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      Exploring the origin and potential for spread of the 2013 dengue outbreak in Luanda, Angola

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          Abstract

          Introduction

          Dengue in Africa is underreported. Simultaneous reports of travellers with dengue returning from Luanda, Angola, to six countries on four continents suggest that a major dengue outbreak is currently occurring in Angola, South West Africa.

          Methods

          To identify the origin of the imported dengue virus, we sequenced the virus from Angola and investigated the interconnectivity via air travel between dengue-endemic countries and Angola.

          Results and Conclusion

          Our analyses show that the Angola outbreak was most likely caused by an endemic virus strain that had been circulating in West Africa for many years. We also show that Portugal and South Africa are most likely at the highest risk of importation of dengue from Angola due to the large number of air passengers between Angola and these countries.

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          Dengue, Urbanization and Globalization: The Unholy Trinity of the 21st Century

          Duane J. Gubler (2011)
          Dengue is the most important arboviral disease of humans with over half of the world’s population living in areas of risk. The frequency and magnitude of epidemic dengue have increased dramatically in the past 40 years as the viruses and the mosquito vectors have both expanded geographically in the tropical regions of the world. There are many factors that have contributed to this emergence of epidemic dengue, but only three have been the principal drivers: 1) urbanization, 2) globalization and 3) lack of effective mosquito control. The dengue viruses have fully adapted to a human-Aedes aegypti-human transmission cycle, in the large urban centers of the tropics, where crowded human populations live in intimate association with equally large mosquito populations. This setting provides the ideal home for maintenance of the viruses and the periodic generation of epidemic strains. These cities all have modern airports through which 10s of millions of passengers pass each year, providing the ideal mechanism for transportation of viruses to new cities, regions and continents where there is little or no effective mosquito control. The result is epidemic dengue. This paper discusses this unholy trinity of drivers, along with disease burden, prevention and control and prospects for the future.
          Article 0 comments Cited 411 times – based on 0 reviews     Review now
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            Molecular evolution and distribution of dengue viruses type 1 and 2 in nature.

            R Rico-Hesse (1990)
            During the past several decades, dengue viruses have progressively extended their geographic distribution, and are currently some of the most important mosquito-borne viruses associated with human illness. Determining the genetic variability and transmission patterns of these RNA viruses is crucial in developing effective control strategies for the disease. Primer-extension sequencing of less than 3% of the dengue genome (across the E/NS1 gene junction) provided sufficient information for estimating genetic relationships among 40 dengue type 1 and 40 type 2 virus isolates from diverse geographic areas and hosts. A quantitative comparison of these 240-nucleotide-long sequences revealed previously unrecognized evolutionary relationships between disease outbreaks. Five distinct virus genotypic groups were detected for each of the two serotypes. The evolutionary rates of epidemic dengue viruses of types 1 and 2 were similar, although the transmission pathways of these viruses around the world are different. For dengue type 2, one genotypic group represents an isolated, forest virus cycle which seems to have evolved independently in West Africa. This is the first genetic evidence of the existence of a sylvatic cycle of dengue virus, which is clearly distinct from outbreak viruses.
            Article 0 comments Cited 165 times – based on 0 reviews     Review now
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              Serotype-specific detection of dengue viruses in a fourplex real-time reverse transcriptase PCR assay.

              Barbara Johnson, Brandy J Russell, Robert Lanciotti (2005)
              The dengue (DEN) viruses are positive-strand RNA viruses in the genus Flavivirus. Dengue fever and dengue hemorrhagic fever/dengue shock syndrome are important human arboviral diseases caused by infection with one of four closely related but serologically distinct DEN viruses, designated DEN-1, DEN-2, DEN-3, and DEN-4 viruses. All four DEN serotypes are currently co-circulating throughout the subtropics and tropics, and genotypic variation occurs among isolates within a serotype. A real-time quantitative nucleic acid amplification assay has been developed to detect viral RNA of a single DEN virus serotype. Each primer-probe set is DEN serotype specific, yet detects all genotypes in a panel of 7 to 10 representative isolates of a serotype. In single reactions and in fourplex reactions (containing four primer-probe sets in a single reaction mixture), standard dilutions of virus equivalent to 0.002 PFU of DEN-2, DEN-3, and DEN-4 viruses were detected; the limit of detection of DEN-1 virus was 0.5 equivalent PFU. Singleplex and fourplex reactions were evaluated in a panel of 40 viremic serum specimens with 10 specimens per serotype, containing 0.002 to 6,000 equivalent PFU/reaction (0.4 to 1.2 x 10(6) PFU/ml). Viral RNA was detected in all viremic serum specimens in singleplex and fourplex reactions. Thus, this serotype-specific, fourplex real-time reverse transcriptase PCR nucleic acid detection assay can be used as a method for differential diagnosis of a specific DEN serotype in viremic dengue patients and as a tool for rapid identification and serotyping of DEN virus isolates.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Glob Health Action
                Journal ID (iso-abbrev): Glob Health Action
                Journal ID (publisher-id): GHA
                Title: Global Health Action
                Publisher: Co-Action Publishing
                ISSN (Print): 1654-9716
                ISSN (Electronic): 1654-9880
                Publication date (Electronic): 02 August 2013
                Publication date Collection: 2013
                Volume: 6
                Electronic Location Identifier: 10.3402/gha.v6i0.21822
                Affiliations
                [1 ]Program in Emerging Infectious Diseases, Duke-NUS, Singapore
                [2 ]Division of Infectious Diseases, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
                [3 ]Center for Geographic Medicine and Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel
                [4 ]Sackler Faculty of Medicine, Tel Aviv University, Israel
                [5 ]Institute of Public Health, University of Heidelberg, Heidelberg, Germany
                [6 ]Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
                [7 ]Epidemiology and Global Health, University of Umea, Umea, Sweden
                Author notes
                [* ]Correspondence to: October M. Sessions, Duke-NUS Graduate Medical School, Emerging Infectious Diseases Program, Singapore, Email: october.sessions@ 123456duke-nus.edu.sg
                Article
                Publisher ID: 21822
                DOI: 10.3402/gha.v6i0.21822
                PMC ID: 3733016
                PubMed ID: 23911088
                SO-VID: abf56094-2949-4819-ad61-aad937e66461
                Copyright © © 2013 October M. Sessions et al.
                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 work is properly cited.

                History
                Date received : 23 June 2013
                Date revision received : 08 July 2013
                Date accepted : 10 July 2013
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Health & Social care
                Keywords: dengue,angola,dengue sequence,international travel,dengue in africa
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: dengue, angola, dengue sequence, international travel, dengue in africa

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