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Fong SL, Wong KT, Tan CT. Dengue virus infection and neurological manifestations: an update. Brain 2024; 147:830-838. [PMID: 38079534 DOI: 10.1093/brain/awad415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/03/2023] [Accepted: 11/27/2023] [Indexed: 03/03/2024] Open
Abstract
Dengue virus is a flavivirus transmitted by the mosquitoes, Aedes aegypti and Aedes albopictus. Dengue infection by all four serotypes (DEN 1 to 4) is endemic globally in regions with tropical and subtropical climates, with an estimated 100-400 million infections annually. Among those hospitalized, the mortality is about 1%. Neurological involvement has been reported to be about 5%. The spectrum of neurological manifestations spans both the peripheral and central nervous systems. These manifestations could possibly be categorized into those directly related to dengue infection, i.e. acute and chronic encephalitis, indirect complications leading to dengue encephalopathy, and post-infectious syndrome due to immune-mediated reactions, and manifestations with uncertain mechanisms, such as acute transverse myelitis, acute cerebellitis and myositis. The rising trend in global dengue incidence calls for attention to a more explicit definition of each neurological manifestation for more accurate epidemiological data. The actual global burden of dengue infection with neurological manifestation is essential for future planning and execution of strategies, especially in the development of effective antivirals and vaccines against the dengue virus. In this article, we discuss the recent findings of different spectrums of neurological manifestations in dengue infection and provide an update on antiviral and vaccine development and their challenges.
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Affiliation(s)
- Si-Lei Fong
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Federal Territory of Kuala Lumpur, Malaysia
| | - Kum-Thong Wong
- Department of Pathology, Faculty of Medicine, University of Malaya, 50603 Federal Territory of Kuala Lumpur, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
| | - Chong-Tin Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Federal Territory of Kuala Lumpur, Malaysia
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Sirikajornpan K, Suntarattiwong P, Suwanpakdee D, Tabprasit S, Buddhari D, Thaisomboonsuk B, Klungthong C, Poolpanichupatam Y, Buathong R, Srikiatkhachorn A, Jones A, Fernandez S, Hunsawong T. Standardization and Evaluation of an Anti-ZIKV IgM ELISA Assay for the Serological Diagnosis of Zika Virus Infection. Am J Trop Med Hyg 2021; 105:936-941. [PMID: 34339380 PMCID: PMC8592169 DOI: 10.4269/ajtmh.21-0163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/24/2021] [Indexed: 11/07/2022] Open
Abstract
Here, we describe the development of the in-house anti-Zika virus (ZIKV) IgM antibody capture ELISA (in-house ZIKV IgM ELISA) for the detection and diagnosis of acute ZIKV infections. We compared the in-house ZIKV IgM ELISA assay performance against two commercial kits, Euroimmun ZIKV IgM and InBios 2.0 ZIKV IgM ELISA. We tested the assays' ability to detect anti-ZIKV IgM using a well-defined serum sample panel. This panel included 80 ZIKV negative samples (20 negative, 20 found to be primary dengue virus [DENV][ infections, 20 secondary DENV infections, and 20 Japanese encephalitis virus [JEV] infections) and 67 ZIKV reverse transcriptase-polymerase chain reaction-positive acute serum samples. The OD values were calculated to enzyme immunoassay (EIA) unts by comparing them to weak positive controls. The results demonstrated the high sensitivity (88.06%) and specificity (90.00%) of our in-house ZIKV IgM ELISA and its 89.12% overall percentage agreement. The kappa values were deemed to be within excellent range and comparable to the InBios ZIKV IgM ELISA. Some cross-reactivity was observed among secondary DENV and JEV samples, and to a much lower extent, among primary DENV samples. These data indicate that our in-house ZIKV IgM ELISA is a reliable assay for the detection of anti-ZIKV IgM antibodies in serum.
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Affiliation(s)
- Kanittha Sirikajornpan
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Piyarat Suntarattiwong
- Pediatrician, Infectious Diseases Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | | | - Sutchana Tabprasit
- Research Division, Royal Thai Army-Armed Forces Research Institute of Medical Sciences (RTA-AFRIMS), Bangkok, Thailand
| | - Darunee Buddhari
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Butsaya Thaisomboonsuk
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Chonticha Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Yongyuth Poolpanichupatam
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Rome Buathong
- Department of Disease Control, Bureau of Epidemiology, Ministry of Public Health, Nonthaburi, Thailand
| | - Anon Srikiatkhachorn
- Institute for Immunology and Informatics, University of Rhode Island, Providence, Rhode Island
- Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Anthony Jones
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Taweewun Hunsawong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
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Dangsagul W, Ruchusatsawat K, Tawatsin A, Changsom D, Noisumdaeng P, Putchakarn S, Phatihattakorn C, Auewarakul P, Puthavathana P. Zika virus isolation, propagation, and quantification using multiple methods. PLoS One 2021; 16:e0255314. [PMID: 34329309 PMCID: PMC8323943 DOI: 10.1371/journal.pone.0255314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/13/2021] [Indexed: 11/19/2022] Open
Abstract
Zika virus (ZIKV) was isolated from the archival urine, serum, and autopsy specimens by intrathoracic inoculation of Toxorhynchitis splendens and followed by three blind sub-passaging in C6/36 mosquito cells. The virus isolates were identified using an immunofluorescence assay and real-time reverse transcription-polymerase chain reaction (real-time RT-PCR). This study analyzed 11 ZIKV isolates. One isolate (0.6%) was obtained from 171 urine samples, eight (8.7%) from 92 serum samples and two from tissues of an abortive fetus. After propagation in C6/36 cells, ZIKV was titrated by plaque and focus forming unit (FFU) assays in Vero cell monolayers, and viral genomes were determined via real-time and digital RT-PCR. Plaque and FFU assay quantitations were comparable, with the amount of infectious viruses averaging 106-107 PFU or FFU/ml. Real-time RT-PCR semi-quantified the viral genome numbers, with Ct values varying from 12 to 14. Digital RT-PCR, which precisely determines the numbers of the viral genomes, consistently averaged 10-100 times higher than the number of infectious units. There was good correlation between the results of these titration methods. Therefore, the selection of a method should be based on the objectives of each research studies.
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Affiliation(s)
- Worawat Dangsagul
- Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
| | | | - Apiwat Tawatsin
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Don Changsom
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Pirom Noisumdaeng
- Faculty of Public Health, Thammasat University, Pathum Thani, Thailand
- Thammasat University Research Unit in Modern Microbiology and Public Health Genomics, Thammasat University, Pathum Thani, Thailand
| | - Sukontip Putchakarn
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Prasert Auewarakul
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Palermo PM, de la Mora-Covarrubias A, Orbegozo J, Plante JA, Plante KS, Jimenez-Vega F, Watts DM. Characterization of a Dengue Virus Serotype 1 Isolated from a Patient in Ciudad Juarez, Mexico. Pathogens 2021; 10:872. [PMID: 34358022 DOI: 10.3390/pathogens10070872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/23/2022] Open
Abstract
Dengue (DEN) is the most important human arboviral disease worldwide. Sporadic outbreaks of DEN have been reported since 1980 in urban communities located along the border in southeast Texas and northern Mexico. Other than the Rio Grande Valley region of TX, autochthonous transmission of DENV has not been reported from any other US border communities. As part of a surveillance program for arthropod-borne viruses in Ciudad Juarez, Mexico, during November 2015, a blood sample was obtained from a female patient who experienced an undifferentiated fever and arthralgia. The plasma of the sample was tested for virus in Vero-76 and C6/36 cells. DENV serotype 1 (DENV-1) was isolated in the C6/36 cells, and nucleotide sequencing of the envelope gene and full genome grouped the DENV-1 isolate in the Central America clade. The patient had not traveled outside of Ciudad Juarez, Mexico, thus suggesting DENV-1 infection was acquired in this community.
