Secuencias de infección viral asociadas a la fiebre del dengue durante la epidemia de dengue 3 en la ciudad de La Habana, 2001-2002

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Abstract

OBJETIVO: estudiar el papel de la infección secundaria y de la influencia de determinadas secuencias de infección virales en los casos de fiebre del dengue durante la epidemia de dengue 3, en la ciudad de La Habana, 2001-2002. MÉTODOS: se estudiaron 141 muestras clínicas de casos confirmados de dengue en la epidemia cubana dengue 3. Todos los casos incluidos fueron clasificados de acuerdo con el criterio de la OMS como casos de fiebre del dengue, 101 de estas muestras fueron colectadas en la fase aguda de la enfermedad y 40 colectadas en la fase convaleciente tardía (16-18 meses después de la enfermedad). RESULTADOS: los sueros colectados en la fase convaleciente tardía permitieron conocer las secuencias virales de infección, las cuales en orden descendiente fueron DEN-1/DEN-3, DEN-2/DEN-3 y DEN-1/DEN-2/DEN-3. CONCLUSIONES: los resultados confirman que la secuencia de infección DEN-2/DEN-3 estuvo asociada a los casos de fiebre del dengue y no a los de fiebre hemorrágica del dengue; un porcentaje elevado de los casos estudiados se correspondió con una infección secundaria.

Translated abstract

OBJECTIVE: To study the role of secondary infection and of certain viral infection sequences in dengue fever cases during the dengue 3 epidemics occurred in the City of Havana. METHODS: One hundred and forty one laboratory-confirmed clinical samples from dengue 3 cases were studied. According to WHO criteria, all included cases were classified as dengue fever cases; 101 of these samples were collected at the acute phase of the disease whereas 40 were collected in the late convalescence (16 to 18 months after the onset of disease). RESULTS: The late convalescence serum samples allowed identifying the viral dengue infection sequences, which in downward order were DENV-1/DENV-3, DENV-2/DENV-3 and DENV-1/DENV-2/DENV-3. CONCLUSIONS: The results confirmed that the sequence infection DENV-2 / DENV-3 was associated with Dengue Fever Cases but not with the Dengue Hemorrhagic Fever Cases and that a high percentage of studied cases proved to be secondary infection.

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Most cited references 40

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Origins of dengue type 2 viruses associated with increased pathogenicity in the Americas.

R Rico-Hesse, L Harrison, R A Salas … (1997)

The recent emergence and spread of dengue hemorrhagic fever in the Americas have been a major source of concern. Efforts to control this disease are dependent on understanding the pathogenicity of dengue viruses and their transmission dynamics. Pathogenicity studies have been hampered by the lack of in vitro or in vivo models of severe dengue disease. Alternatively, molecular epidemiologic studies which associate certain dengue virus genetic types with severe dengue outbreaks may point to strains with increased pathogenicity. The comparison of nucleotide sequences (240 bp) from the E/NS1 gene region of the dengue virus genome has been shown to reflect evolutionary relationships and geographic origins of dengue virus strains. This approach was used to demonstrate an association between the introduction of two distinct genotypes of dengue type 2 virus and the appearance of dengue hemorrhagic fever in the Americas. Phylogenetic analyses suggest that these genotypes originated in Southeast Asia and that they displaced the native, American genotype in at least four countries. Vaccination and other control efforts should therefore be directed at decreasing the transmission of these "virulent" genotypes.

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Risk factors in dengue shock syndrome: a prospective epidemiologic study in Rayong, Thailand. I. The 1980 outbreak.

N Sangkawibha, S Rojanasuphot, S Ahandrik … (1984)

