Clinical, Virological, and Cytokine Profiles of Children Infected with Dengue Virus during the Outbreak in Southern Vietnam in 2017

Abstract

Dengue virus (DENV) infection is a major cause of morbidity and mortality in Vietnam, and the incidence is higher and more consistent in the southern part of the country. This study investigated the circulation of DENV serotypes, viremia levels, immunological status, and cytokine levels, with disease severities among children infected in 2017 in Ho Chi Minh City, Southern Vietnam. Acute and convalescent serum samples were collected from clinically diagnosed dengue children. They were confirmed to have DENV infection by NS1 antigen, IgM and IgG ELISAs, virus isolation, and conventional and real-time RT-PCR. Measurement of 10 cytokine levels was performed in the serum samples. All the children were dengue IgM positive; 28% and 72% of them had primary and secondary DENV infections, respectively, whereas 54% of those with secondary infection were children with dengue with warning signs and with severe dengue. Any or mixed infection of the four serotypes of DENV RNA was detected in 58 children. Twenty DENV strains (DENV-1 = 16 and DENV-4 = 4) were isolated. Levels of IFN-γ, TNF-α, MCP-1, IL-10, and IL-6 were significantly higher in severe dengue cases. We report the predominance of DENV-1 over other serotypes in the 2017 dengue outbreak in Southern Vietnam. Our data showed that cytokine expressions were correlated with dengue pathogenesis and may help in identifying an effective therapeutic strategy.

Improving dengue case confirmation by combining rapid diagnostic test, clinical, and laboratory variables

“…However, our results differ from the findings of studies conducted in Vietnam [24, 60, 74] and Malaysia [85], where the sensitivity of these tests has been reported to be over 80%. These differences in the sensitivity may be related to factors such as the assay type (ELISA or RDT) [46, 47, 50] and the frequency of DENV-2 infections, since a loss of sensitivity of NS1 detection has been reported in previous studies when this serotype was involved [47, 49, 60, 86].…”

“…The evaluation of diagnostic algorithms for dengue is challenging because of the dynamics of its clinical presentation [53,58]. Similarly, hematological, biochemical, and immunological biomarkers assessed by clinicians in dengue patients show significant variations [73][74][75]. These variations are observed even in populations evaluated with similar characteristics such as age, time of disease, degree of severity, and genetic factors of individuals [54,76,77].…”

Unusal Presentation of Dengue Fever as Pyomyositis

“…Few present with elevated CPK levels and they rarely go on to develop rhabdomyolysis and acute renal failure. 1,9 A few cases of dengue fever associated with acute myositis with or without rhabdomyolysis which was confirmed by muscle biopsy and EMG has been reported in the past. 1,10 In this case, the appropriate timely intervention of myositis has prevented the lethal complication of rhabdomyolysis and acute renal failure and there was complete recovery of the patient without any residual damage.…”

Acute-phase Serum Cytokine Levels and Correlation with Clinical Outcomes in Children and Adults with Primary and Secondary Dengue Virus Infection in Myanmar between 2017 and 2019

“…Serotype specific primers and probes are described in ( Supplementary Table S1 ). Ten-fold serial dilutions of standard RNA (10 2 –10 8 genome copies) were amplified for quantification of viral genome copies [ 12 , 13 ]. The detection limit was 100 genome copies, and the results are expressed as log10 genome copies/mL of serum [ 13 ].…”