Dengue Viremia Titer, Antibody Response Pattern, and Virus Serotype Correlate with Disease Severity

Vaughn, David W.; Green, Sharone; Kalayanarooj, Siripen; Innis, Bruce L.; Nimmannitya, Suchitra; Suntayakorn, Saroj; Endy, Timothy P.; Raengsakulrach, Boonyos; Rothman, Alan L.; Ennis, Francis A.; Nisalak, Ananda

doi:10.1086/315215

Cited by 1,400 publications

(1,174 citation statements)

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“…8,21 Various studies are trying to establish connection between causative serotype and disease outcome. Few of which propose that Den-2 and Den-3 may cause more severe disease, 8,[22][23][24] however, a defi nite link between distinct serotypes and severe manifestations has not been established yet. This study provided direct evidence for the presence of all four serotypes in this geographical region, with Den-2 and Den-3 as two predominant serotypes.…”

Section: Discussionmentioning

confidence: 99%

Correlation of disease spectrum among four Dengue serotypes: a five years hospital based study from India

Kumaria¹

2010

Braz J Infect Dis

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The recognition of DF (DHF Dengue Hemorrhagic Fever) is very complicated due to occurrence of a wide spectrum of clinical signs and symptoms during acute phase of illness. Moreover, presence of four serotypes further complicates the prognosis. To investigate the predictors of disease severity and elucidate the prognostic markers among four dengue serotypes, this study was conducted on 320 inpatients having acute febrile illness clinically suspected as DI, over a period of fi ve years. Dengue serotypes were confi rmed by multiplex reverse transcriptase (RT)-PCR. Eighty patients were positive for DI with presence of Den-1, Den-2, Den-3, and Den-4 in 8, 35, 27 and 10 patients, respectively. The severe clinical manifestations, abdominal pain and hepatomegaly, were comparatively higher in Den-2 patients. Liver aminotransferases levels were also higher in Den-2 patients (app. 5 fold). This study clearly indicates the hyperendemicity of all dengue serotypes. Nucleotide sequencing of Envelope region revealed that the presently emerged Den-3 belongs to type III, having high homology with genotype responsible for number of outbreaks in 1980s. The re-emergence of this deadly type can be suspected to cause more outbreaks in future and is a matter of great concern.

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Section: Discussionmentioning

confidence: 99%

Correlation of disease spectrum among four Dengue serotypes: a five years hospital based study from India

Kumaria¹

2010

Braz J Infect Dis

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“…Many real-time RT-PCR assays have been developed that are either 'singleplex', detecting one single serotype per reaction, or 'multiplex', identifying all four serotypes from a single sample [99][100][101] . One advantage of this assay is the ability to determine viral titre early in dengue illness, which is believed to be an important predictor of disease severity 102 .…”

Section: Real-time Rt-pcrmentioning

confidence: 99%

Dengue: a continuing global threat

et al. 2010

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Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ~50 million dengue infections and ~500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes. A global strategy aimed at increasing the capacity for surveillance and outbreak response, changing behaviours and reducing the disease burden using integrated vector management in conjunction with early and accurate diagnosis has been advocated. Antiviral drugs and vaccines that are currently under development could also make an important contribution to dengue control in the future.Dengue is the most important arthropod-borne viral infection of humans. Worldwide, an estimated 2.5 billion people are at risk of infection, approximately 975 million of whom live in urban areas in tropical and sub-tropical countries in Southeast Asia, the Pacific and the Americas 1 . Transmission also occurs in Africa and the Eastern Mediterranean, and rural Europe PMC Funders GroupAuthor Manuscript Nat Rev Microbiol. Author manuscript; available in PMC 2015 February 19. Published in final edited form as:Nat Rev Microbiol. 2010 December ; 8(12 0): S7-16. doi:10.1038/nrmicro2460. Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts communities are increasingly being affected. It is estimated that more than 50 million infections occur each year, including 500,000 hospitalizations for dengue haemorrhagic fever, mainly among children, with the case fatality rate exceeding 5% in some areas [1][2][3][4] . The geographical areas in which dengue transmission occurs have expanded in recent years (FIG. 1), and all four dengue virus serotypes (DENV-1-4) are now circulating in Asia, Africa and the Americas, a dramatically different scenario from that which prevailed 20 or 30 years ago (FIG. 2). The molecular epidemiology of these serotypes has been studied in an attempt to understand their evolutionary relationships 11 .This Review will provide an update on our understanding of the pathogenesis of this successful pathogen, how we diagnose and control infection and the progress that has been made in vaccine development. Dengue virus pathogenesisDengue viruses belong to the genus flavivirus within the Flaviviridae family. DENV-1-4 evolved in non-human primates from a common ancestor and each entered the urban cycle independently an estimated 500-1,000 years ago 12 . The virion comprises a spherical particle, 40-50 nm in diameter, with a lipopolysaccharide envelope. The positive singlestrand RNA genome (FIG. 3), which is approximately 11 kb in length, has a single open reading frame that encodes three structural proteins -the capsid (C), membrane (M) and envelope (E) glycoproteins -and seven non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B and NS5 [18][19][20] . ADE occurs when mononuclear phagocytes are infected through their Fc receptors by immune complexes that form between DE...

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“…Each of the DEN virus serotypes is capable of causing severe dengue and early viral burdens in the course of illness are associated with severe disease. 74,82,115 Oscillations in the prevalence of each serotype are common in endemic settings. Typically, one serotype is dominant for a period of 2-4 years, after which it declines in prevalence as a different serotype(s) emerges to replace it.…”

Section: Virus Epidemiology and Virulencementioning

confidence: 99%