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Iani FCDM, Caetano ACB, Cocovich JCW, Amâncio FF, Pereira MA, Adelino TÉR, Caldas S, Silva MVF, Pereira GDC, Duarte MM. Dengue diagnostics: serious inaccuracies are likely to occur if pre-analytical conditions are not strictly followed. Mem Inst Oswaldo Cruz 2021; 115:e200287. [PMID: 33533869 PMCID: PMC7849175 DOI: 10.1590/0074-02760200287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/30/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The heat-labile nature of Dengue virus (DENV) in serum samples must be considered when applying routine diagnostic tests to avoid issues that could impact the accuracy of test results with direct implications for case management and disease reporting. OBJECTIVES To check if pre-analytical variables, such as storage time and temperature, have an impact on the accuracy of the main routine diagnostic tests for dengue. METHODS Virus isolation, reverse transcription real-time polymerase chain reaction (RT-PCR) and NS1 enzyme-linked immunosorbent assay (ELISA) were evaluated using 84 samples submitted to different pre-analytical conditions. FINDINGS Sensitivity and negative predictive value were directly affected by sample storage conditions. RT-PCR and virus isolation showed greater dependence on well-conserved samples for an accurate diagnosis. Interestingly, even storage at -30ºC for a relatively short time (15 days) was not adequate for accurate results using virus isolation and RT-PCR tests. On the other hand, NS1 ELISA showed no significant reduction in positivity for aliquots tested under the same conditions as in the previous tests. MAIN CONCLUSIONS Our results support the stability of the NS1 marker in ELISA diagnosis and indicate that the accuracy of routine tests such as virus isolation and RT-PCR is significantly affected by inadequate transport and storage conditions of serum samples.
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Affiliation(s)
- Felipe Campos de Melo Iani
- Fundação Ezequiel Dias, Diretoria do Instituto Octávio Magalhães, Serviço de Virologia e Riquetsioses, Belo Horizonte, MG, Brasil
| | | | | | - Frederico Figueiredo Amâncio
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Maira Alves Pereira
- Fundação Ezequiel Dias, Diretoria do Instituto Octávio Magalhães, Serviço de Virologia e Riquetsioses, Belo Horizonte, MG, Brasil
| | - Talita Émile Ribeiro Adelino
- Fundação Ezequiel Dias, Diretoria do Instituto Octávio Magalhães, Serviço de Virologia e Riquetsioses, Belo Horizonte, MG, Brasil
| | - Sérgio Caldas
- Fundação Ezequiel Dias, Diretoria de Pesquisa e Desenvolvimento, Serviço de Biotecnologia e Saúde, Belo Horizonte, MG, Brasil
| | - Marcos Vinícius Ferreira Silva
- Fundação Ezequiel Dias, Diretoria do Instituto Octávio Magalhães, Serviço de Virologia e Riquetsioses, Belo Horizonte, MG, Brasil
| | - Glauco de Carvalho Pereira
- Fundação Ezequiel Dias, Diretoria do Instituto Octávio Magalhães, Serviço de Virologia e Riquetsioses, Belo Horizonte, MG, Brasil
| | - Myrian Morato Duarte
- Fundação Ezequiel Dias, Diretoria do Instituto Octávio Magalhães, Serviço de Virologia e Riquetsioses, Belo Horizonte, MG, Brasil
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Xue Z, Zhao N, Wang J, Song X, Meng F, Liang W, Zhou J, Wang D, Zhang Z, Liu Q. Establishment and Application of Heminested RT-PCR Assay for Detection of Mosquito-Borne Flavivirus - Guizhou Province, China, 2018. China CDC Wkly 2021; 3:4-9. [PMID: 34594845 PMCID: PMC8393079 DOI: 10.46234/ccdcw2021.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/28/2020] [Indexed: 12/04/2022] Open
Affiliation(s)
- Zhijing Xue
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,School of Basic Medical Sciences, Shandong First Medical University, Taian, Shandong, China
| | - Ning Zhao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiuping Song
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fengxia Meng
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenqin Liang
- Guizhou Province Center for Disease Control and Prevention, Guiyang, Guizhou, China
| | - Jingzhu Zhou
- Guizhou Province Center for Disease Control and Prevention, Guiyang, Guizhou, China
| | - Dan Wang
- Guizhou Province Center for Disease Control and Prevention, Guiyang, Guizhou, China
| | - Zhong Zhang
- School of Life Sciences, Shandong First Medical University, Taian, Shandong, China.,Collaborative Innovation Center for the Origin and Control of Emerging Infectious Diseases, Taian, Shandong, China
| | - Qiyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Kongmanas K, Punyadee N, Wasuworawong K, Songjaeng A, Prommool T, Pewkliang Y, Manocheewa S, Thiemmeca S, Sa-ngiamsuntorn K, Puttikhunt C, Faull KF, Hongeng S, Avirutnan P. Immortalized stem cell-derived hepatocyte-like cells: An alternative model for studying dengue pathogenesis and therapy. PLoS Negl Trop Dis 2020; 14:e0008835. [PMID: 33216752 PMCID: PMC7717553 DOI: 10.1371/journal.pntd.0008835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 12/04/2020] [Accepted: 09/29/2020] [Indexed: 12/31/2022] Open
Abstract
Suitable cell models are essential to advance our understanding of the pathogenesis of liver diseases and the development of therapeutic strategies. Primary human hepatocytes (PHHs), the most ideal hepatic model, are commercially available, but they are expensive and vary from lot-to-lot which confounds their utility. We have recently developed an immortalized hepatocyte-like cell line (imHC) from human mesenchymal stem cells, and tested it for use as a substitute model for hepatotropic infectious diseases. With a special interest in liver pathogenesis of viral infection, herein we determined the suitability of imHC as a host cell target for dengue virus (DENV) and as a model for anti-viral drug testing. We characterized the kinetics of DENV production, cellular responses to DENV infection (apoptosis, cytokine production and lipid droplet metabolism), and examined anti-viral drug effects in imHC cells with comparisons to the commonly used hepatoma cell lines (HepG2 and Huh-7) and PHHs. Our results showed that imHC cells had higher efficiencies in DENV replication and NS1 secretion as compared to HepG2 and Huh-7 cells. The kinetics of DENV infection in imHC cells showed a slower rate of apoptosis than the hepatoma cell lines and a certain similarity of cytokine profiles to PHHs. In imHC, DENV-induced alterations in levels of lipid droplets and triacylglycerols, a major component of lipid droplets, were more apparent than in hepatoma cell lines, suggesting active lipid metabolism in imHC. Significantly, responses to drugs with DENV inhibitory effects were greater in imHC cells than in HepG2 and Huh-7 cells. In conclusion, our findings suggest superior suitability of imHC as a new hepatocyte model for studying mechanisms underlying viral pathogenesis, liver diseases and drug effects. A model system resembling normal human liver cells is needed for advancement of hepatotropic infectious disease research. Here we show that immortalized cells (imHC) derived from human stem cells have a higher efficiency of DENV replication and a lower rate of cell death in response to DENV infection than the cancer cell-derived model systems currently used. The imHC also have active fat metabolism and respond well to anti-viral drug treatment, making them an attractive model for the initial stage of drug discovery and testing.