In January 1980, the municipal area of Rayong, Thailand, and contiguous suburban villages were chosen for a long-term study on dengue epidemiology. From 3,185 children randomly sampled in schools and households, the population prevalence of neutralizing antibody to the four dengue serotypes was estimated. To estimate the incidence of infection with each dengue virus serotype (dengue seroconversions), first grade children were re-bled in January 1981 (cohort study). Children admitted to hospital were studied for dengue virus isolation and antibody responses in paired sera. An epidemic of dengue occurred in 1980. Plaque reduction neutralization tests of 1,009 pre-epidemic sera from children aged less than 1-10 years of age determined that 3.3% were immune to dengue 1, 13.2% to dengue 2, 6.4% to dengue 3, and 5.8% to dengue 4. Examination of pre- and post-epidemic cohort blood samples revealed that the incidence of dengue infection in 251 seronegative children was 39.4% (15.1% dengue 1, 11.1% dengue 2, 2.0% dengue 3, 4.8% dengue 4, and 6.4% two or more dengue viruses). Among the 52,935 residents of the study area, there were 22 cases of virologically and clinically confirmed dengue shock syndrome, in children 15 years or younger. All 22 shock syndrome cases had secondary type antibody responses. Eight of 22 had been included in the random serologic sample prior to onset of shock; five had been immune to dengue 1, two to dengue 3, one to dengue 4, and none to dengue 2. Despite the high rate of dengue 1 infections in 1980, only dengue 2 viruses were recovered from dengue shock syndrome cases, including two dengue 1 immune children with pre-illness serum specimens. Although the pre-epidemic prevalence of antibodies to dengue 1 was the lowest to any type, children with this immunologic background contributed disproportionately to shock cases. In descending order of magnitude, risk factors for dengue shock syndrome in Rayong were secondary infections with dengue 2 which followed primary infections with dengue 1, dengue 3, or dengue 4.

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Serotype-specific differences in clinical manifestations of dengue.

Eva Harris, Y Téllez, Roberto Perez … (2006)

Dengue, the most prevalent arthropod-borne viral disease of humans, is caused by four serotypes of dengue virus (DENV 1-4). Although all four DENV serotypes cause a range of illness, defining precisely which clinical characteristics are associated with the distinct serotypes has been elusive. A cross-sectional study was conducted on 984 and 313 hospitalized children with confirmed DENV infections during two time periods, respectively, in the same hospitals in Nicaragua: a 3-year period (1999-2001) when DENV-2 accounted for 96% of the viruses identified, and the 2003 dengue season when DENV-1 predominated (87% of identified serotypes). When the two periods were compared, more shock (OR 1.91, 95% CI 1.35-2.71) and internal hemorrhage (OR 2.05, CI 1.16-3.78) were observed in the period when DENV-2 predominated, whereas increased vascular permeability was associated to a greater degree with the DENV-1 period (OR 2.36, CI 1.80-3.09). Compared with the DENV-2 period, the DENV-1 season was associated with more hospitalized primary dengue cases (OR 3.86, CI 2.72-5.48) and more primary DENV infections with severe manifestations (OR 2.93, CI 2.00-4.28). These findings provide new data to characterize the pathogenic potential of distinct DENV serotypes in human populations.

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Author and article information

Contributors

Mayling Álvarez: Role: ND

Alequis Pavón-Oro: Role: ND

Susana Vázquez: Role: ND

Luis Morier: Role: ND

Ángel Manuel Álvarez: Role: ND

María G. Guzmán: Role: ND

Journal

Journal ID (publisher): mtr

Title: Revista Cubana de Medicina Tropical

Abbreviated Title: Rev Cubana Med Trop

Publisher: Centro Nacional de Información de Ciencias Médicas (Ciudad de la Habana )

ISSN: 1561-3054

Publication date (Print): April 2008

Volume: 60

Issue: 1

Page: 0

Affiliations

[1 ] Laboratorio de Arbovirus. Departamento de Virología, IPK. Cuba

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Publisher ID: S0375-07602008000100003

SO-VID: fa529436-64f4-421f-91e4-a7cf2d955ebf

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http://creativecommons.org/licenses/by/4.0/

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Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0375-0760&lng=en

Secuencias de infección viral asociadas a la fiebre del dengue durante la epidemia de dengue 3 en la ciudad de La Habana, 2001-2002 Translated title: Viral infection sequences related to dengue fever in dengue 3 epidemics occurred in the City of Havana, 2001-2002

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Most cited references 40

Origins of dengue type 2 viruses associated with increased pathogenicity in the Americas.

Risk factors in dengue shock syndrome: a prospective epidemiologic study in Rayong, Thailand. I. The 1980 outbreak.

Serotype-specific differences in clinical manifestations of dengue.

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