Dataset Information

Characterization of Dengue Virus 4 Cases in Paraguay, 2019-2020.

ABSTRACT: In 2019-2020, dengue virus (DENV) type 4 emerged to cause the largest DENV outbreak in Paraguay's history. This study sought to characterize dengue relative to other acute illness cases and use phylogenetic analysis to understand the outbreak's origin. Individuals with an acute illness (≤7 days) were enrolled and tested for DENV nonstructural protein 1 (NS1) and viral RNA by real-time RT-PCR. Near-complete genome sequences were obtained from 62 DENV-4 positive samples. From January 2019 to March 2020, 799 participants were enrolled: 253 dengue (14 severe dengue, 5.5%) and 546 other acute illness cases. DENV-4 was detected in 238 dengue cases (94.1%). NS1 detection by rapid test was 52.5% sensitive (53/101) and 96.5% specific (387/401) for dengue compared to rRT-PCR. DENV-4 sequences were grouped into two clades within genotype II. No clustering was observed based on dengue severity, location, or date. Sequences obtained here were most closely related to 2018 DENV-4 sequences from Paraguay, followed by a 2013 sequence from southern Brazil. DENV-4 can result in large outbreaks, including severe cases, and is poorly detected with available rapid diagnostics. Outbreak strains seem to have been circulating in Paraguay and Brazil prior to 2018, highlighting the importance of sustained DENV genomic surveillance.

SUBMITTER: Rojas A

PROVIDER: S-EPMC10892180 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Characterization of Dengue Virus 4 Cases in Paraguay, 2019-2020.

Rojas Alejandra A Shen John J Cardozo Fátima F Bernal Cynthia C Caballero Oliver O Ping Sara S Key Autum A Haider Ali A de Guillén Yvalena Y Langjahr Patricia P Acosta Maria Eugenia ME Aria Laura L Mendoza Laura L Páez Malvina M Von-Horoch Marta M Luraschi Patricia P Cabral Sandra S Sánchez María Cecilia MC Torres Aurelia A Pinsky Benjamin A BA Piantadosi Anne A Waggoner Jesse J JJ

Viruses 20240125 2

In 2019-2020, dengue virus (DENV) type 4 emerged to cause the largest DENV outbreak in Paraguay's history. This study sought to characterize dengue relative to other acute illness cases and use phylogenetic analysis to understand the outbreak's origin. Individuals with an acute illness (≤7 days) were enrolled and tested for DENV nonstructural protein 1 (NS1) and viral RNA by real-time RT-PCR. Near-complete genome sequences were obtained from 62 DENV-4 positive samples. From January 2019 to March ...[more]

PMID: 38399957

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Project description:BackgroundDengue is one of the most important re-emerging viral diseases and the most common human arthropod-borne viral infection worldwide. Any of the four Dengue virus serotypes (DENV-1 to 4) can cause asymptomatic infections or clinical manifestations that range in severity from a mild, self-limited illness, to a severe disease characterized by a shock syndrome that can lead to death. Paraguay suffers periodic epidemic outbreaks of dengue since 1988 when the DENV-1 was introduced in the country. Epidemics caused by all four serotypes have been reported and the country. Although dengue is endemic in Paraguay, few studies have described the molecular epidemiology of DENV in the country, which is important to understand the local and global spread, as well as the evolution of this pathogen.MethodsThis was a cross-sectional study of a convenience sample. Suspected dengue patients of any age were recruited from the Emergency Laboratory of the Central Hospital of the Institute of Social Welfare, Asuncion, Paraguay, from February to June of 2011. A DENV antigen test was used to confirm the infection. The protein E gene sequences of isolated viruses were sequenced for phylogenetic analysis.ResultsDengue was confirmed in 55.1% of the participants (n = 98/178). The most frequent clinical findings were fever, headache, and myalgia. Identity analyses of the protein E gene sequence of 56 viruses isolated showed the circulation of DENV-1 (n = 45) and DENV-2 (n = 11) in the Asuncion metropolitan area in 2011. Molecular epidemiology analyses suggest that DENV-1 was introduced into Paraguay from Argentina, while the DENV-2 from Brazil, replacing previous virus lineages.ConclusionsWe have analyzed the molecular epidemiology of DENV-1 and DENV-2 isolated in Paraguay in 2011. We found strong evidence that DENV-1 was introduced into Paraguay from Argentina, while the DENV-2 from Brazil, replacing previous virus lineages. Molecular epidemiology studies are of great interest to analyze the dynamic of DENV spread, which are useful for early implementation of containment measures to reduce the risk of explosive epidemics caused by this virus.

