Serotype-Specific Dengue Virus Circulation and Dengue Disease in Bangkok, Thailand From 1973 to 1999

Abstract

Dengue virus circulation and association with epidemics and severe dengue disease were studied in hospitalized children with suspected dengue at the Queen Sirikit National Institute of Child Health in Bangkok, Thailand, from 1973 to 1999. Dengue serology was performed on all patients and viral isolation attempted on laboratoryconfirmed patients. Acute dengue was diagnosed in 15,569 children and virus isolated from 4,846. DEN-3 was the most frequent serotype in primary dengue (49% of all isolates), DEN-2 in secondary and in dengue hemorrhagic fever (37% and 35%, respectively). The predominant dengue serotype varied by year: DEN-1 from 1990-92, DEN-2 from 1973-86 and 1988-89; DEN-3 in 1987 and 1995-99; and DEN-4 from 1993-94. Only DEN-3 was associated with severe outbreak years. Our findings illustrate the uniqueness of each serotype in producing epidemics and severe disease and underscore the importance of long-term surveillance of dengue serotypes in understanding the epidemiology of these viruses. * Moderately severe dengue year. †Severe dengue year. (See Methods for definition.) Source: 6

Instabilities in multiserotype disease models with antibody-dependent enhancement

“…We hypothesize that the dynamics for some ADE parameter value greater than 1.91 (the onset of chaotic oscillations) could qualitatively agree with the Bangkok data reported in Nisalak et al (2003). Vaccination schemes against all four serotypes can be tested with this model, and optimal strategies could be determined.…”

“…Primary infection with any one serotype confers immunity to that serotype but not to the others. Since tertiary infections are rare, we assume that individuals are immune to all four serotypes after two sequential serotype infections (Nisalak et al, 2003). It is also hypothesized that secondary infections carry a higher viral load, causing that person to be more infectious due to ADE (CDC website, 2006).…”

“…We note that DHF has been found in infections of all serotypes, but has been associated with some serotypes more than others in certain locations, and with certain strains within serotypes more than others. Overall, DHF is reported to occur more frequently among individuals experiencing a secondary infection (Nisalak et al, 2003). Therefore, administering a vaccine against one specific serotype could possibly increase the incidence of DHF.…”

“…As we begin to understand the complexity of the dengue model, we gain a better perspective in formulating optimal vaccination strategies. Dengue has become a severe and intractable public health problem in Thailand (Nisalak et al, 2003), and we hope that models such as this will aid in the prediction and prevention of future outbreaks. While we use parameters for dengue, the model is general enough to be considered for other multistrain or multiserotype diseases.…”

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

“…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.…”