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Affiliation(s)
- Kessiri Kongmanas
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Metabolomics and Phenomics Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nuntaya Punyadee
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kasima Wasuworawong
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Adisak Songjaeng
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tanapan Prommool
- Molecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Bangkok, Thailand
| | - Yongyut Pewkliang
- Excellent Center for Drug Discovery, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Siriphan Manocheewa
- Siriraj Metabolomics and Phenomics Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Somchai Thiemmeca
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Graduate Program in Immunology, Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Chunya Puttikhunt
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Molecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Bangkok, Thailand
| | - Kym Francis Faull
- Pasarow Mass Spectrometry Laboratory, Jane and Terry Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, California, United States of America
| | - Suradej Hongeng
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Panisadee Avirutnan
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Metabolomics and Phenomics Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Molecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Bangkok, Thailand
- * E-mail:
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MacLeod HJ, Dimopoulos G. Detailed Analyses of Zika Virus Tropism in Culex quinquefasciatus Reveal Systemic Refractoriness. mBio 2020; 11:e01765-20. [PMID: 32817107 PMCID: PMC7439479 DOI: 10.1128/mbio.01765-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/15/2020] [Indexed: 01/01/2023] Open
Abstract
The role of Culex quinquefasciatus in Zika virus transmission has been debated since the epidemic of Zika occurred in the Americas in 2015 to 2016. The majority of studies have found no evidence that C. quinquefasciatus or other Culex species are competent vectors of Zika virus, and the few studies that have proposed Zika vector status for C. quinquefasciatus have relied predominantly on quantitative real-time PCR (qRT-PCR) for viral detection. We assessed the infectious range of pre- and post-epidemic Zika virus isolates in order to classify mosquito samples based on titer infectiousness and demonstrated that two strains of C. quinquefasciatus, including one previously found to be competent, are highly resistant to infection with these Zika isolates compared to Aedes aegypti and are not competent for virus transmission. Further dissection of the dynamics of Zika exposure in both A. aegypti and C. quinquefasciatus revealed that while virus transmission by C. quinquefasciatus is blocked at the levels of the midgut and salivary glands, viral RNA persists in these tissues for prolonged periods post-exposure. We assessed Zika entry dynamics in both Aedes and Culex cells, and our results suggest that Zika virus infection in Culex cells may be blocked downstream of cell entry. These findings strongly suggest that C. quinquefasciatus is not a vector of Zika virus and additionally inform the use of qRT-PCR in vector competence assays as well as our understanding of barriers to arbovirus infection in non-susceptible mosquito species.IMPORTANCE Understanding which mosquito species transmit an emerging arbovirus is critical to effective vector control. During the Zika virus epidemic in 2015 to 2016, Aedes mosquitoes were confirmed as vectors. However, studies addressing the vector status of Culex quinquefasciatus mosquitoes presented conflicting evidence and remain an outstanding source of confusion in the field. Here, we established a robust cell-based assay to identify infectious titers of Zika virus and assessed the virus titers in C. quinquefasciatus by quantitative real-time PCR (qRT-PCR). We found that while low levels of virus were detected in C. quinquefasciatus, these titers did not correspond to infectious virus, and these mosquitoes did not transmit virus in the saliva. We also present evidence that the virus may enter Culex cells before infection is disrupted. Our findings are important for future studies incriminating vector species using qRT-PCR for virus detection and offer new information on how virus transmission is blocked by mosquitoes.
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Affiliation(s)
- Hannah J MacLeod
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - George Dimopoulos
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Avilés-Vergara PA, Trujillo-Correa A, Gómez-Suárez LA, Ricardo-Caldera D, Soto-De León SC, Brango H, Tovar Acero C. DENV and ZIKV detection in patients with acute febrile syndrome in Córdoba, Colombia. Int J Infect Dis 2020; 99:458-465. [PMID: 32777585 DOI: 10.1016/j.ijid.2020.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To determine simultaneous circulation of DENV serotypes and ZIKV in Córdoba, Colombia, during 2015 and 2016. MATERIAL AND METHODS A total of 294 samples from patients with clinical diagnosis of febrile syndrome compatible with dengue were collected between June 2015 and December 2016. All samples were tested for DENV and ZIKV by RT-PCR using C6/36 cells culture supernatant. RESULTS Thirty-three percent of the samples were positive (97/294); from these, 61.8% were positive for DENV and 31% were positive for Zika. The predominant serotype was DENV-2 (70.1%), followed by DENV-3 (8.9%), DENV-4 (6%), and DENV-1 (3%). DENV/ZIKV coinfection was identified in 7.2% of the cases associated with DENV-1 and DENV-3 serotypes. The confirmed cases of dengue, Zika, and DENV/ZIKV coinfections were clinically mild and self-limited. CONCLUSIONS We reported the co-circulation of all four DENV serotypes, with a higher frequency of DENV-2, and ZIKV introduction in Córdoba department-Colombia in August 2015. This scenario favored the appearance of DENV/ZIKV coinfections.
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Affiliation(s)
- Paula A Avilés-Vergara
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Montería, Córdoba, Colombia.
| | | | - Luz A Gómez-Suárez
- Grupo de Investigación Biomédica y Biología Molecular, Universidad del Sinú, Montería, Córdoba, Colombia
| | - Dina Ricardo-Caldera
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Montería, Córdoba, Colombia
| | - Sara C Soto-De León
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Montería, Córdoba, Colombia
| | - Hugo Brango
- Departamento de Matemáticas y Estadística, Facultad de Ciencias Básica, Universidad de Córdoba, Colombia
| | - Catalina Tovar Acero
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Montería, Córdoba, Colombia
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Bavia L, Melanda FN, de Arruda TB, Mosimann ALP, Silveira GF, Aoki MN, Kuczera D, Sarzi ML, Junior WLC, Conchon-Costa I, Pavanelli WR, Duarte Dos Santos CN, Barreto RC, Bordignon J. Epidemiological study on dengue in southern Brazil under the perspective of climate and poverty. Sci Rep 2020; 10:2127. [PMID: 32034173 PMCID: PMC7005746 DOI: 10.1038/s41598-020-58542-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/13/2020] [Indexed: 11/09/2022] Open
Abstract
Social and epidemiological aspects of dengue were evaluated in an important metropolitan area in southern Brazil, from August 2012 to September 2014. Demographic, clinical, serological data were collected from patients with acute dengue symptoms treated at public health system units (HSUs). A systematic approach to analyze the spatial and temporal distribution of cases was developed, considering the temporal cross-correlation between dengue and weather, and the spatial correlation between dengue and income over the city's census tracts. From the 878 patients with suggestive symptoms, 249 were diagnosed as positive dengue infection (28%). Considering the most statistically significant census tracts, a negative correlation was found between mean income and dengue (r = -0.65; p = 0.02; 95% CI: -0.03 to -0.91). The occurrence of dengue followed a seasonal distribution, and it was found to be three and four months delayed in relation to precipitation and temperature, respectively. Unexpectedly, the occurrence of symptomatic patients without dengue infection followed the same seasonal distribution, however its spatial distribution did not correlate with income. Through this methodology, we have found evidence that suggests a relation between dengue and poverty, which enriches the debate in the literature and sheds light on an extremely relevant socioeconomic and public health issue.
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Affiliation(s)
- Lorena Bavia
- Setor de Ciências da Saúde, Hospital de Clínicas, UFPR, Curitiba, 80060-900, Brazil
| | - Francine Nesello Melanda
- Laboratório de Parasitologia Experimental, Departamento de Ciências Patológicas, UEL, Londrina, 86057-970, Brazil
| | - Thais Bonato de Arruda
- Laboratório de Virologia Molecular do Instituto Carlos Chagas, ICC/Fiocruz/PR, Curitiba, 81350-010, Brazil
| | | | | | - Mateus Nóbrega Aoki
- Laboratório de Ciências e Tecnologias Aplicadas em Saúde do Instituto Carlos Chagas, ICC/Fiocruz/PR, Curitiba, 81350-010, Brazil
| | - Diogo Kuczera
- Laboratório de Virologia Molecular do Instituto Carlos Chagas, ICC/Fiocruz/PR, Curitiba, 81350-010, Brazil
| | - Maria Lo Sarzi
- Secretaria Municipal de Saúde de Cambé, Cambé, 86181-300, Brazil
| | | | - Ivete Conchon-Costa
- Laboratório de Parasitologia Experimental, Departamento de Ciências Patológicas, UEL, Londrina, 86057-970, Brazil
| | - Wander Rogério Pavanelli
- Laboratório de Parasitologia Experimental, Departamento de Ciências Patológicas, UEL, Londrina, 86057-970, Brazil
| | | | | | - Juliano Bordignon
- Laboratório de Virologia Molecular do Instituto Carlos Chagas, ICC/Fiocruz/PR, Curitiba, 81350-010, Brazil.
