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      2013 Dengue Outbreaks in Singapore and Malaysia Caused by Different Viral Strains

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          Abstract

          Characterization of 14,079 circulating dengue viruses in a cross-border surveillance program, UNITEDengue, revealed that the 2013 outbreaks in Singapore and Malaysia were associated with replacement of predominant serotype. While the predominant virus in Singapore switched from DENV2 to DENV1, DENV2 became predominant in neighboring Malaysia. Dominance of DENV2 was most evident on the southern states where higher fatality rates were observed.

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          Cost of dengue cases in eight countries in the Americas and Asia: a prospective study.

          Marcos Siqueira, Maria de Fatima Garrido Klingbeil, Sukhontha Kongsin … (2009)
          Despite the growing worldwide burden of dengue fever, the global economic impact of dengue illness is poorly documented. Using a common protocol, we present the first multicountry estimates of the direct and indirect costs of dengue cases in eight American and Asian countries. We conducted prospective studies of the cost of dengue in five countries in the Americas (Brazil, El Salvador, Guatemala, Panama, and Venezuela) and three countries in Asia (Cambodia, Malaysia, and Thailand). All studies followed the same core protocol with interviews and medical record reviews. The study populations were patients treated in ambulatory and hospital settings with a clinical diagnosis of dengue. Most studies were performed in 2005. Costs are in 2005 international dollars (I$). We studied 1,695 patients (48% pediatric and 52% adult); none died. The average illness lasted 11.9 days for ambulatory patients and 11.0 days for hospitalized patients. Among hospitalized patients, students lost 5.6 days of school, whereas those working lost 9.9 work days per average dengue episode. Overall mean costs were I$514 and I$1,394 for an ambulatory and hospitalized case, respectively. With an annual average of 574,000 cases reported, the aggregate annual economic cost of dengue for the eight study countries is at least I$587 million. Preliminary adjustment for under-reporting could raise this total to $1.8 billion, and incorporating costs of dengue surveillance and vector control would raise the amount further. Dengue imposes substantial costs on both the health sector and the overall economy.
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            The origin, emergence and evolutionary genetics of dengue virus.

            Edward C Holmes, S Susanna Twiddy (2003)
            Dengue is one of the most important emerging viruses, posing a threat to one-third of the global human population. Herein we show how the comparative analysis of gene sequence data has shed light on the origin and spread of dengue virus, as well as on the evolutionary processes that structure its genetic diversity. This reveals that dengue virus has a relatively recent evolutionary history, with the four serotypes originating approximately 1000 years ago and only establishing endemic transmission in humans in the last few hundred years. However, its place of origin remains uncertain as does the extent of genetic and phenotypic diversity present in the sylvatic (primate) transmission cycle. Although there is some evidence that viral strains differ in key phenotypic features such as virulence, and for positive selection at immunologically important sites, it seems likely that stochastic processes also play a major role in shaping viral genetic diversity, with lineage extinction a common occurrence. A more complete understanding of the evolution and epidemiology of dengue virus, particularly with respect to the aetiology of severe disease, will require large-scale prospective studies and the comparative analysis of complete genome sequences.
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              Dengue hemorrhagic fever in Cuba, 1981: a retrospective seroepidemiologic study.

              Andres S. Vázquez, L. Morier, G Kouri … (1990)
              In Cuba, 2 epidemics of dengue virus occurred: 1 caused by DEN-1 in 1977 and 1 caused by DEN-2 in 1981. The latter was associated with cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). To study viral risk factors for DHF/DSS, a retrospective seroepidemiological survey was conducted in Cerro, a densely populated district in Havana City. The prevalence of plaque reduction neutralizing antibodies to DEN-1 and DEN-2 viruses was measured in 1,295 individuals (children and adults). Of these, 43.7% were immune to DEN-1 virus and 23.6% to DEN-2 virus. Of those individuals who were immune, 26.1% were immune to DEN-1 virus only, 6% to DEN-2 virus only, and 17.6% to both viruses. The DEN-2 virus infection rate in DEN-1 immune individuals was 3.8 times higher than in non-immune individuals. The 5 DHF/DSS cases in the sample had evidence of DEN-1 virus plus DEN-2 virus infections. Three were children and 2 were young adults. No cases were found in individuals infected with DEN-1 virus or DEN-2 virus only. Children infected by DEN-1 virus followed by DEN-2 virus had a high risk of acquiring DHF/DSS. Blacks and whites were equally infected with DEN-1 and DEN-2 viruses.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Am J Trop Med Hyg
                Journal ID (iso-abbrev): Am. J. Trop. Med. Hyg
                Journal ID (publisher-id): tpmd
                Title: The American Journal of Tropical Medicine and Hygiene
                Publisher: The American Society of Tropical Medicine and Hygiene
                ISSN (Print): 0002-9637
                ISSN (Electronic): 1476-1645
                Publication date (Print): 03 June 2015
                Publication date PMC-release: 03 June 2015
                Volume: 92
                Issue: 6
                Pages: 1150-1155
                Affiliations
                Environmental Health Institute, National Environment Agency, Singapore; Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
                Author notes
                *Address correspondence to Lee-Ching Ng, Environmental Health Institute, 11 Biopolis Way, 06-05/08 Helios Block, Singapore 138667. E-mail: ng_lee_ching@ 123456nea.gov.sg
                Article
                DOI: 10.4269/ajtmh.14-0588
                PMC ID: 4458818
                PubMed ID: 25846296
                SO-VID: 40f616dd-cfd6-4dd1-a519-fa6a77659d20
                Copyright © ©The American Society of Tropical Medicine and Hygiene
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 17 September 2014
                Date accepted : 14 January 2015
                Categories
                Subject: Articles

                ScienceOpen disciplines: Infectious disease & Microbiology
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                ScienceOpen disciplines: Infectious disease & Microbiology

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