Genetic Analysis of Dengue Virus in Severe and Non-Severe Cases in Dhaka, Bangladesh, in 2018–2022

Abstract

Dengue virus (DENV) infections have unpredictable clinical outcomes, ranging from asymptomatic or minor febrile illness to severe and fatal disease. The severity of dengue infection is at least partly related to the replacement of circulating DENV serotypes and/or genotypes. To describe clinical profiles of patients and the viral sequence diversity corresponding to non-severe and severe cases, we collected patient samples from 2018 to 2022 at Evercare Hospital Dhaka, Bangladesh. Serotyping of 495 cases and sequencing of 179 cases showed that the dominant serotype of DENV shifted from DENV2 in 2017 and 2018 to DENV3 in 2019. DENV3 persisted as the only representative serotype until 2022. Co-circulation of clades B and C of the DENV2 cosmopolitan genotype in 2017 was replaced by circulation of clade C alone in 2018 with all clones disappearing thereafter. DENV3 genotype I was first detected in 2017 and was the only genotype in circulation until 2022. We observed a high incidence of severe cases in 2019 when the DENV3 genotype I became the only virus in circulation. Phylogenetic analysis revealed clusters of severe cases in several different subclades of DENV3 genotype I. Thus, these serotype and genotype changes in DENV may explain the large dengue outbreaks and increased severity of the disease in 2019.

Dengue Virus Serotype 2 Cosmopolitan C Genotype Reemerges with a New Subclade in Southwest Region of Bangladesh

“…Dengue outbreaks in Bangladesh were caused by several serotypes and genotypes in recent years including during the Covid-19 pandemic (Al-Emran et al, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4401701. ; Rahim et al, 2023; Sarkar et al, 2023). The two-layered hypothesis examination proved that, despite endemic months, 2023 dengue outbreak had a higher morbidity rate compared to previous years (2019-2022) in Southwest of Bangladesh.…”

“…Cosmopolitan genotype of DENV-2 is the most widespread and genetically heterogeneous of all (Yenamandra et al, 2021). In Bangladesh, although sequence data is limited, DENV2 was prevalent in 2017 and 2018, whereas DENV3 was prevalent in 2019 until August 2022(Rahim et al 2023). However, there was no report published on circulating DENV serotypes/genotypes data about ongoing 2023 outbreak in Bangladesh where more than 1500 died so far (MIS, 2023).…”

Whole Genome Sequencing of DENV-2 isolated fromAedes aegyptimosquitoes in Esmeraldas, Ecuador. Genomic epidemiology of genotype III Southern Asian-American in the country

“…For DENV2, it includes the genotypes: Asian-I, Asian-II, Asian/American, American, Cosmopolitan, and sylvatic genotype. DENV3, includes genotypes I, II, III, IV, and V. Finally, DENV4, has genotypes I, IIA, IIB, III, and sylvatic genotypes [1,9]. The four main serotypes of DENV share approximately 70% of nucleotide identity, but they are antigenically distinct [10], thus, infection with one serotype confers protection mostly to homologous viruses.…”

Pre-dominance of dengue non-cross-reacting SARS-CoV-2 spike antibodies during the Omicron era and their role in the ADE-mediated surge of Dengue virus serotype 3

“…In recent times (2022-), there has been an increase in DV3 cases in India and many other dengue endemic regions globally [11][12][13][14][15][16] (DV prevalence, Supplementary Table S1). For instance, Kerala, a south-Indian state reported a surge in DV3 cases in 2022, a shift from the previously dominant DV2 serotype 17 .…”