Clinical and virological characteristics of dengue in Surabaya, Indonesia

Abstract

Dengue disease is still a major health problem in Indonesia. Surabaya, the second largest city in the country, is endemic for dengue. We report here on dengue disease in Surabaya, investigating the clinical manifestations, the distribution of dengue virus (DENV) serotypes, and the relationships between clinical manifestations and the genetic characteristics of DENV. A total of 148 patients suspected of having dengue were recruited during February-August 2012. One hundred one (68%) of them were children, and 47 (32%) were adults. Dengue fever (DF) and Dengue hemorrhagic fever (DHF) were equally manifested in all of the patients. We performed DENV serotyping on all of the samples using real-time RT-PCR. Of 148, 79 (53%) samples were detected as DENV positive, with DENV-1 as the predominant serotype (73%), followed by DENV-2 (8%), DENV-4 (8%), and DENV-3 (6%), while 5% were mixed infections. Based on the Envelope gene sequences, we performed phylogenetic analyses of 24 isolates to genotype the DENV circulating in Surabaya in 2012, and the analysis revealed that DENV-1 consisted of Genotypes I and IV, DENV-2 was of the Cosmopolitan genotype, the DENV-3 viruses were of Genotype I, and DENV-4 was detected as Genotype II. We correlated the infecting DENV serotypes with clinical manifestations and laboratory parameters; however, no significant correlations were found. Amino acid analysis of Envelope protein did not find any unique mutations related to disease severity.

Dengue viruses circulating in Indonesia: A systematic review and phylogenetic analysis of data from five decades

“…A full assessment of the 120 references resulted in the exclusion of 53 references due to the following: full texts were unavailable, and the available abstracts did not include adequate information to satisfy our outcome, the full text did not include adequate or complete serotype data, and nonstandard methods were used for serotyping. This resulted in 67 eligible studies, of which 13 references were from national journals . An additional 11 studies were included from reference list .…”

“…In total, 78 eligible studies were included for DENV serotype analysis . Of all the eligible studies, four studies were conducted based on mosquito isolates while the remaining studies assessed DENV isolates from human samples . Sixty two studies investigated dengue cases among local inhabitants of Indonesia,…”

“…Of all the eligible studies, four studies were conducted based on mosquito isolates while the remaining studies assessed DENV isolates from human samples . Sixty two studies investigated dengue cases among local inhabitants of Indonesia, and the remaining 16 reported traveller‐associated dengue cases from other countries …”

“…Between 2008 and 2012, however, DENV‐1 become the dominant serotype in most Indonesian regions (Table ). Data of traveller‐associated dengue from Australia, Taiwan, Germany, and Romania support this finding.…”

“…Our group has previously conducted studies relating to the molecular epidemiology of dengue in several major Indonesian cities, including Bali, Jakarta, Jambi, Makassar, Semarang, Sukabumi, Surabaya, and Purwokerto . Similar studies have also been conducted in other regions of Indonesia, with local inhabitants or travellers returning from Indonesia .…”