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11
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Kyaw AK, Ngwe Tun MM, Nabeshima T, Buerano CC, Ando T, Inoue S, Hayasaka D, Lim CK, Saijo M, Thu HM, Thant KZ, Morita K. Japanese Encephalitis- and Dengue-Associated Acute Encephalitis Syndrome Cases in Myanmar. Am J Trop Med Hyg 2020; 100:643-646. [PMID: 30628568 DOI: 10.4269/ajtmh.18-0530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This study was conducted to find the burden of dengue virus (DENV) and Japanese encephalitis virus (JEV) among children under the age of 13, who presented with acute encephalitis syndrome at Mandalay Children Hospital in Myanmar in 2013. Molecular and serological investigations were performed on 123 cerebrospinal fluid (CSF) samples collected from these patients. By neutralization tests and/or virus isolation, four (3.3%) JEV- and one DENV-associated encephalitis cases (0.8%) were confirmed. Antibody titer against JEV Genotype 3 was the highest among the laboratory-confirmed JEV cases. One strain of DENV-1 with Genotype 1 was isolated from the CSF sample of the dengue encephalitis patient; this was similar to the virus circulating in the study area and neighboring countries. This study shows that flaviviruses are important pathogens causing encephalitis in Myanmar. Active disease surveillance, vector control, and vaccination programs should be enforced to reduce the morbidity and mortality caused by flavivirus encephalitis.
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Affiliation(s)
- Aung Kyaw Kyaw
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Pyin Oo Lwin, Mandalay Region, Myanmar.,Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Takeshi Nabeshima
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Corazon C Buerano
- Research and Biotechnology, St. Luke's Medical Center, Quezon City, Philippines.,Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Tsuyoshi Ando
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Shingo Inoue
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Daisuke Hayasaka
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Chang-Kweng Lim
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hlaing Myat Thu
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Pyin Oo Lwin, Mandalay Region, Myanmar
| | - Kyaw Zin Thant
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Pyin Oo Lwin, Mandalay Region, Myanmar
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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12
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Abstract
Dengue virus (DENV) belongs to the family Flaviviridae, genus Flavivirus. It is a single-stranded positive-sense ribonucleic acid virus with 10,700 bases. The genus Flavivirus includes other arthropod borne viruses such as yellow fever virus, West Nile virus, Zika virus, tick-borne encephalitis virus. It infects ~50–200 million people annually, putting over 3.6 billion people living in tropical regions at risk and causing ~20,000 deaths annually. The expansion of dengue is attributed to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement, and also viral evolution. There are four antigenically different serotypes of DENV based on the differences in their viral structural and nonstructural proteins. DENV infection causes a spectrum of illness ranging from asymptomatic to dengue fever to severe dengue shock syndrome. Infection with one serotype confers lifelong immunity against that serotype, but heterologus infection leads to severe dengue hemorrhagic fever due to antibody-dependent enhancement. Diagnosis of dengue infections is based mainly on serological detection of either antigen in acute cases or antibodies in both acute and chronic infection. Viral detection and real-time PCR detection though helpful is not feasible in resource poor setup. Treatment of dengue depends on symptomatic management along with fluid resuscitation and may require platelet transfusion. Although vaccine development is in late stages of development, developing a single vaccine against four serotypes often causes serious challenges to researchers; hence, the main stay of prevention is vector control and management.
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13
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Sippert E, Rocha BC, Assis FL, Ok S, Rios M. Use of Monocyte-Derived Macrophage Culture Increases Zika Virus Isolation Rate from Human Plasma. Viruses 2019; 11:v11111058. [PMID: 31739467 PMCID: PMC6893817 DOI: 10.3390/v11111058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 12/19/2022] Open
Abstract
Viral isolation is desirable for many reasons, including development of diagnostic assays and reference materials, and for virology basic research. Zika virus (ZIKV) isolation from clinical samples is challenging, but isolates are known to infect various cell lines. Here, we evaluated suitability of Vero, C6/36 and JEG-3 as host cells, for direct isolation of ZIKV from human plasma. We also assessed the use of primary monocyte-derived macrophages (MDMs) culture to enhance ZIKV isolation from human plasma samples followed by virus expansion in Vero, C6/36 and JEG-3 cultures. Direct inoculation of cell lines with 42 ZIKV-RNA positive samples resulted in isolation rates of 9.52% (4/42) in Vero and C6/36, and of 7.14% (3/42) in JEG-3 cells. Inoculation of plasma in MDMs followed by supernatant testing by TaqMan RT-PCR, resulted in 33/42 (78.57%) ZIKV-RNA-positive supernatants, which expansion in cell lines increased isolation rates to 24.24% (8/33) in Vero and to 27.27% (9/33) in C6/36 and JEG-3 regardless of the presence of ZIKV-antibody. Isolates generated in JEG-3 cells were also produced in Vero and C6/36 with similar viral titers. These results suggest that efficiency of ZIKV isolation from human plasma can be enhanced when MDM culture is used before viral expansion in cell lines.
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14
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Thongyuan S, Kittayapong P. First evidence of dengue infection in domestic dogs living in different ecological settings in Thailand. PLoS One 2017; 12:e0180013. [PMID: 28854207 PMCID: PMC5576688 DOI: 10.1371/journal.pone.0180013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 06/08/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Dengue is a vector-borne disease transmitted by Aedes mosquitoes. It is considered an important public health problem in many countries worldwide. However, only a few studies have been conducted on primates and domestic animals that could potentially be a reservoir of dengue viruses. Since domestic dogs share both habitats and vectors with humans, this study aimed to investigate whether domestic dogs living in different ecological settings in dengue endemic areas in Thailand could be naturally infected with dengue viruses. METHODOLOGY/PRINCIPAL FINDINGS Serum samples were collected from domestic dogs in three different ecological settings of Thailand: urban dengue endemic areas of Nakhon Sawan Province; rubber plantation areas of Rayong Province; and Koh Chang, an island tourist spot of Trat Province. These samples were screened for dengue viral genome by using semi-nested RT-PCR. Positive samples were then inoculated in mosquito and dog cell lines for virus isolation. Supernatant collected from cell culture was tested for the presence of dengue viral genome by semi-nested RT-PCR, then double-strand DNA products were double-pass custom-sequenced. Partial nucleotide sequences were aligned with the sequences already recorded in GenBank, and a phylogenetic tree was constructed. In the urban setting, 632 domestic dog serum samples were screened for dengue virus genome by RT-PCR, and six samples (0.95%) tested positive for dengue virus. Four out of six dengue viruses from positive samples were successfully isolated. Dengue virus serotype 2 and serotype 3 were found to have circulated in domestic dog populations. One of 153 samples (0.65%) collected from the rubber plantation area showed a PCR-positive result, and dengue serotype 3 was successfully isolated. Partial gene phylogeny revealed that the isolated dengue viruses were closely related to those strains circulating in human populations. None of the 71 samples collected from the island tourist spot showed a positive result. CONCLUSIONS/SIGNIFICANCE We concluded that domestic dogs can be infected with dengue virus strains circulating in dengue endemic areas. The role of domestic dogs in dengue transmission needs to be further investigated, i.e., whether they are potential reservoirs or incidental hosts of dengue viruses.
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Affiliation(s)
- Suporn Thongyuan
- Center of Excellence for Vectors and Vector-Borne Diseases, Faculty of Science, Mahidol University at Salaya, Nakhon Pathom, Thailand
- Department of Biology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Pattamaporn Kittayapong
- Center of Excellence for Vectors and Vector-Borne Diseases, Faculty of Science, Mahidol University at Salaya, Nakhon Pathom, Thailand
- Department of Biology, Faculty of Science, Mahidol University, Bangkok, Thailand
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15
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Kyaw AK, Ngwe Tun MM, Moi ML, Nabeshima T, Soe KT, Thwe SM, Myint AA, Maung KTT, Aung W, Hayasaka D, Buerano CC, Thant KZ, Morita K. Clinical, virological and epidemiological characterization of dengue outbreak in Myanmar, 2015. Epidemiol Infect 2017; 145:1886-97. [DOI: 10.1017/s0950268817000735] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
SUMMARYHospital-based surveillance was conducted at two widely separated regions in Myanmar during the 2015 dengue epidemic. Acute phase serum samples were collected from 332 clinically diagnosed dengue patients during the peak season of dengue cases. Viremia levels were measured by quantitative real-time PCR and plaque assays using FcγRIIA-expressing and non-FcγRIIA-expressing BHK cells to specifically determine the infectious virus particles. By serology and molecular techniques, 280/332 (84·3%) were confirmed as dengue patients. All four serotypes of dengue virus (DENV) were isolated from among 104 laboratory-confirmed patients including two cases infected with two DENV serotypes. High percentage of primary infection was noted among the severe dengue patients. Patients with primary infection or DENV IgM negative demonstrated significantly higher viral loads but there was no significant difference among the severity groups. Viremia levels among dengue patients were notably high for a long period which was assumed to support the spread of the virus by the mosquito vector during epidemic. Phylogenetic analyses of the envelope gene of the epidemic strains revealed close similarity with the strains previously isolated in Myanmar and neighboring countries. DENV-1 dominated the epidemic in 2015 and the serotype (except DENV-3) and genotype distributions were similar in both study sites.