Project description:BackgroundDengue is the most important mosquito-borne viral disease worldwide. Dengue virus comprises four antigenically related viruses named dengue virus type 1 to 4 (DENV1-4). DENV-3 was re-introduced into the Americas in 1994 causing outbreaks in Nicaragua and Panama. DENV-3 was introduced in Brazil in 2000 and then spread to most of the Brazilian States, reaching the neighboring country, Paraguay in 2002. In this study, we have analyzed the phylogenetic relationship of DENV-3 isolated in Brazil and Paraguay with viruses isolated worldwide. We have also analyzed the evolutionary divergence dynamics of DENV-3 viruses.ResultsThe entire open reading frame (ORF) of thirteen DENV-3 isolated in Brazil (n = 9) and Paraguay (n = 4) were sequenced for phylogenetic analysis. DENV-3 grouped into three main genotypes (I, II and III). Several internal clades were found within each genotype that we called lineage and sub-lineage. Viruses included in this study belong to genotype III and grouped together with viruses isolated in the Americas within the lineage III. The Brazilian viruses were further segregated into two different sub-lineage, A and B, and the Paraguayan into the sub-lineage B. All three genotypes showed internal grouping. The nucleotide divergence was in average 6.7% for genotypes, 2.7% for lineages and 1.5% for sub-lineages. Phylogenetic trees constructed with any of the protein gene sequences showed the same segregation of the DENV-3 in three genotypes.ConclusionOur results showed that two groups of DENV-3 genotypes III circulated in Brazil during 2002-2009, suggesting different events of introduction of the virus through different regions of the country. In Paraguay, only one group DENV-3 genotype III is circulating that is very closely related to the Brazilian viruses of sub-lineage B. Different degree of grouping can be observed for DENV-3 and each group showed a characteristic evolutionary divergence. Finally, we have observed that any protein gene sequence can be used to identify the virus genotype.

Project description:Acute arboviral infections like dengue have a significant negative socioeconomic and health impact on many tropical and subtropical areas of the world. About 3.9 billion Individuals are at risk of contracting the dengue virus and Asia bears the brunt of that load. Bangladesh, like other south-east Asian countries faced a massive outbreak of dengue in 2019. This cross sectional study was done in three tertiary care centers in Dhaka, Bangladesh during this worst outbreak of dengue. The study was conducted from 1st July to 31st December, 2019 with an aim to describe the clinical and laboratory variations among severe dengue cases and to conduct a serotype survey. This might help to understand the future changes in the clinical or serological profile of the circulating dengue virus. The study enrolled 1978 participants who were grouped into group B (Patients with warning signs or risk factors who should be admitted for close observation as they approach critical phase) and C (Patients having severe plasma leakage leading to dengue shock and/or fluid accumulation with respiratory distress, severe organ impairment and severe metabolic abnormalities) according to national guidelines. Furthermore, 81 samples were serotyped using Qiagen One step RT-PCR kit (Cat. No: 210212). In addition sequencing (ABI sequencing platform) of partial C-prM gene of five DENV-3 isolates were done and analyzed (BLAST tool of NCBI) for phylogenetics (MEGA6 software package). Among the 1978 enrolled participants group B and C patients were 1580 (80%) and 398 (20%) respectively. The median (IQR) age of the patients were 26(11 to 41). Maximum proportion of the enrolled were male (72.3%) (p = 0.0002). Most common co- morbidities were hypertension (90; 4.5%) and DM (70; 3.5%). Group C patients more commonly presented with vomiting (p 0.133), diarrhea (p<0.0001) and abdominal pain (p 0.0203). The common mode of bleeding was melaena (12%). Thirteen (0.7%) patients succumbed to death, 12 of them belonged to group B who mostly presented with GI manifestations (99.9%) and melaena (12%). Only 5.6% of the cases were secondarily infected. In group C cases low hemoglobin and hematocrit was observed with high AST (p 0.004, 0.006 and 0.0016 respectively). Fluid requirement was also more in the same group (p<0.0001). Group B patients had a higher platelet requirement (p = 0.0070). Twelve patients (0.7%) required ICU. The management profile of these cases are showcased here which highlights minimal use of antibiotics and no application of steroids, which abides by the current national protocol. Furthermore, 81 samples from enrolled participants were serotyped and majority (79%) yielded DENV-3, followed by DENV 2 & 3 co-infection (13.6%) and DENV-2 alone (7.4%). Following phylogenetic analysis DENV-3 and DENV2 were deemed to be of genotype I and cosmopolitan variety respectively. This study presents the first instance of heterogeneous co-infection with several serotypes since 2000 in Bangladesh. It also gives an overview of serotype prevalence, management evaluation and clinical results that promises to navigate future control planning.

Dataset Information

Characterization of Dengue Virus 4 Cases in Paraguay, 2019-2020.

Publications

Characterization of Dengue Virus 4 Cases in Paraguay, 2019-2020.

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