Molecular detection of dengue virus serotypes prevalent in central Kerala and its correlation with disease severity

R. R., C. Valsan, E. Sreekumar, K. Sathiavathy
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Abstract

Dengue is the most important mosquito-borne viral disease in the world. In 2017, a concerning increase in dengue cases with high mortality was seen in India with Kerala topping the list. Changing pattern of circulating dengue virus serotype and co infection with multiple serotypes contribute to the increasing trend in severity and increased mortality of dengue fever. The present study focused to find the dengue serotypes prevalent in central Kerala and prevalence of co infection with multiple serotypes here with an attempt to correlate these with clinical severity of dengue: This descriptive study was done in the Microbiology department of Jubilee Mission Medical College, Thrissur for a period of 18 months. Blood samples of clinically suspected dengue fever cases which were positive for NS1 antigen and having fever not more than 5 days were subjected to molecular methods to detect dengue virus RNA followed by multiplex RTPCR to find its serotype. Demographic features, clinical details and lab parameters were also collected from each patient. A total of 108 samples positive for Dengue NS1 antigen were subjected to RT-PCR. Among them 61(56.5%) were positive by RT-PCR. All the 4 Dengue serotypes were found with DENV-2 with 30 cases (49.2%) being the predominant serotype followed by DENV-1 with 20 cases (32.8%), DENV-3 with 12 cases (19.6%) and DENV-4 with 2 cases (3.27%). Three cases (4.9%) of co infection with DENV-1,2, DENV-1, 4 and DENV-2,3 were also found. Two among the 108 patients (1.85%) died in the present study. Significant correlation between severity of dengue infection and serotypes could not be found due to very few severe cases encountered during the study. : The dengue serotypes predominant in central Kerala is DENV-2. The prevalence of co infection with multiple serotypes is 4.9% which proves that this area has become hyper endemic to the disease, which increases the risk of emergence of more severe cases.
喀拉拉邦中部流行登革热病毒血清型的分子检测及其与疾病严重程度的相关性
登革热是世界上最重要的蚊媒病毒性疾病。2017年,印度出现了令人担忧的登革热病例增加,死亡率高,喀拉拉邦高居榜首。登革热病毒血清型流行模式的改变和多种血清型的合并感染导致登革热的严重程度和死亡率呈上升趋势。本研究的重点是寻找喀拉拉邦中部流行的登革热血清型和多种血清型的合并感染的流行情况,并试图将这些与登革热的临床严重程度联系起来:这项描述性研究是在Thrissur的Jubilee Mission医学院微生物学系进行的,为期18个月。对NS1抗原阳性且发热时间不超过5天的临床疑似登革热病例,采用分子方法检测登革病毒RNA,并采用多重RTPCR检测其血清型。还收集了每位患者的人口统计学特征、临床细节和实验室参数。对108份登革热NS1抗原阳性样本进行RT-PCR检测。其中61例(56.5%)为RT-PCR阳性。4种登革热血清型均有发现,以DENV-2型30例(49.2%)为主,其次为DENV-1型20例(32.8%)、DENV-3型12例(19.6%)、DENV-4型2例(3.27%)。DENV-1、2、DENV-1、4和DENV-2、3合并感染3例(4.9%)。108例患者中有2例(1.85%)死亡。由于研究期间遇到的严重病例很少,因此无法发现登革热感染严重程度与血清型之间的显著相关性。:喀拉拉邦中部主要的登革热血清型是DENV-2。多种血清型合并感染的流行率为4.9%,这证明该地区已成为该病的高流行区,这增加了出现更严重病例的风险。
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