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16
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Iani FCDM, Caldas S, Duarte MM, Cury ALF, Cecílio AB, Costa PAC, Antonelli LR, Gollob KJ. Dengue Patients with Early Hemorrhagic Manifestations Lose Coordinate Expression of the Anti-Inflammatory Cytokine IL-10 with the Inflammatory Cytokines IL-6 and IL-8. Am J Trop Med Hyg 2016; 95:193-200. [PMID: 27139443 DOI: 10.4269/ajtmh.15-0537] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 02/07/2016] [Indexed: 12/25/2022] Open
Abstract
Dengue is responsible for a wide range of clinical manifestations, ranging from asymptomatic infections to severe cases. The alteration of cytokine levels correlated with clinical characteristics can help determine prognostic markers of the disease and the identification of targets for immunotherapy. We measured the viral load, serotype, and cytokine levels of 212 serum samples from patients with acute dengue infection during days 1-4 after the onset of symptoms. The patients were classified as either with hemorrhagic manifestations (HM) or with no hemorrhagic manifestations (NHM). The cytokines interleukin-6 (IL-6), IL-8, and IL-10 were increased (P < 0.05) in the dengue virus+ group, compared with the control group. A higher viral load (P < 0.05) and IL-6 was detected in the HM group compared with the NHM group. Interestingly, the NHM group demonstrated a significant positive correlation between inflammatory (IL-6 and 8) and anti-inflammatory (IL-10) cytokines, whereas the HM group did not. These findings suggest that a disturbance in the balance of inflammatory cytokines IL-6 and IL-8 with the anti-inflammatory cytokine, IL-10, combined with the high levels of IL-6 and viral load, characterize possible mechanisms related to the formation of HM.
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Affiliation(s)
- Felipe Campos de Melo Iani
- Divisão de Epidemiologia e Controle de Doenças/Instituto Octávio Magalhães, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil. Programa de Pós-graduação em Medicina e Biomedicina, Instituto de Ensino e Pesquisa, Hospital Santa Casa, Belo Horizonte, Minas Gerais, Brazil
| | - Sérgio Caldas
- Divisão de Plataformas Tecnológicas/Diretoria de Pesquisa e Desenvolvimento, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Myrian Morato Duarte
- Divisão de Epidemiologia e Controle de Doenças/Instituto Octávio Magalhães, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Luisa Furtado Cury
- Divisão de Epidemiologia e Controle de Doenças/Instituto Octávio Magalhães, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Alzira Batista Cecílio
- Divisão de Plataformas Tecnológicas/Diretoria de Pesquisa e Desenvolvimento, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | | | - Lis R Antonelli
- Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Kenneth J Gollob
- Programa de Pós-graduação em Medicina e Biomedicina, Instituto de Ensino e Pesquisa, Hospital Santa Casa, Belo Horizonte, Minas Gerais, Brazil. Institutos Nacionais de Ciências e Tecnologia-Doenças Tropicais, Belo Horizonte, Minas Gerais, Brazil. Núcleo de Ensino e Pesquisa, Instituto Mario Penna, Belo Horizonte, Minas Gerais, Brazil.
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17
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Nisalak A, Clapham HE, Kalayanarooj S, Klungthong C, Thaisomboonsuk B, Fernandez S, Reiser J, Srikiatkhachorn A, Macareo LR, Lessler JT, Cummings DAT, Yoon IK. Forty Years of Dengue Surveillance at a Tertiary Pediatric Hospital in Bangkok, Thailand, 1973-2012. Am J Trop Med Hyg 2016; 94:1342-7. [PMID: 27022151 DOI: 10.4269/ajtmh.15-0337] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 12/09/2015] [Indexed: 11/07/2022] Open
Abstract
Long-term observational studies can provide valuable insights into overall dengue epidemiology. Here, we present analysis of dengue cases at a pediatric hospital in Bangkok, Thailand, during a 40-year period from 1973 to 2012. Data were analyzed from 25,715 hospitalized patients with laboratory-confirmed dengue virus (DENV) infection. Several long-term trends in dengue disease were identified including an increase in mean age of hospitalized cases from an average of 7-8 years, an increase after 1990 in the proportion of post-primary cases for DENV-1 and DENV-3, and a decrease in the proportion of dengue hemorrhagic fever and dengue shock syndrome cases in primary and post-primary cases over time. Exploratory mechanistic analysis of these observed trends considered changes in diagnostic methods, demography, force of infection, and Japanese encephalitis vaccination as possible explanations. Thailand is an important setting for studying DENV transmission as it has a "mature" dengue epidemiology with a strong surveillance system in place since the early 1970s. We characterized changes in dengue epidemiology over four decades, and possible impact of demographic and other changes in the human population. These results may inform other countries where similar changes in transmission and population demographics may now or may soon be occurring.
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Affiliation(s)
- Ananda Nisalak
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Hannah E Clapham
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Siripen Kalayanarooj
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Chonticha Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Butsaya Thaisomboonsuk
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Julia Reiser
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Anon Srikiatkhachorn
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Louis R Macareo
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Justin T Lessler
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Derek A T Cummings
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - In-Kyu Yoon
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland; Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
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18
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Clapham H, Cummings DAT, Nisalak A, Kalayanarooj S, Thaisomboonsuk B, Klungthong C, Fernandez S, Srikiatkhachorn A, Macareo LR, Lessler J, Reiser J, Yoon IK. Epidemiology of Infant Dengue Cases Illuminates Serotype-Specificity in the Interaction between Immunity and Disease, and Changes in Transmission Dynamics. PLoS Negl Trop Dis 2015; 9:e0004262. [PMID: 26658730 PMCID: PMC4684242 DOI: 10.1371/journal.pntd.0004262] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/03/2015] [Indexed: 12/31/2022] Open
Abstract
Background Infants born to dengue immune mothers acquire maternal antibodies to dengue. These antibodies, though initially protective, decline during the first year of life to levels thought to be disease enhancing, before reaching undetectable levels. Infants have long been studied to understand the interaction between infection and disease on an individual level. Methods/Findings Considering infants (cases <1 year old) as a unique group, we analyzed serotype specific dengue case data from patients admitted to a pediatric hospital in Bangkok, Thailand. We show differences in the propensity of serotypes to cause disease in individuals with dengue antibodies (infants and post-primary cases) and in individuals without dengue antibodies (primary cases). The mean age of infant cases differed among serotypes, consistent with previously observed differential waning of maternal antibody titers by serotype. We show that trends over time in epidemiology of infant cases are consistent with those observed in the whole population, and therefore with trends in the force of infection. Conclusions/Significance Infants with dengue are informative about the interaction between antibody and the dengue serotypes, confirming that in this population DENV-2 and DENV-4 almost exclusively cause disease in the presence of dengue antibody despite infections occurring in others. We also observe differences between the serotypes in the mean age in infant cases, informative about the interaction between waning immunity and disease for the different serotypes in infants. In addition, we show that the mean age of infant cases over time is informative about transmission in the whole population. Therefore, ongoing surveillance for dengue in infants could provide useful insights into dengue epidemiology, particularly after the introduction of a dengue vaccine targeting adults and older children. Infants born to dengue immune mothers acquire maternal dengue antibodies. These antibodies, though initially protective, decline during the first year of life to levels thought to be disease enhancing, before reaching undetectable levels. We show that in this population, DENV-2 and DENV-4 almost exclusively cause disease in the presence of dengue antibody, despite infections occurring in others. We also observe serotype-specificity in the mean age of infant cases, consistent with differential waning of antibody to each serotype. These results highlight serotype-specificity in the way the immune response interacts with infection to cause disease. In addition, we show that the mean age of infant cases over time is informative about transmission in the whole population. Therefore, ongoing surveillance for dengue in infants could provide useful insights into dengue epidemiology, particularly after the introduction of a dengue vaccine targeting adults and older children.
