation(s)
- Shyam Prakash Dumre
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.,Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Renu Bhandari
- Kantipur College of Medical Sciences, Kathmandu, Nepal
| | - Geeta Shakya
- National Public Health Laboratory, Ministry of Health and Population, Kathmandu, Nepal
| | | | | | | | - Chonticha Klungthong
- Virology Department, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - In-Kyu Yoon
- International Vaccine Institute, Seoul, Republic of Korea.,Virology Department, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Kenji Hirayama
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Kesara Na-Bangchang
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand.,Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Stefan Fernandez
- Virology Department, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
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13
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Enhancing the sensitivity of Dengue virus serotype detection by RT-PCR among infected children in India. J Virol Methods 2017; 244:46-54. [PMID: 28254680 DOI: 10.1016/j.jviromet.2017.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/23/2017] [Accepted: 02/27/2017] [Indexed: 12/19/2022]
Abstract
Dengue surveillance relies on reverse transcription-polymerase chain reaction (RT-PCR), for confirmation of dengue virus (DENV) serotypes. We compared efficacies of published and modified primer sets targeting envelope (Env) and capsid-premembrane (C-prM) genes for detection of circulating DENV serotypes in southern India. Acute samples from children with clinically-diagnosed dengue were used for RT-PCR testing. All samples were also subjected to dengue serology (NS1 antigen and anti-dengue-IgM/IgG rapid immunochromatographic assay). Nested RT-PCR was performed on viral RNA using three methods targeting 654bp C-prM, 511bp C-prM and 641bp Env regions, respectively. RT-PCR-positive samples were validated by population sequencing. Among 171 children with suspected dengue, 121 were dengue serology-positive and 50 were dengue serology-negative. Among 121 serology-positives, RT-PCR detected 91 (75.2%) by CprM654, 72 (59.5%) by CprM511, and 74 (61.1%) by Env641. Among 50 serology-negatives, 10 (20.0%) were detected by CprM654, 12 (24.0%) by CprM511, and 11 (22.0%) by Env641. Overall detection rate using three methods sequentially was 82.6% (100/121) among serology-positive and 40.0% (20/50) among serology-negative samples; 6.6% (8/120) had co-infection with multiple DENV serotypes. We conclude that detection of acute dengue was enhanced by a modified RT-PCR method targeting the 654bp C-prM region, and further improved by using all three methods sequentially.
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Shi Y, Li S, Li X, Zheng K, Yuan S, Huang J. Epidemiological and molecular characterization of dengue viruses imported into Guangzhou during 2009-2013. SPRINGERPLUS 2016; 5:1635. [PMID: 27722053 PMCID: PMC5031575 DOI: 10.1186/s40064-016-3257-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/08/2016] [Indexed: 12/02/2022]
Abstract
Background Dengue virus causes one of the most significant infectious diseases in tropical and subtropical regions, notable number of which is imported into China every year. Results In this study, the molecular epidemiologic and phylogenetic analyses of dengue cases imported into Guangzhou in South China during 2009–2013 were conducted. During that period, 46 imported dengue cases were identified, including four serotypes. Most of the dengue patients were travelling from Southeast Asia, South Asia and Africa. The envelope (E) genes of 20 imported dengue viruses introduced from 13 countries and regions, were sequenced and used for phylogenetic analyses. The results indicated that the DENV-1 genotype I and DENV-2 Asian genotype I were the most predominant DENV strains, which were circulating in Southeast Asia and imported into South China. In addition, the new introduction of DENV-3 genotype III from West Asia was observed. Conclusions This study provided an overview on the genetic diversity of DENV strains imported into South China, and also gave information about the geographic distribution, dynamic transmission and molecular evolution of epidemic DENV strains.
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Affiliation(s)
- Yongxia Shi
- Inspection and Quarantine Technology Center, Guangdong Entry-Exit Inspection and Quarantine Bureau, No. 13, Gangwan Road, Huangpu District, Guangzhou, 510700 Guangdong China
| | - Shufen Li
- Inspection and Quarantine Technology Center, Guangdong Entry-Exit Inspection and Quarantine Bureau, No. 13, Gangwan Road, Huangpu District, Guangzhou, 510700 Guangdong China
| | - Xiaobo Li
- Inspection and Quarantine Technology Center, Guangdong Entry-Exit Inspection and Quarantine Bureau, No. 13, Gangwan Road, Huangpu District, Guangzhou, 510700 Guangdong China
| | - Kui Zheng
- Inspection and Quarantine Technology Center, Guangdong Entry-Exit Inspection and Quarantine Bureau, No. 13, Gangwan Road, Huangpu District, Guangzhou, 510700 Guangdong China
| | - Shuai Yuan
- Inspection and Quarantine Technology Center, Guangdong Entry-Exit Inspection and Quarantine Bureau, No. 13, Gangwan Road, Huangpu District, Guangzhou, 510700 Guangdong China
| | - Jicheng Huang
- Inspection and Quarantine Technology Center, Guangdong Entry-Exit Inspection and Quarantine Bureau, No. 13, Gangwan Road, Huangpu District, Guangzhou, 510700 Guangdong China
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