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Affiliation(s)
- Hannah Clapham
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Derek A. T. Cummings
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
- Department of Biology, University of Florida, Gainesville, Florida, United States of America
| | - Ananda Nisalak
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Butsaya Thaisomboonsuk
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Chonticha Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Anon Srikiatkhachorn
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Louis R. Macareo
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Justin Lessler
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Julia Reiser
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - In-Kyu Yoon
- Dengue Vaccine Initiative, International Vaccine Institute, Seoul, Korea
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19
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Andries AC, Duong V, Ly S, Cappelle J, Kim KS, Lorn Try P, Ros S, Ong S, Huy R, Horwood P, Flamand M, Sakuntabhai A, Tarantola A, Buchy P. Value of Routine Dengue Diagnostic Tests in Urine and Saliva Specimens. PLoS Negl Trop Dis 2015; 9:e0004100. [PMID: 26406240 PMCID: PMC4583371 DOI: 10.1371/journal.pntd.0004100] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 08/31/2015] [Indexed: 11/23/2022] Open
Abstract
Background Dengue laboratory diagnosis is essentially based on detection of the virus, its components or antibodies directed against the virus in blood samples. Blood, however, may be difficult to draw in some patients, especially in children, and sampling during outbreak investigations or epidemiological studies may face logistical challenges or limited compliance to invasive procedures from subjects. The aim of this study was to assess the possibility of using saliva and urine samples instead of blood for dengue diagnosis. Methodology/Principal Findings Serial plasma, urine and saliva samples were collected at several time-points between the day of admission to hospital until three months after the onset of fever in children with confirmed dengue disease. Quantitative RT-PCR, NS1 antigen capture and ELISA serology for anti-DENV antibody (IgG, IgM and IgA) detection were performed in parallel on the three body fluids. RT-PCR and NS1 tests demonstrated an overall sensitivity of 85.4%/63.4%, 41.6%/14.5% and 39%/28.3%, in plasma, urine and saliva specimens, respectively. When urine and saliva samples were collected at the same time-points and tested concurrently, the diagnostic sensitivity of RNA and NS1 detection assays was 69.1% and 34.4%, respectively. IgG/IgA detection assays had an overall sensitivity of 54.4%/37.4%, 38.5%/26.8% and 52.9%/28.6% in plasma, urine and saliva specimens, respectively. IgM were detected in 38.1% and 36% of the plasma and saliva samples but never in urine. Conclusions Although the performances of the different diagnostic methods were not as good in saliva and urine as in plasma specimens, the results obtained by qRT-PCR and by anti-DENV antibody ELISA could well justify the use of these two body fluids to detect dengue infection in situations when the collection of blood specimens is not possible. Dengue is the most important arthropod-borne disease affecting humans and represents a huge public health burden in affected countries. Symptoms are often non-specific hence the need for an early, sensitive and specific diagnosis of dengue for appropriate management as well as for early epidemic detection. Currently, almost all laboratory diagnostic methods require a blood specimen that may be sometimes be difficult or inconvenient to obtain. In this study, we assessed the possibility to use saliva and urine samples as alternatives to blood specimens in dengue diagnosis. We demonstrated that the performances of the different diagnostic methods (RT-PCR, NS1 antigen detection and anti-DENV IgM/IgG/IgA ELISAs) were in general not as good in saliva and urine as in plasma, but that the use of these body fluids obtained by non-invasive methods could be of value in certain circumstances such as outbreak investigations or in young children (once they are old enough to comply to instructions), in addition to the situations when blood cannot be easily collected (e.g., lack of phlebotomist, refusal of the procedure, etc.).
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Affiliation(s)
| | - Veasna Duong
- Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia
| | - Sowath Ly
- Institut Pasteur in Cambodia, Epidemiology and Public Health Unit, Phnom Penh, Cambodia
| | - Julien Cappelle
- Institut Pasteur in Cambodia, Epidemiology and Public Health Unit, Phnom Penh, Cambodia
- Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), Unité AGIRs, Montpellier, France
| | - Kim Srorn Kim
- Kampong Cham Provincial Hospital, Pediatric Department, Kampong Cham, Cambodia
| | - Patrich Lorn Try
- Kampong Cham Provincial Hospital, Pediatric Department, Kampong Cham, Cambodia
| | - Sopheaktra Ros
- Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia
| | - Sivuth Ong
- Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia
| | - Rekol Huy
- Ministry of Health, Centre National de Malariologie, Phnom Penh, Cambodia
| | - Paul Horwood
- Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia
| | - Marie Flamand
- Institut Pasteur, Structural Virology Unit & CNRS UMR 3569, Paris, France
| | - Anavaj Sakuntabhai
- Institut Pasteur, Functional Genetics of Infectious Diseases Unit, Paris, France
- Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, Paris, France
| | - Arnaud Tarantola
- Institut Pasteur in Cambodia, Epidemiology and Public Health Unit, Phnom Penh, Cambodia
| | - Philippe Buchy
- Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia
- GlaxoSmithKline Vaccines, Vaccine Value and Health Sciences, Singapore, Singapore
- * E-mail:
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De La Cruz Hernández SI, Reyes-del Valle J, Villegas-del Angel E, Ludert JE, del Angel RM. Dengue laboratory diagnosis: still some room for improvement. Future Virol 2015. [DOI: 10.2217/fvl.15.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dengue is the most important and widely distributed arthropod-borne viral disease affecting humans. The number of dengue virus infections has steadily grown and more than 100 countries survey dengue incidence every year. Due to the lack of an approved antiviral treatment or licensed preventative vaccine, accurate and opportune diagnosis is commended for efficient dengue epidemiological surveillance, to propose control measures in order to curtail outbreaks timely and treat patients satisfactorily. In this review, the basis, application and indications for different diagnostic tests are described, and their advantages and limitations considered. At the end of this piece, we speculate what the future may hold for the diagnosis of dengue infections.
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Affiliation(s)
- Sergio Isaac De La Cruz Hernández
- Department of Virology, Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Mexico
- Departament of Infectomics & Molecular Pathogenesis, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), D.F., Mexico
| | | | | | - Juan E Ludert
- Departament of Infectomics & Molecular Pathogenesis, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), D.F., Mexico
| | - Rosa M del Angel
- Departament of Infectomics & Molecular Pathogenesis, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), D.F., Mexico
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Yoon IK, Alera MT, Lago CB, Tac-An IA, Villa D, Fernandez S, Thaisomboonsuk B, Klungthong C, Levy JW, Velasco JM, Roque VG, Salje H, Macareo LR, Hermann LL, Nisalak A, Srikiatkhachorn A. High rate of subclinical chikungunya virus infection and association of neutralizing antibody with protection in a prospective cohort in the Philippines. PLoS Negl Trop Dis 2015; 9:e0003764. [PMID: 25951202 PMCID: PMC4423927 DOI: 10.1371/journal.pntd.0003764] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 04/15/2015] [Indexed: 01/04/2023] Open
Abstract
Background Chikungunya virus (CHIKV) is a globally re-emerging arbovirus for which previous studies have indicated the majority of infections result in symptomatic febrile illness. We sought to characterize the proportion of subclinical and symptomatic CHIKV infections in a prospective cohort study in a country with known CHIKV circulation. Methods/Findings A prospective longitudinal cohort of subjects ≥6 months old underwent community-based active surveillance for acute febrile illness in Cebu City, Philippines from 2012-13. Subjects with fever history were clinically evaluated at acute, 2, 5, and 8 day visits, and at a 3-week convalescent visit. Blood was collected at the acute and 3-week convalescent visits. Symptomatic CHIKV infections were identified by positive CHIKV PCR in acute blood samples and/or CHIKV IgM/IgG ELISA seroconversion in paired acute/convalescent samples. Enrollment and 12-month blood samples underwent plaque reduction neutralization test (PRNT) using CHIKV attenuated strain 181/clone25. Subclinical CHIKV infections were identified by ≥8-fold rise from a baseline enrollment PRNT titer <10 without symptomatic infection detected during the intervening surveillance period. Selected CHIKV PCR-positive samples underwent viral isolation and envelope protein-1 gene sequencing. Of 853 subjects who completed all study procedures at 12 months, 19 symptomatic infections (2.19 per 100 person-years) and 87 subclinical infections (10.03 per 100 person-years) occurred. The ratio of subclinical-to-symptomatic infections was 4.6:1 varying with age from 2:1 in 6 month-5 year olds to 12:1 in those >50 years old. Baseline CHIKV PRNT titer ≥10 was associated with 100% (95%CI: 46.1, 100.0) protection from symptomatic CHIKV infection. Phylogenetic analysis demonstrated Asian genotype closely related to strains from Asia and the Caribbean. Conclusions Subclinical infections accounted for a majority of total CHIKV infections. A positive baseline CHIKV PRNT titer was associated with protection from symptomatic CHIKV infection. These findings have implications for assessing disease burden, understanding virus transmission, and supporting vaccine development. Chikungunya virus (CHIKV) is a re-emerging mosquito-borne pathogen for which the majority of infections have been considered to result in febrile illness. We sought to characterize the proportion of subclinical and symptomatic CHIKV infections in a prospective cohort of subjects ≥6 months old who underwent active surveillance for acute febrile illness from 2012–13 in Cebu City, Philippines. Symptomatic CHIKV infections were detected by PCR and/or ELISA in acute/convalescent blood samples. Subclinical infections were identified by neutralizing antibody seroconversion between enrollment and 12-month visits without symptomatic infection. Among 853 subjects who completed all study activities at 12 months, 19 symptomatic and 87 subclinical infections occurred (2.19 and 10.03 per 100 person-years, respectively). A positive baseline CHIKV PRNT titer was associated with 100% (95%CI: 46.1, 100.0) protection from symptomatic infection. Phylogenetic analysis showed Asian genotype closely related to strains from the recent Caribbean epidemic. These findings can help to assess disease burden, understand virus transmission, and support vaccine development.
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Affiliation(s)
- In-Kyu Yoon
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
- * E-mail:
| | | | | | | | - Daisy Villa
- Cebu City Health Department, Cebu City, Philippines
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Butsaya Thaisomboonsuk
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Chonticha Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Jens W. Levy
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Vito G. Roque
- National Epidemiology Center, Department of Health, Manila, Philippines
| | - Henrik Salje
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Louis R. Macareo
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Laura L. Hermann
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ananda Nisalak
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Anon Srikiatkhachorn
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
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Sasmono RT, Wahid I, Trimarsanto H, Yohan B, Wahyuni S, Hertanto M, Yusuf I, Mubin H, Ganda IJ, Latief R, Bifani PJ, Shi PY, Schreiber MJ. Genomic analysis and growth characteristic of dengue viruses from Makassar, Indonesia. Infect Genet Evol 2015; 32:165-77. [PMID: 25784569 DOI: 10.1016/j.meegid.2015.03.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 11/20/2022]
Abstract
Dengue fever is currently the most important mosquito-borne viral disease in Indonesia. In South Sulawesi province, most regions report dengue cases including the capital city, Makassar. Currently, no information is available on the serotypes and genotypes of the viruses circulating in the area. To understand the dynamic of dengue disease in Makassar, we carried out dengue fever surveillance study during 2007-2010. A total of 455 patients were recruited, in which antigen and serological detection revealed the confirmed dengue cases in 43.3% of patients. Molecular detection confirmed the dengue cases in 27.7% of patients, demonstrating that dengue places a significant disease burden on the community. Serotyping revealed that dengue virus serotype 1 (DENV-1) was the most predominant serotype, followed by DENV-2, -3, and -4. To determine the molecular evolution of the viruses, we conducted whole-genome sequencing of 80 isolates. Phylogenetic analysis grouped DENV-2, -3 and -4 to the Cosmopolitan genotype, Genotype I and Genotype II, respectively. Intriguingly, each serotype paints a different picture of evolution and transmission. DENV-1 appears to be undergoing a clade replacement with Genotype IV being supplanted by Genotype I. The Cosmopolitan DENV-2 isolates were found to be regionally endemic and is frequently being exchanged between countries in the region. By contrast, DENV-3 and DENV-4 isolates were related to strains with a long history in Indonesia although the DENV-3 strains appear to have been following a distinct evolutionary path since approximately 1998. To assess whether the various DENV serotypes/genotypes possess different growth characteristics, we performed growth kinetic assays on selected viruses. We observed the relatively higher rate of replication for DENV-1 and -2 compared to DENV-3 and -4. Within the DENV-1, viruses from Genotype I grow faster than that of Genotype IV. This higher replication rate may underlie their ability to replace the circulation of Genotype IV in the community.
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Affiliation(s)
- R Tedjo Sasmono
- Novartis-Eijkman-Hasanuddin Clinical Research Initiative (NEHCRI), Indonesia; Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia.
| | - Isra Wahid
- Novartis-Eijkman-Hasanuddin Clinical Research Initiative (NEHCRI), Indonesia; Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan 10, Tamalanrea, Makassar 90245, Indonesia
| | - Hidayat Trimarsanto
- Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia; Agency for the Assessment and Application of Technology, Jakarta 10340, Indonesia
| | - Benediktus Yohan
- Novartis-Eijkman-Hasanuddin Clinical Research Initiative (NEHCRI), Indonesia; Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia
| | - Sitti Wahyuni
- Novartis-Eijkman-Hasanuddin Clinical Research Initiative (NEHCRI), Indonesia; Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan 10, Tamalanrea, Makassar 90245, Indonesia
| | - Martin Hertanto
- Novartis-Eijkman-Hasanuddin Clinical Research Initiative (NEHCRI), Indonesia
| | - Irawan Yusuf
- Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan 10, Tamalanrea, Makassar 90245, Indonesia
| | - Halim Mubin
- Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan 10, Tamalanrea, Makassar 90245, Indonesia
| | - Idham J Ganda
- Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan 10, Tamalanrea, Makassar 90245, Indonesia
| | - Rachmat Latief
- Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan 10, Tamalanrea, Makassar 90245, Indonesia
| | - Pablo J Bifani
- Novartis Institute for Tropical Diseases (NITD), 10 Biopolis Road, Chromos #05-01, Singapore 138670, Singapore
| | - Pei-Yong Shi
- Novartis Institute for Tropical Diseases (NITD), 10 Biopolis Road, Chromos #05-01, Singapore 138670, Singapore
| | - Mark J Schreiber
- Novartis Institute for Tropical Diseases (NITD), 10 Biopolis Road, Chromos #05-01, Singapore 138670, Singapore
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Pal S, Dauner AL, Valks A, Forshey BM, Long KC, Thaisomboonsuk B, Sierra G, Picos V, Talmage S, Morrison AC, Halsey ES, Comach G, Yasuda C, Loeffelholz M, Jarman RG, Fernandez S, An US, Kochel TJ, Jasper LE, Wu SJ. Multicountry prospective clinical evaluation of two enzyme-linked immunosorbent assays and two rapid diagnostic tests for diagnosing dengue fever. J Clin Microbiol 2015; 53:1092-102. [PMID: 25588659 DOI: 10.1128/JCM.03042-14] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We evaluated four dengue diagnostic devices from Alere, including the SD Bioline Dengue Duo (nonstructural [NS] 1 Ag and IgG/IgM), the Panbio Dengue Duo Cassette (IgM/IgG) rapid diagnostic tests (RDTs), and the Panbio dengue IgM and IgG capture enzyme-linked immunosorbent assays (ELISAs) in a prospective, controlled, multicenter study in Peru, Venezuela, Cambodia, and the United States, using samples from 1,021 febrile individuals. Archived, well-characterized samples from an additional 135 febrile individuals from Thailand were also used. Reference testing was performed on all samples using an algorithm involving virus isolation, in-house IgM and IgG capture ELISAs, and plaque reduction neutralization tests (PRNT) to determine the infection status of the individual. The primary endpoints were the clinical sensitivities and specificities of these devices. The SD Bioline Dengue Duo had an overall sensitivity of 87.3% (95% confidence interval [CI], 84.1 to 90.2%) and specificity of 86.8% (95% CI, 83.9 to 89.3%) during the first 14 days post-symptom onset (p.s.o.). The Panbio Dengue Duo Cassette demonstrated a sensitivity of 92.1% (87.8 to 95.2%) and specificity of 62.2% (54.5 to 69.5%) during days 4 to 14 p.s.o. The Panbio IgM capture ELISA had a sensitivity of 87.6% (82.7 to 91.4%) and specificity of 88.1% (82.2 to 92.6%) during days 4 to 14 p.s.o. Finally, the Panbio IgG capture ELISA had a sensitivity of 69.6% (62.1 to 76.4%) and a specificity of 88.4% (82.6 to 92.8%) during days 4 to 14 p.s.o. for identification of secondary dengue infections. This multicountry prospective study resulted in reliable real-world performance data that will facilitate data-driven laboratory test choices for managing patient care during dengue outbreaks.
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De La Cruz Hernández SI, Flores-Aguilar H, González-Mateos S, López-Martínez I, Ortiz-Navarrete V, Ludert JE, Del Angel RM. Viral load in patients infected with dengue is modulated by the presence of anti-dengue IgM antibodies. J Clin Virol 2013; 58:258-61. [DOI: 10.1016/j.jcv.2013.06.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 06/06/2013] [Accepted: 06/10/2013] [Indexed: 11/16/2022]
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Abstract
Early diagnosis of dengue, the most common mosquito-borne disease globally, remains challenging. Dengue presents initially as undifferentiated fever, with symptoms becoming more pathognomonic in the later stages of illness. This limits the timeliness in the delivery of appropriate supportive interventions. Laboratory tests are useful for diagnosis although the short-lived viremia and the presence of secondary infection with one of the four heterologous viral serotypes collectively complicate the choice and interpretation of laboratory tests. In this article, the authors review the various approaches for diagnosis of dengue and discuss the appropriate tests to use, including when a dengue vaccine, which is in the late stages of development, is licensed for use. The ensuing reduced dengue prevalence could make diagnosis for vaccine efficacy and escape-mutant monitoring even more challenging.
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Affiliation(s)
- Kin Fai Tang
- Program in Emerging Infectious Disease, Duke-NUS Graduate Medical School Singapore, 8 College Road, 169857 Singapore.
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Abstract
We analyzed surveillance data of a dengue outbreak (2010) reported to the Hadramout Health Office (Yemen) and retrospectively analyzed dengue-related epidemiological and entomological events reported in Hadramout from 2005 to 2009. A total of 630 immunoglobulin M (IgM) -confirmed dengue cases of 982 febrile cases was reported during the period from February to June of 2010; 12 cases died, giving case fatality a rate of 1.9%. Among febrile cases, the highest proportion of dengue cases (37.3%) was reported in the 15- to 24-year-old age group. The overall attack rate was 0.89/1,000. The average number of cases reported by month over the preceding 5-year period compared with the 2010 data is consistent with endemicity of dengue in the region and supports epidemic designation for the dengue activity in 2010. Recognition of endemic dengue transmission and potential for substantial dengue epidemics highlight the need for consistent laboratory-based surveillance that can support prevention and control activities accordingly.
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Affiliation(s)
- Abdulla Salim Bin Ghouth
- Department of Community Medicine, Hadramout University Malaria Control Program, Hadramout, Yemen.
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Sabchareon A, Sirivichayakul C, Limkittikul K, Chanthavanich P, Suvannadabba S, Jiwariyavej V, Dulyachai W, Pengsaa K, Margolis HS, Letson GW. Dengue infection in children in Ratchaburi, Thailand: a cohort study. I. Epidemiology of symptomatic acute dengue infection in children, 2006-2009. PLoS Negl Trop Dis 2012; 6:e1732. [PMID: 22860141 PMCID: PMC3409110 DOI: 10.1371/journal.pntd.0001732] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 06/01/2012] [Indexed: 12/04/2022] Open
Abstract
Background There is an urgent need to field test dengue vaccines to determine their role in the control of the disease. Our aims were to study dengue epidemiology and prepare the site for a dengue vaccine efficacy trial. Methods and Findings We performed a prospective cohort study of children in primary schools in central Thailand from 2006 through 2009. We assessed the epidemiology of dengue by active fever surveillance for acute febrile illness as detected by school absenteeism and telephone contact of parents, and dengue diagnostic testing. Dengue accounted for 394 (6.74%) of the 5,842 febrile cases identified in 2882, 3104, 2717 and 2312 student person-years over the four years, respectively. Dengue incidence was 1.77% in 2006, 3.58% in 2007, 5.74% in 2008 and 3.29% in 2009. Mean dengue incidence over the 4 years was 3.6%. Dengue virus (DENV) types were determined in 333 (84.5%) of positive specimens; DENV serotype 1 (DENV-1) was the most common (43%), followed by DENV-2 (29%), DENV-3 (20%) and DENV-4 (8%). Disease severity ranged from dengue hemorrhagic fever (DHF) in 42 (10.5%) cases, dengue fever (DF) in 142 (35.5%) cases and undifferentiated fever (UF) in 210 (52.5%) cases. All four DENV serotypes were involved in all disease severity. A majority of cases had secondary DENV infection, 95% in DHF, 88.7% in DF and 81.9% in UF. Two DHF (0.5%) cases had primary DENV-3 infection. Conclusion The results illustrate the high incidence of dengue with all four DENV serotypes in primary school children, with approximately 50% of disease manifesting as mild clinical symptoms of UF, not meeting the 1997 WHO criteria for dengue. Severe disease (DHF) occurred in one tenth of cases. Data of this type are required for clinical trials to evaluate the efficacy of dengue vaccines in large scale clinical trials. There is an urgent need to field test dengue vaccine. Efficacy trials need to be conducted in study sites with
sufficiently high dengue incidence to make a robust estimate of vaccine efficacy and where all dengue virustypes
circulate frequently. In this paper, we report on dengue disease surveillance on approximately 3000 primary-school children in seven schools in Muang district of Ratchaburi province, central Thailand, from 2006 through 2009. We report on the characteristics of children in this cohort who fell ill with laboratory confirmed dengue disease. The study showed that approximately four percent of the children had laboratory confirmed dengue per year. All four dengue virus types were found to be the causes of illness in children in all seven schools. This study has shown Muang district of Ratchaburi province to be suitable for dengue vaccine testing and the site has been selected for the world’s first dengue vaccine safety and efficacy study, being conducted from 2009–2014 in children aged 4–11 years.
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Affiliation(s)
- Arunee Sabchareon
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Abstract
Viral infections of the central nervous system (CNS) are commonly encountered and there has been continued emergence of new neurotropic viruses which are being frequently recognized. These may present clinically as encephalitis, meningitis, encephalomyelitis, and encephalomyeloradiculitis. The clinical manifestations are usually nonspecific and diagnosis is usually based on the laboratory investigations. Imaging plays a role in its early detection and at times suggests the specific diagnosis that may help in early institution of appropriate therapy. In this review, we summarize the pathology, clinical, and imaging features of the common viral infections that affect the CNS.
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Affiliation(s)
- Rakesh Kumar Gupta
- Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
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Petersen LR, Tomashek KM, Biggerstaff BJ. Estimated prevalence of dengue viremia in Puerto Rican blood donations, 1995 through 2010. Transfusion 2012; 52:1647-51. [DOI: 10.1111/j.1537-2995.2011.03529.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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